Trial Lecture – time and place
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Adjudication committee
- First opponent: Associate Professor Stelian Hodorogea, Department of Obstetrics and Gynecology, State Medical and Pharmaceutical University "N. Testemitanu", Chisinau
- Second opponent: Professor Dace Rezeberga, Department of Obstetrics and Gynecology, Riga Stradins University
- Third member and chair of the evaluation committee: Professor Emerita Britt Ingjerd Nesheim, University of Oslo
Chair of the Defence
Professor Emerita Grete Botten,
Principal Supervisor
M.D. Ekaterine Pestvenidze was supervised by the late Professor Emerita Babill Stray-Pedersen, University of Oslo throughout the project and until Professor Emerita Stray-Pedersen's passing away in May 2019.
Summary
Historically, alarmingly high rates of induced abortion were documented in post-soviet Georgia, notorious for lack of support to family planning and use of abortion as a primary mean of fertility control.
The study aims to: identify socio-demographic subgroups of women in Georgia predominantly affected by abortion; investigate the problem of repeat induced abortions (RIAs) and postabortion family planning services; evaluate postabortion complications in relation with method of abortion and gestational age; identify underlying health system gaps in maternal death due to self-induced medical abortion. The research aims were accomplished by secondary analysis of nationwide reproductive health survey and reproductive age maternal mortality study. Women having two and more children, representing an Azeri ethnic group, practicing Islam, 25-34 years old and married were predominantly affected by abortion in Georgia.
70% of women with abortion had it repeatedly. The odds of RIA increased exponentially with age, number of complete pregnancies, lower education and reduced with use of contraception. 32% of induced abortions were followed by family planning counseling and only 6% by contraceptive method provision immediately after abortion.
Dilatation and Curettage – the least safe surgical abortion technique was still applied at early gestational ages in Georgia and was shown to be associated with fourfold increased risk of hemorrhage and a twofold increased risk of fever compared with vacuum aspiration. Socially disadvantaged women had limited access to safe abortion services and self-induced abortion to terminate unintended pregnancy.
The work underscores the pressing need to implement and sustain a robust government supported family planning and safe abortion program at least for socially disadvantaged, to ensure use of safer abortion techniques and provision of universal postabortion and postpartum family planning at sites of care.
Additional information
Contact the research support staff.