Unsafe abortion: An avoidable tragedy

Best Practice and Research: Clinical Obstetrics and Gynaecology

Volumn 16, Issue 2, 2002, Pages 205-220

  Van Look, Paul F A ^a   Cottingham, Jane C ^a  

^a WORLD HEALTH ORGANIZATION   (Switzerland)

Author keywords

Abortion; Dilatation and curettage; Dilatation and evacuation; Legal abortion; Mifepristone; Misoprostol; Prostaglandin; Unsafe abortion; Vacuum aspiration

Indexed keywords

CONTRACEPTIVE AGENT; MIFEPRISTONE; MISOPROSTOL; PROSTAGLANDIN; ABORTIVE AGENT;

ABORTION; CONTRACEPTION; COST EFFECTIVENESS ANALYSIS; CURETTAGE; DIARRHEA; DRUG COST; FEMALE INFERTILITY; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH SERVICE; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; LAW; MATERNAL MORBIDITY; MATERNAL MORTALITY; MEDICAL INFORMATICS; NAUSEA; PELVIS PAIN SYNDROME; PREGNANCY; PRIORITY JOURNAL; RAPE; REVIEW; SEXUAL BEHAVIOR; SEXUAL INTERCOURSE; SEXUALLY TRANSMITTED DISEASE; VACUUM ASPIRATION; VOMITING; WORLD HEALTH ORGANIZATION; ATTITUDE TO HEALTH; CLINICAL COMPETENCE; FAMILY RELATION; FEMALE; HEALTH CARE DELIVERY; INDUCED ABORTION; METHODOLOGY; SAFETY; STANDARD; STATISTICS; THERAPEUTIC ABORTION; UTILIZATION REVIEW;

ABORTIFACIENT AGENTS; ABORTION, INDUCED; ABORTION, LEGAL; ATTITUDE TO HEALTH; CLINICAL COMPETENCE; CONTRACEPTION; FAMILY RELATIONS; FEMALE; HEALTH POLICY; HEALTH SERVICES ACCESSIBILITY; HUMANS; PREGNANCY; QUALITY OF HEALTH CARE; RAPE; SAFETY; VACUUM CURETTAGE;

EID: 0036528036     PISSN: 15216934     EISSN: None     Source Type: Journal    
DOI: 10.1053/beog.2002.0271     Document Type: Article

References (78)

1. World Health Organization. The Prevention and Management of Unsafe Abortion. Report of a Technical Working Group. Geneva: World Health Organization, 1993 (document WHO/MSM/92.5).
2. The Alan Guttmacher Institute. Sharing Responsibility: Women, Society and Abortion Worldwide. New York and Washington, DC: The Alan Guttmacher Institute, 1999.
3. World Health Organization. Unsafe Abortion: Global and Regional Estimates of Incidence of and Mortality due to Unsafe Abortion with a Listing of Available Country Data. Geneva: World Health Organization, 1998. Third edition, (document WHO/RHT/MSM/97.16).
4. Bongaarts J & Westoff CF. The potential role of contraception in reducing abortion. Studies in Family Planning 2000; 31: 193-202.
5. Estrin DJ. In three former Soviet states, rates of abortion are declining as contraceptive prevalence increases. International Family Planning Perspectives 1999; 25: 49-50.
6. Westoff CF & Bankole A. Trends in the demand for family limitation in developing countries. International Family Planning Perspectives 2000; 26: 56-62 & 97.
7. Mundigo AI & Indriso CAbortion in the Developing World. New Delhi: Vistaar Publications for the World Health Organization, 1999.
8. Paiewonsky D. Social determinants of induced abortion in the Dominican Republic. In Mundigo AI & Indriso C (eds) Abortion in the Developing World, pp 131-150. New Delhi: Vistaar Publications for the World Health Organization, 1999.
9. Akin A. Cultural and psychosocial factors affecting contraceptive use and abortion in two provinces of Turkey. In Mundigo AI & Indriso C (eds) Abortion in the Developing World, pp 191-211. New Delhi: Vistaar Publications for the World Health Organization, 1999.
10. Gui S. Factors affecting induced abortion behaviour among married women in Shanghai, China. In Mundigo AI & Indriso C (eds) Abortion in the Developing World, pp 78-97. New Delhi: Vistaar Publications for the World Health Organization, 1999.
11. United Nations. Key Actions for the Further Implementation of the Programme of Action of the International Conference on Population and Development. New York: United Nations Population Fund, 1999.
12. Heise LL, Pitanguy J & Germain A. Violence against women: the Hidden Health Burden. Washington, DC: The World Bank (World Bank Discussion Paper 255), 1994.
13. Brown A, Jejeebhoy SJ, Shah I & Yount KM. Sexual Relations among Young People in Developing Countries: Evidence from WHO Case Studies. Geneva: World Health Organization, 2001 (document WHO/RHR/01.8).
14. Gardner R & Blackburn R. People who move: new reproductive health focus. Population Reports 1996. Series J: No. 45.
15. Trussell J. Contraceptive efficacy. In Hatcher RA, Trussell J, Stewart F et al (eds) Contraceptive Technology. 17th revised edition, pp 779-844. New York: Ardent Media Inc, 1998.
16. United Nations Department of Economic and Social Affairs, Population Division. Levels and Trends of Contraceptive Use as Assessed in 1998. New York: United Nations (Sales No. E.01.XIII.4), 2000.
17. Henshaw SK & Kost K. Abortion patients in 1994-1995: characteristics and contraceptive use. Family Planning Perspectives 1996; 18: 140-147 & 158.
18. Royston E & Armstrong S (eds). Preventing Maternal Deaths. Geneva: World Health Organization, 1989.
19. Tietze C. Induced Abortion: a World Review, 1981. New York: The Population Council, 1981. Fourth Edition.
20. United Nations Population Division. World Abortion Policies 1999. New York: United Nations Population Division (ST/ESA/SER.A/178), 1999.
21. Berer M. Making abortions safe: a matter of good public health policy and practice. Bulletin of the World Health Organization 2000; 78: 580-592.
22. AbouZahr C & Åhman E. Unsafe abortion and ectopic pregnancy. In Murray CJL & Lopez AD (eds) Health Dimensions of Sex and Reproduction, pp 267-296. Boston: Harvard School of Public Health for the World Health Organization and The World Bank, 1998.
23. Germain A & Kim T. Expanding Access to Safe Abortion: Strategies for Action. New York: International Women's Health Coalition, 1998.
24. Dickson-Tetteh K, Mavuya LM, Gabriel M et al. Abortion Care Services Provided by Registered Midwives in South Africa: a Report on the Midwifery Training Programme. Johannesburg: Reproductive Health Research Unit and Ipas, 2000.
25. Rogo K, Orero S & Oguttu M. Preventing unsafe abortion in western Kenya: an innovative approach through private physicians. Reproductive Health Matters 1998; 11: 77-83.
26. World Health Organization. Maternal Mortality in 1995: Estimates Developed by WHO, UNICEF, UNFPA. Geneva: World Health Organization, 2001 (document WHO/RHR/01.9).
27. Adewole IF. Trends in postabortal mortality and morbidity in Ibadan, Nigeria. International Journal of Gynaecology and Obstetrics 1992; 38: 115-118.
28. Figa-Talamanca I, Sinnathuray TA, Yusof K et al. Illegal abortion: an attempt to assess its cost to the health services and its incidence in the community. International Journal of Health Services 1986; 16: 375-389.
29. Fortney JA. The use of hospital resources to treat incomplete abortions: examples from Latin America. Public Health Reports 1981; 96: 574-579.
30. Tshibangu K, Ntabona B, Liselele-Bolemba L & Mbiye K. Avortement clandestin, problème de santé publique à Kinshasa. [Illicit abortion, a public health problem in Kinshasa (Zaire)]. Journal de Gynécologie, Obstétrique et Biologie de la Reproduction (Paris) 1984; 13: 759-763.
31. Mpangile GS, Leshabari MT & Kihwele DJ. Induced abortion in Dar es Salaam, Tanzania: the plight of adolescents. In Mundigo AI & Indriso C (eds) Abortion in the Developing World, pp 387-403. New Delhi: Vistaar Publications for the World Health Organization, 1999.
32. RCOG - Royal College of Obstetricians and Gynaecologists. The Care of Women Requesting Induced Abortion. London: RCOG Press, 2000. Evidence-based guideline No.7.
33. Greenslade FC, Benson J, Winkler J et al. Summary of clinical and programmatic experience with manual vacuum aspiration. IPAS Advances in Abortion Care 1993; 3: 1-4.
34. Westfall JM, O'Brien-Gonzales A & Barley G. Update on early medical and surgical abortion. Journal of Women's Health 1998; 7: 991-995.
35. Hakim-Elahi E, Tovell HM & Burnhill MS. Complications of first-trimester abortion: a report of 170,000 cases. Obstetrics and Gynecology 1990; 76: 129-135.
36. Grimes DA & Cates W Jr. Complications from legally-induced abortion: a review. Obstetrical and Gynecological Survey 1979; 34: 177-191.
37. Grimes DA, Schulz KF & Cates WJ Jr. Prevention of uterine perforation during currettage abortion. Journal of the American Medical Association 1984; 251: 2108-2112.
38. Grimes DA, Hulka JF & McCutchen ME. Midtrimester abortion by dilatation and evacuation versus intra-amniotic instillation of prostaglandin F2 alpha: a randomized clinical trial. American Journal of Obstetrics and Gynecology 1980; 137: 785-790.
39. Atrash HK, Cheek TG & Hogue CJ. Legal abortion mortality and general anesthesia. American Journal of Obstetrics and Gynecology 1988; 158: 420-424.
40. Ashok PW, Penney GC, Flett GMM & Templeton A. An effective regimen for early medical abortion: a report of 2000 consecutive cases. Human Reproduction 1998; 13: 2962-2965.
41. Peyron R, Aubény E, Targosz V et al. Early termination of pregnancy with mifepristone (RU486) and the orally active prostaglandin misoprostol. New England Journal of Medicine 1993; 21: 1509-1513.
42. Schaff EA, Eisinger SH, Stadalius LS et al. Low-dose mifepristone 200 mg and vaginal misoprostol for abortion. Contraception 1999; 59: 1-6.
43. Spitz IM, Bardin CW, Benton L & Robbins A. Early pregnancy termination with mifepristone and misoprostol in the United States. New England Journal of Medicine 1998; 338: 1241-1247.
44. Davey A, Urquhart DR, Templeton AA et al. The efficacy and tolerance of mifepristone and prostaglandin in termination of pregnancy of less than 63 days gestation; UK multicentre study - final results. Contraception 1997; 55: 1-5.
45. Winikoff B, Sivin I, Coyaji KJ et al. Safety, efficacy, and acceptability of medical abortion in China, Cuba, and India: a comparative trial of mifepristone-misoprostol versus surgical abortion. American Journal of Obstetrics and Gynecology 1997; 176: 431-437.
46. Trussell J & Ellertson C. Estimating the efficacy of medical abortion. Contraception 1999; 60: 119-135.
47. World Health Organization Task Force on Post-ovulatory Methods for Fertility Regulation. Comparison of two doses of mifepristone in combination with misoprostol for early medical abortion: a randomised trial. British Journal of Obstetrics and Gynaecology 2000; 107: 524-530.
48. World Health Organization Task Force on Post-ovulatory Methods for Fertility Regulation. Lowering the doses of mifepristone and gemeprost for early abortion: a randomised controlled trial. British Journal of Obstetrics and Gynaecology 2001; 108: 738-742.
49. Penney G. Medical versus surgical termination of pregnancy. Reviews in Gynaecological Practice 2001; 1: 18-23.
50. Evidence-Based Medicine. Vaginal misoprostol was superior to oral misoprostol after pretreatment with mifepristone in induced abortion. Evidence-Based Medicine 1996; 1: 46.
51. Creinin MD & Aubény E. Medical abortion in early pregnancy. In Paul M, Lichtenberg ES, Borgatta L, Grimes D & Stubblefield PG (eds) A Clinician's Guide to Medical and Surgical Abortion, pp 91-106. New York: Churchill Livingstone, 1999.
52. Schaff EA, Stadalius LS, Eisinger SH & Franks P. Vaginal misoprostol administered at home after mifepristone (RU486) for abortion, journal of Family Practice 1997; 44: 353-360.
53. Elul B, Hajri S, Ngoc NN et al. Can women in less-developed countries use a simplified medical abortion regimen? Lancet 2001; 357: 1402-1405.
54. Breitbart V. Counseling for medical abortion. American Journal of Obstetrics and Gynecology 2000; 183 (Suppl 2): S26-S33.
55. Elul B, Ellertson C, Winikoff B & Coyaji K. Side effects of mifepristone-misoprostol abortion versus surgical abortion. Data from a trial in China, Cuba, and India. Contraception 1999; 59: 107-114.
56. Ngoc NN, Winikoff B, Clark S et al. Safety, efficacy and acceptability of mifepristone-misoprostol medical abortion in Vietnam. International Family Planning Perspectives 1999; 25: 10-14 & 33.
57. Waldron KW, Renou PM, Lolatgis N et al. Second-trimester termination with 16,16 dimethyl-PGEI-methyl ester (gemeprost), compared with a regimen that included intra-amniotic PGF2 alpha and hypertonic saline. Reproduction, Fertility and Development 1990; 2: 495-498.
58. Andersen LF, Poulsen HK, Sorensen SS et al. Termination of second trimester pregnancy with gemeprost vaginal pessaries and intra-amniotic PGF2alpha. A comparative study. European Journal of Obstetrics, Gynecology and Reproductive Biology 1989; 31: 1-7.
59. Ho PC, Chan YF & Lau W. Misoprostol is as effective as gemeprost in termination of second trimester pregnancy when combined with mifepristone: a randomised comparative trial. Contraception 1996; 53: 281-283.
60. Cates W, Grimes DA & Schulz KF. Abortion surveillance at CDC: creating public health light out of political heat. American Journal of Preventive Medicine 2000; 19 (suppl 1): 12-17.
61. Grimes D, Schulz KF, Cates W & Tyler CW. The Joint Program for the Study of Abortion. CDC: a preliminary report. In Hern W & Andrikopolous B (eds) Abortion in the Seventies, pp 41-46. New York: National Abortion Federation, 1977.
62. Lean TH, Vengadasalam D, Pachauri S & Miller ER. A comparison of D&C and vacuum aspiration for performing first trimester abortion. International Journal of Gynaecology and Obstetrics 1976; 14: 481-486.
63. Baird TL, Gringle RE & Greenslade F. MVA in the Treatment of Incomplete Abortion: Clinical and Programmatic Experiences. Carrboro: Ipas, 1995.
64. Coeytaux FM, Leonard AH & Bloomer CM. Abortion. In Koblinsky M, Timyan J & Gay J (eds) The Health of Women: A Global Perspective, pp 133-146. Boulder: Westview Press, 1993.
65. Sundstrom K. Abortion: a Reproductive Health Issue. Washington, DC: The World Bank, 1993.
66. Freedman MA, Jillson DA, Coffin RR & Novick LF. Comparison of complication rates in first trimester abortions performed by physician assistants and physicians. American Journal of Public Health 1986; 76: 550-554.
67. Ashok PW, Flett GM & Templeton A. Termination of pregnancy at 9-13 weeks' amenorrhoea with mifepristone and misoprostol. Lancet 1998; 352: 542-543.
68. Cheng L, Wu Y, Jin Q et al. Termination of 10-16 weeks' gestation with mifepristone plus misoprostol: a multicentre randomized clinical trial. Chinese Journal of Obstetrics and Gynecology 1999; 34: 268-271.
69. Costa SH & Vessy MP. Misoprostol and illegal abortion in Rio de Janeiro, Brazil. Lancet 1993; 341: 1258-1261.
70. Bugalho A, Mocumbi S, Faúndes A & David E. Termination of pregnancies < 6 weeks gestation with a single dose of 800 μg of vaginal misoprostol. Contraception 2000; 61: 47-50.
71. Ngai SW, Tang OS, Chan YM & Ho PC. Vaginal misoprostol alone for medical abortion up to 9 weeks of gestation: efficacy and acceptability. Human Reproduction 2000; 15: 1159-1162.
72. Gonzalez CH, Marques-Dias MJ, Kim CA et al. Congenital abnormalities in Brazilian children associated with misoprostol misuse in first trimester of pregnancy. Lancet 1998; 351: 1624-1627.
73. Fonseca W, Alencar AJ, Mota FS & Coelho HL. Misoprostol and congenital malformations. Lancet 1991; 338: 56.
74. Schonhofer PS. Brazil: misuse of misoprostol as an abortifacient may induce malformations. Lancet 1991; 337: 1534-1535.
75. Zamudio L, Rubiano N & Wartenberg L. The incidence and social and demographic characteristics of abortion in Colombia. In Mundigo AI & Indriso C (eds) Abortion in the Developing World, pp 407-446. New Delhi: Vistaar Publications for the World Health Organization, 1999.
76. Tamang AK, Shrestha N & Sharma K. Determinants of induced abortion and subsequent reproductive behaviour among women in three urban districts of Nepal. In Mundigo AI & Indriso C (eds) Abortion in the Developing World, pp 167-190. New Delhi: Vistaar Publications for the World Health Organization, 1999.
77. Oodit G & Bhowon U. The use of induced abortion in Mauritius: an alternative to fertility regulation or an emergency procedure?. In Mundigo AI & Indriso C (eds) Abortion in the Developing World, pp 151-166. New Delhi: Vistaar Publications for the World Health Organization, 1999.
78. Riley AP, Stewart MK & Chakraborty J. Program- and method-related determinants of first DMPA use duration in rural Bangladesh. Studies in Family Planning 1994; 25: 255-267.