Abortion Care in Ghana: A Critical Review of the Literature

Purpose/Aim To critically review the published literature around abortion care in Ghana, a country in sub‐Saharan Africa with a relatively liberal abortion law. Research Questions What are the methodological and substantive gaps in the abortion literature in Ghana, where there is a robust community of researchers from multiple disciplines and a liberal law? Background The government of Ghana has taken important steps to mitigate the impact of unsafe abortion. However, the expected decline in maternal deaths has yet to be realized. This integrated literature review aims to present findings from empirical research directly related to abortion provision in Ghana and identify gaps for future research. Methods Four databases were searched with the keywords “Ghana & abortion,” and a hand review of reference lists was conducted. All abstracts were reviewed. Results Thirty‐nine articles were included in the final sample. Abortion‐related complications represent a large component of admissions to gynecologic wards in hospitals in Ghana as well as a large contributor to maternal mortality. Between 10% and 47% of those sampled reported ever having an induced abortion, although induced abortions are notoriously underreported. Demographic characteristics associated with seeking an abortion included being younger, unmarried, better educated, urban‐dwelling, and of higher income. Almost half (n = 19) of the included studies were hospital‐based, with the majority of those being chart reviews. Discussion Ghana has one on of the most liberal abortion laws on the African continent, and the government has taken explicit steps to reduce the impact of unsafe abortion on maternal health. However, unsafe abortion continues to contribute significantly to the stubbornly high level of maternal mortality in the country. This review of the literature has identified gaps in the literature including interviewing women who have sought unsafe abortions and health care providers who may act as gatekeepers to women wishing to access safe abortion services.