The Deadly Toll of Abortion by Amateurs

The Deadly Toll of Abortion by Amateurs

Béatrice de Géa for The New York Times

COMPLICATIONS A woman in Berega, Tanzania, who sought care after a botched abortion. In Tanzania, where abortion is illegal, the maternal death rate is high in part because of failed abortions.


By DENISE GRADY
Published: June 1, 2009


BEREGA, Tanzania — A handwritten ledger at the hospital tells a grim story. For the month of January, 17 of the 31 minor surgical procedures here were done to repair the results of “incomplete abortions.” A few may have been miscarriages, but most were botched operations by untrained, clumsy hands.

Abortion is illegal in Tanzania (except to save the mother’s life or health), so women and girls turn to amateurs, who may dose them with herbs or other concoctions, pummel their bellies or insert objects vaginally. Infections, bleeding and punctures of the uterus or bowel can result, and can be fatal. Doctors treating women after these bungled attempts sometimes have no choice but to remove the uterus.

Pregnancy and childbirth are among the greatest dangers that women face in Africa, which has the world’s highest rates of maternal mortality — at least 100 times those in developed countries. Abortion accounts for a significant part of the death toll.

Maternal mortality is high in Tanzania: for every 100,000 births, 950 women die. In the United States, the figure is 11, and it is even lower in other developed countries. But Tanzania’s record is neither the best nor the worst in Africa. Many other countries have similar statistics; quite a few do better and a handful do markedly worse.

Eighty percent of Tanzanians live in rural areas, and the hospital in Berega — miles from paved roads and electric poles — is a typical rural hospital, struggling to deal with the same problems faced by hospitals and clinics in much of the country. Abortion is a constant worry.

Worldwide, there are 19 million unsafe abortions a year, and they kill 70,000 women (accounting for 13 percent of maternal deaths), mostly in poor countries like Tanzania where abortion is illegal, according to the World Health Organization. More than two million women a year suffer serious complications. According to Unicef, unsafe abortions cause 4 percent of deaths among pregnant women in Africa, 6 percent in Asia and 12 percent in Latin America and the Caribbean.

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http://www.nytimes.com/2009/06/02/health/02abort.html?ref=health