Legal abortion services have been available in public and private health facilities in Mexico City since April 2007 for pregnancies of up to 12 weeks gestation. As of January 2011, more than 50,000 procedures have been performed by Ministry of Health hospitals and clinics. We researched trends in service users' characteristics, types of procedures performed, post-procedure complications, repeat abortions, and postabortion uptake of contraception in 15 designated hospitals from April 2007 to March 2010. The trend in procedures has been toward more medication and manual vacuum aspiration abortions and fewer done through dilation and curettage. Percentages of post-procedure complications and repeat abortions remain low (2.3 and 0.9 percent, respectively). Uptake of postabortion contraception has increased over time; 85 percent of women selected a method in 2009-10, compared with 73 percent in 2007-08. Our findings indicate that the Ministry of Health's program provides safe services that contribute to the prevention of repeat unintended pregnancies.

Evidence suggests that restricting abortion does not reduce its occurrence but increases health risk. A qualitative analysis was performed, reviewing the medical charts of 12 women who died from unsafe induced abortions in Mexico City; most deaths occurred before abortion was decriminalized. Women resorted to using unsafe techniques, without medical guidance or under incorrect recommendations by providers, ultimately resulting in the loss of their lives. Postabortion care in private and public health facilities was often inadequate. The cases illustrate the importance of liberalizing abortion laws and improving postabortion care to protect the life and health of women seeking to terminate pregnancy.