Unsafe Abortion
Unit III Unsafe abortion Unsafe abortion is a persistent, preventable pandemic. WHO defines unsafe abortion as a procedure for terminating an unintended pregnancy either by individuals without the necessary skills or in an environment that does not conform to minimum medical standards, or both.1?
References
1 World Health Organization. The prevention and management of unsafe abortion. Report of a Technical Working Group. http://whqlibdoc.who.int/hq/1992/WHO_MSM_92.5.pdf (accessed July 6, 2006).
Unsafe abortion mainly endangers women in developing countries where abortion is highly restricted by law and countries where, although legally permitted, safe abortion is not easily accessible. In these settings, women faced with an unintended pregnancy often self-induce abortions or obtain clandestine abortions from medical practitioners, paramedical workers, or traditional healers. 2
Twenty-four percent of the doctors reported that they routinely terminate unwanted pregnancies when requested to do so by women, while 82% reported that they frequently treat women who experience complications of unsafe abortion. Over 45% reported that they use manual vacuum aspiration (MVA) for the management of abortion in the first trimester, while 25% use dilatation and curettage (D and C). Nearly 28% reported the use of MVA followed by D and C in the first trimester. Fifty-seven percent reported their lack of expertise in managing second-trimester abortions, while those admitting that they manage second-trimester abortions reported nonstandard methods and procedures. In addition, there was evidence of inadequate counseling of women, lack of institutional protocols and poor use of postabortion family planning by the doctors.
CONCLUSIONS:
These results suggest the need for a program of retraining of private practitioners on the principles and practices of safe abortion, postabortion care and family planning in Nigeria and the integration of these topics into medical
References
1 World Health Organization. The prevention and management of unsafe abortion. Report of a Technical Working Group. http://whqlibdoc.who.int/hq/1992/WHO_MSM_92.5.pdf (accessed July 6, 2006).
Unsafe abortion mainly endangers women in developing countries where abortion is highly restricted by law and countries where, although legally permitted, safe abortion is not easily accessible. In these settings, women faced with an unintended pregnancy often self-induce abortions or obtain clandestine abortions from medical practitioners, paramedical workers, or traditional healers. 2
Twenty-four percent of the doctors reported that they routinely terminate unwanted pregnancies when requested to do so by women, while 82% reported that they frequently treat women who experience complications of unsafe abortion. Over 45% reported that they use manual vacuum aspiration (MVA) for the management of abortion in the first trimester, while 25% use dilatation and curettage (D and C). Nearly 28% reported the use of MVA followed by D and C in the first trimester. Fifty-seven percent reported their lack of expertise in managing second-trimester abortions, while those admitting that they manage second-trimester abortions reported nonstandard methods and procedures. In addition, there was evidence of inadequate counseling of women, lack of institutional protocols and poor use of postabortion family planning by the doctors.
CONCLUSIONS:
These results suggest the need for a program of retraining of private practitioners on the principles and practices of safe abortion, postabortion care and family planning in Nigeria and the integration of these topics into medical
References: 105 Fathalla MF. Human rights aspects of safe motherhood. Best Pract Res Clin Obstet Gynaecol 2006; 20: 409–19