Knowledge, Attitudes, and Perceptions of Unsafe Abortion among Reproductive-Age Women in Rural Ghana: A Cross-sectional Study

Abstract

This study aimed to assess women’s knowledge, attitudes, and perceptions regarding unsafe abortion at the Gynaecological Outpatient Clinic of Agogo Presbyterian Hospital in Ghana, generating foundational evidence to guide future research and inform targeted interventions. A descriptive cross-sectional survey among women aged 15-49 attending the Gynaecological Outpatient clinic at Agogo Presbyterian Hospital in Ghana was conducted. A convenience sample of 100 women was recruited during data collection. This sample size was considered adequate for an exploratory survey, as samples of 50–100 participants are commonly recommended to obtain reasonably stable estimates of key parameters in preliminary quantitative research (Hertzog, 2008; Julious, 2005; Teare et al., 2014). Data were collected using a structured self-administered questionnaire and analysed in Stata version 14.0 using descriptive statistics. The study found high general awareness, with 98% of respondents having heard of abortion and only 7% reporting no knowledge of the legal indications in Ghana. Nonetheless, recognition of specific legal grounds varied, with 28–49% identifying rape, incest, or maternal health risk as permissible. A large proportion of participants (68%) reported feeling uncomfortable discussing abortion, primarily due to stigma (94%). Even so, 75% recognised unsafe abortion as a major health concern, and shame (32%) was identified as a key factor contributing to unsafe practices. Notably, 55% of respondents report they would likely consider an unsafe abortion. Although awareness of abortion is high, knowledge of specific legal indications is variable, and stigma limits open discussion, contributing to unsafe practices. Targeted interventions addressing legal knowledge and societal attitudes are needed to reduce unsafe abortion and related health risks in Ghana.