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Bringing medical abortion closer to women: Accuracy of women’s dating of gestational age using the Gestational Wheel in Ghana

Kristen Shellenberg, Ipas, 2013

Project abstract

Despite a relatively liberal law regarding abortion in Ghana, unsafe abortion remains prevalent and contributes to the nation’s high maternal mortality rate. The use of misoprostol for medical abortion (MA) outside of a clinical context appears common in Ghana as in other settings. This practice requires that women be able to accurately assess the duration of their gestation in order to determine whether it is early enough to safely and effectively abort with the method.

We propose to conduct a cross-sectional, observational study of 800 women presenting for an induced abortion at three study sites (one private facility and two public facilities) during six months in Ghana. Our primary aim is to determine the proportion of women who can accurately determine whether their pregnancy is ≤12 weeks of gestation using a special tool (“Gestational Wheel”) designed to help women calculate gestational age based on their last menstrual period (LMP). The reference standard will consist of results from clinical evaluation. We will administer a short questionnaire to participants and collect information from their clinical examination.

Study findings will inform future efforts to demedicalize MA. The ability to document women’s ability to safely use misoprostol without medical supervision could potentially increase women’s access to safe abortion.

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