Boniface Ayanbekongshie Ushie,1 Margaret Giorgio,2 Kenneth Juma,3 Vekeh Lama Donzo,4 Jesse Philbin,2 Lily Lu,4 Akinrinola Bankole,2 Moses BF Massaquoi Snr,4 Ramatou Ouedraogo,3 Nelson Konteh Dunbar5 1Beshi King Development Services, Abuja, Nigeria; 2Guttmacher Institute, New York, NY, USA; 3Sexual Reproductive Maternal Newborn Child and Adolescent Health, African Population Health and Research Center, Nairobi, Kenya; 4Department of Programs, Clinton Health Access Initiative, Monrovia, Liberia; 5Department of Research, Ministry of Health, Monrovia, LiberiaCorrespondence: Boniface Ayanbekongshie Ushie, Beshi King Development Services, House 156B, Zone C, Apo Resettlement Apo, FCT, Abuja, Nigeria, Email boniface.ushie@gmail.comPurpose: More than 60% of unintended pregnancies globally end in induced abortions. In Liberia, limited access to contraceptives leads to many unintended pregnancies, with little known about the incidence of induced abortion and unintended pregnancy in the country. This study aimed to estimate the incidence of induced abortion and unintended pregnancy in Liberia in 2021.Methods: The Abortion Incidence Complications Method was used. First, the induced abortions that resulted in women seeking facility-based post-abortion care (PAC) in 2021 were estimated using data from a nationally representative sample of health facilities (n=128). Next, data from a survey of experts on abortion in Liberia (n=89) were used to estimate the proportion of induced abortions that resulted in complications treated in health facilities in 2021. The inverse of this proportion is a multiplier, which was applied to the estimate of the total induced abortion-related complications treated in health facilities, generating the total induced abortions in 2021. This estimate of induced abortion was complemented with the Demographic Health Survey data to estimate the 2021 incidence of unintended pregnancies in Liberia.Results: An estimated 14,555 women received PAC treatment in Liberia in 2021. Approximately 58% of these PAC cases (n=8461) were due to induced abortions. Accounting for uncomplicated induced abortions and complicated abortions not requiring facility-based treatment, an estimated 38,779 induced abortions occurred in Liberia in 2021, corresponding to a national induced abortion incidence rate of 30.7 per 1000 women of reproductive age (WRA) (15– 49). The unintended pregnancy rate among WRA was 86.54 per 1000, and approximately 35.0% of all pregnancies ended in induced abortions.Conclusion: Despite the legal restrictions on abortions, unintended pregnancy and induced abortion are common in Liberia. Increasing access to contraceptives, safe abortion care, and quality PAC will improve socioeconomic and health outcomes for women/girls in Liberia.Keywords: abortion incidence complications method, health facility survey, knowledgeable informant survey, post-abortion care
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