unsafe abortion
TRANSCRIPT
Created by Mahfuz ChowdhuryDepartment of Population Sciences
University of Dhaka
Fb/mahfuz1989 [email protected]/mahfuz-chowdhury-62a60b74?trk=hp-identity-name
UNSAFEABORTION
@ Mahfuz Chowdhury
global & regional aspects
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21.6 Million Unsafe
abortions occurred worldwide annually
47,000 Death
due to unsafe abortions
13% Maternal death
14 unsafe abortions per 1000 women aged 15–44 years
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A procedure for terminating an
unintended pregnancy carried out either by persons lacking the
necessary skills or in an environment that does not conform to
minimal medical standards, or both.
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The following conditions typically characterize an unsafe abortion, sometimes only a few conditions prevail, and sometimes all or most of them: . @ Mahfuz Chowdhury
• No pre-abortion counselling and advice;
• Unskilled provider, unhygienic conditions,
• Insertion of an object into the uterus
• Wrong or inadequate treatment in medical abortion
• Abortion is self-induced by ingestion of traditional medication or hazardous substances. .
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• The lack of immediate intervention in emergency cases;
• Failure to provide post abortion check-up and care,
• The reluctance of a woman to seek medical care in case of complications because of legal restrictions and social and cultural beliefs linked to induced abortion
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Global and regional approximate current scenario of
unsafe abortion
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Every 8 Minutes A Woman In A Developing Nation
Dies Of Complications
Arising From An Unsafe Abortion.
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Trends in different regions
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In the Africa Region the case–fatality rate decreased by 31% from 680 in 1990 to 470 in 2008.
In the Asia Region, the case–fatality rate in 2008 was 40% lower than in 1990.
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La ti n Amer ica & T he Ca r ibbea n Afr ic a Asia Eur ope
45
28
14
12
31
28
12
2
Estimated number of unsafe abortions per 1000 women aged 15–44 years, 1990 and 2008, by major region.
1990 2008
Uns
afe
abor
tions
per
thou
sand
wom
enA
ged
15-4
4 ye
ars
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World D eve loping R eg ions D eveloped R eg ions La ti n Amer ica & The Ca r ibbea n
Afr ica Asia Eur ope
17
20
7
45
28
14
12
14
16
1
31
28
11
2
Estimated number of unsafe abortions per 1000 women aged 15–44 years, 1990 and 2008, by major region.
1990 2008
Uns
afe
abor
tions
per
thou
sand
wom
enAg
ed 1
5-44
yea
rs
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L a tin Amer ica & T he Ca r ibbea n Afr ica Asia Eur ope
37
13
11
20
39
18
14
5
Estimated annual number of unsafe abortion per 100 births, 1990 and 2008, by major region.
1990 2008
Uns
afe
abor
tions
per
thou
sand
wom
enA
ged
15-4
4 ye
ars
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It is clear that the condition of Latin America &the Caribbean region was the highest between the period of 1990 & 2008 which are 45 & 31 respectively.
On the contrary, the lowest condition of European region is 12 & the recent condition is 2.@ Mahfuz Chowdhury
In Asia the rate of unsafe abortion in 1990 was 14% whereas this trend is 12% in 2008.
There is a slight decline in Asia and all other regions excepting Africa.
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Unsafe Abortion In The Context Of Legalization
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Unsafe Abortion Rate Is Lower In The Developed Regions Where
Abortion Is More Permitted
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In developed regions about 69% cases abortion is permitted on request where as in developing regions this rate is only 15%.
In developed regions about 69% cases abortion is permitted on request where as in developing regions this rate is only 15%.
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Mortality Scenario due to Unsafe Abortion
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62%
38%
Death from Unsafe Abortion
Africa
Rest World
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The unsafe abortion mortality ratio was 80 in the Africa Region;
four times higher than in the Asia Region(20) and Eight times as high as in the Latin America and the Caribbean Region (10).
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The national rate for induced abortion was 18.2 per 1,000 for women in the aged 15-44 in Bangladesh.
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Number of Death Mortality calculations includingall countries of each regionwhether with or withoutevidence of unsafe abortion
Mortality calculations includingonly countries of each regionwith evidence of unsafe abortion
Deaths due tounsafe abortionper 100 000 livebirths (rounded)
% ofmaternaldeaths
Deaths due tounsafe abortionper 100’000 livebirths (rounded)
% of maternaldeaths
World 47000 30 13 40 13
Developed Regions 90 .7 4 3 11
Developing Regions 47000 40 13 50 13
Least Developed Countries
23000 80 14 80 14
Sub-Saharan Countries
28500 90 14 90 14
Data for 2008 @ Mahfuz Chowdhury
Barriers to Accessing Safe Abortion Services
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Major issue of service access is the low availability of hospital services in developing countries
particularly in rural areas.
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Social• Religious and cultural
Law• Legal Barrier
Lack of Accessibility• Quality Service• Skilled Provider
Economic
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• Religious and cultural• EconomicSocial
• Legal Barrier• Lack of AwarenessLaw
• Quality Service
• Skilled Provider
Lack of Accessibility
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consequences of unsafe abortion
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Physical Problem of
Mother
Psychological Problem
Waste of public health
resources
Problem to next
generation
Maternal Mortality
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Unsafe Abortion
in
Fertility Transition
Unplanned Pregnancy
contraceptive prevalence
& unmet need
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An increase in contraceptive prevalence and in the use of
effective contraceptive methods reduces the incidence of
abortion.@ Mahfuz Chowdhury
Abortion in Fertility Transition @ Mahfuz Chowdhury
Source: Trussell J. Contraceptive efficacy(2007)@ Mahfuz Chowdhury
62%
38%
Using Contraception
UsingNot using
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In developing Countries
Asia 9.2%
Africa 22.2%
Latin America & The Caribbean 10.5
Unmet Need of Contraception
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Global Scenario
Source: United Nations Population Division, 2009.@ Mahfuz Chowdhury
Possible Solutions
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• women can plan pregnancies through
effective contraception;
• counselling and services meet the
unmet need for family planning,
• safe abortion services are available
and accessible.
Making safe abortions services available and
accessible where abortion is not against the law; @
Mah
fuz C
howd
hury
• ensuring that permitted reasons for
abortion are supported by the
national legislative process
• granting access to services for the management of
complications arising from unsafe abortion
• providing post-abortion counselling
and offering contraceptive services,
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Conclusions
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• The World Health Organization deems unsafe abortion one of the easiest preventable causes of maternal mortality.
• Data suggest that even as the overall abortion rate has declined, the proportion of unsafe abortion is on the rise.
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• Worldwide, 5 million women are hospitalized each year for treatment of abortion-related complications, and abortion-related deaths leave 220,000 children motherless.
• Methods of unsafe abortion include drinking toxic fluids; inflicting direct injury to the vagina, cervix, or rectum; or inflicting external injury to the abdomen. Complications also arise from unskilled providers causing uterine perforation and infections.
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• Data indicate an association between unsafe abortion and restrictive abortion laws.• Preventing unintended pregnancy, providing better access to health care, and liberalizing abortion laws to allow services to be openly provided can reduce the rate of abortion-related morbidity and mortality.
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Thank You
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@ Mahfuz Chowdhury