Health consequences of unsafe abortions.

Maternal morbidity and mortality due to complications of unsafe abortion constitute a major public health concern in many countries. It is estimated that of the approximately 150,000 unwanted pregnancies that are terminated every day by induced abortion, 1/3 are performed under unsafe conditions, resulting in some 500 deaths every day. In many developing countries a substantial proportion of the limited national reproductive health care resources are spent on the management of abortion-related problems. To evaluate further the public health consequences of unsafe abortions, the Programme is supporting hospital-based studies of complications of abortion and their cost to the health care system in countries where safe abortion is not readily available. The studies employ a core protocol adapted to local conditions. Bangladesh, Chile, Ethiopia, and Thailand have completed such research, and similar studies are currently under way in 4 more countries--Benin, Brazil, Senegal, and Uganda. In Bangladesh, 1301 cases of abortion-related diagnoses admitted to hospital were included in the study. Some 46% were judged to have certainly had an induced abortion and another 16% were judged as possible cases of induced abortion. While no deaths occurred in women with spontaneous abortions, 18 of those who had had an induced abortion died. More hospital resources in terms of duration of stay, antibiotics, and blood were spent on cases of induced abortion compared to cases of spontaneous abortion. The study also found that on average abortion cases occupied hospital beds for a much longer duration compared to other obstetric cases.