Severity and Cost of Unsafe Abortion Complications Treated in Nigerian Hospitals

Henshaw, Stanley K.; Adewole, Isaac F.; Singh, Susheela; Bankole, Akinrinola; Oye-Adeniran, Boniface A; Hussain, Rubina

doi:10.1363/3404008

Cited by 67 publications

(67 citation statements)

References 4 publications

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“…Henshaw and colleagues found that in Nigeria, women who receive treatment for complications of unsafe abortion pay more for care than do those who are treated for miscarriage (US$116 vs. US$43). 13 Another…”

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confidence: 99%

Documenting the Individual- and Household-Level Cost of Unsafe Abortion in Uganda

Sundaram¹,

Vlassoff²,

Mugisha³

et al. 2013

IPSRH

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Induced abortion is common in Uganda. In 2003, the estimated rate was 54 abortions per 1,000 women aged 15-49; 1 although the rate may have changed somewhat since then, it is nonetheless likely among the highest in the world. 2 Uganda's abortion laws and policies are overall very restrictive, but contain inconsistencies that make it difficult for the medical community and women themselves to understand what is permitted (see Appendix A). As a result, almost all abortions are clandestine, and a large proportion are performed under dangerous conditions. 3As a result, unsafe abortion is one of the leading causes of maternal morbidity and mortality in the country. A study carried out in 1993 in three Kampala hospitals found that one in five maternal deaths were attributable to unsafe abortion; 4 more recently, a 2010 government document estimated that unsafe abortion is the cause of 8% of maternal deaths. 5 In 2011, Uganda had a maternal mortality ratio of 438 maternal deaths per 100,000 live births-well above the average of 240 per 100,000 among all developing countries-and unsafe abortion is likely an important contributor to these deaths. 6,7 Uganda also has a very high unmet need for contraception. The 2011 Uganda Demographic and Health Survey found that 34% of married women and 35% of sexually active unmarried women had an unmet need for contraception. 6 This high level of unmet need leads to a high incidence of unintended pregnancy; the rate of such pregnancies was 141 per 1,000 women aged 15-49 in 2003. 1 Because of Uganda's restrictive abortion law, many women with unintended pregnancies seek clandestine, unsafe abortions to meet their fertility goals. One of the consequences of unsafe abortion was documented by a nationally representative survey of health facilities, the results of which suggest that almost 85,000 women in Uganda were treated for complications of unsafe abortions in 2003.1 Furthermore, this estimate represents only a portion of the number of women with such complications, as many others do not obtain care at health facilities. The most frequent complications of unsafe abortion are incomplete abortion and hemorrhage; less common but more severe complications include trauma (such as punctures or tearing of the uterus) and sepsis. In addition, some women experience long-term health problems, including chronic pain, pelvic inflammatory disease and infertility. 8,9 Health complications resulting from unsafe abortion clearly constitute a serious burden for both women and the health care system. Less well understood, however, is the social and finan-

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confidence: 99%

Documenting the Individual- and Household-Level Cost of Unsafe Abortion in Uganda

Sundaram¹,

Vlassoff²,

Mugisha³

et al. 2013

IPSRH

Self Cite

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“…These were the reasons given by our patient; the same reasons given by patients who seek to terminate pregnancies especially in Nigeria [6]. This case occurred in the Northern region of Nigeria, which has been reported to have the largest proportion of complications of induced abortion caused by physicians who are mostly untrained to do this procedure [8]. The physician involved in this case was a newly qualified doctor posted to the rural hospital who was just 'helping' out a pitiful young woman.…”

Section: Discussionmentioning

confidence: 57%

“…Women who had abortion complications observed that many doctors were not well trained on how to carry out abortion procedures and post abortion care [8]. This highlights the need for training of doctors on how to do the procedure properly.…”

Section: Discussionmentioning

confidence: 99%

Gangrenous Bowel Prolapse-Disaster of Dilatation and Curettage

Usman¹,

Minoza²,

Inuwa³

et al. 2016

JCR

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Abstract:Termination of pregnancy using dilatation and curettage is still common practice in developing countries despite the morbidities and mortalities associated with the procedure. The morbidities range from minor genital injuries to injuries to the pelvic and abdominal organs such as the bladder and the intestine. Intestinal perforations and prolapse are not only common with inexperienced and untrained persons but also even amongst experienced doctors in certain cases. The commonest surgical management of uterine perforation with bowel injury is repair of the uterine wall as well as resection and anastomosis of the injured bowel. Women empowerment, girl child education, counseling and provision of contraceptive services will by no means reduce unwanted pregnancies and the complications of termination of these pregnancies. Above all, liberalization of abortion laws in the 21 st century is probably the way forward to reducing morbidities and mortalities from unsafe abortion. We present a 21 year-old divorcée, a low social class farmer who had termination of pregnancy with disastrous consequence. The pregnancy was unwanted as it was outside wedlock in a society where such is a taboo. She presented with perforated uterus and prolapse of 174 cm of gangrenous loop of intestine. She had a successful jejeno-ilial anastomosis and repair of the uterine perforation.

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“…It is estimated that 47,000 women will die as a result of unsafe abortion [42]. A study finds that more than 3,000 Nigerian women being treated in hospitals for complications from such procedures die each year [48]. In Argentina and Chile, more than one third of maternal deaths among adolescents are due to complications of unsafe abortions [49].…”

Section: K Delayed Marriage and Abortionmentioning

confidence: 99%

Perceptions on Implications of Delayed Marriage: A Case Study of Married Adults in Kuala Lumpur

Karamat¹

2016

IJSSH

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Abstract-It is an undeniable fact that with demographic imbalance and economic crisis among other things, the age of marriage has risen tremendously throughout the world. This study investigates perceptions of married adults in Kuala Lumpur on both positive and negative implications of delayed marriage. The sample consisted of 132 male and 130 female married staff and post-graduate students from three public Universities in Kuala Lumpur. A self-constructed questionnaire with internal consistence reliability coefficient of 0.70 was used to elicit information from respondents using a purposive sampling method. Findings in this article reveal negative perceptions on the positive implications (maturity in marital relationship, quality partner and marital stability) and no gender difference exists in the perceptions of male and female respondents on this. The study also finds positive perceptions on the negative implications of delayed marriage such as infertility, cohabitation/pre-marital sex, psychosocial effect and stress effect. It finds no difference in the perceptions of male and female on negative implications of delayed marriage such as infertility, cohabitation/pre-marital sex, psychosocial effect and stress effect. However, gender difference exists in the perceptions on the negative effect of delayed marriage on children (producing delinquent children). Negative implications are detrimental to the particular individuals and the society. By paying less attention to it, the aftermath effect may be worse than that of early marriage. In this sense, there should be a continual sensitization of people on the negative implications of delayed marriage.

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Severity and Cost of Unsafe Abortion Complications Treated in Nigerian Hospitals

Cited by 67 publications

References 4 publications

Documenting the Individual- and Household-Level Cost of Unsafe Abortion in Uganda

Documenting the Individual- and Household-Level Cost of Unsafe Abortion in Uganda

Gangrenous Bowel Prolapse-Disaster of Dilatation and Curettage

Perceptions on Implications of Delayed Marriage: A Case Study of Married Adults in Kuala Lumpur

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