Maine D, Karkazis K, Bolan N
Prevention of Maternal Mortality Program, Center for Population and Family Health, Columbia University School of Public Health.
J Am Med Womens Assoc (1972). 1994 Sep-Oct;49(5):137-42.
Each year, complications related to unsafe abortion account for at least one in seven maternal deaths worldwide. Nearly all of these deaths occur in developing countries and most are preventable. The authors argue that to prevent abortion-related deaths, all women must have access to safe abortion and contraceptive services, and they discuss the strategies used to prevent abortion-related deaths--preventing unwanted pregnancy, preventing abortion, preventing unsafe abortion, and treating abortion complications. Some of these strategies have been effective, while others have failed. Preventing unwanted pregnancy is a very important starting point, but evidence suggests that it alone cannot solve the problems of abortion-related deaths. Efforts to prevent abortion, whether through legal or cultural sanctions, do not significantly reduce the number of abortions, and may even increase mortality. The technology to perform safe abortions is available, but remains underused. Finally, even under the best of circumstances, women will experience abortion complications (induced or spontaneous) and only through the prompt and effective treatment of these and other obstetric complications will deaths be averted.
每年,不安全堕胎相关的并发症至少占全球孕产妇死亡人数的七分之一。几乎所有这些死亡都发生在发展中国家,而且大多数是可以预防的。作者认为,为防止与堕胎相关的死亡,所有妇女都必须能够获得安全堕胎和避孕服务,他们还讨论了用于预防与堕胎相关死亡的策略——预防意外怀孕、预防堕胎、预防不安全堕胎以及治疗堕胎并发症。其中一些策略已经取得成效,而另一些则失败了。预防意外怀孕是一个非常重要的起点,但有证据表明,仅靠这一点并不能解决与堕胎相关的死亡问题。通过法律或文化制裁来预防堕胎的努力,并没有显著减少堕胎数量,甚至可能增加死亡率。进行安全堕胎的技术已经具备,但仍未得到充分利用。最后,即使在最好的情况下,妇女也会出现堕胎并发症(人工或自然流产),只有通过及时有效地治疗这些及其他产科并发症,才能避免死亡。