Restrictive abortion laws cost women’s lives, Lancet paper

RESTRICTIVE laws against abortion in Low and Middle Income Countries has resultantly left them with the highest burden of maternal deaths which are abortion related from 55.7 million between 2010 and 2014 to 73.3 million between 2015 and 2019.

“About 4·7–13·2% of maternal deaths annually are abortion-related, with the highest burden in Asia and Africa,” said Lancet in a report.

Abortion rates in settings with restrictive laws are not necessarily lower than in regions with permissive laws.

“In fact, almost 62% of all abortion-related deaths are recorded in Africa alone.

“These predominantly restrictive abortion laws lead to delayed decisions to seek care until advanced gestational ages, when the abortion becomes more difficult to undertake, and care is often sought from clandestine sources to circumvent the law.

“Nigeria and Argentina, which were selected by Heidi Moseson and colleagues for their research, are countries with some of the highest rates of unsafe abortion. Therefore, the findings of this research are relevant to many other countries with similar prevailing circumstances,” added Lancet.

In the report, it was also noted that women in some cultures and settings cannot seek medical abortion services on their own.

“Apart from the social stigma associated with abortion, women cannot seek health care without the permission and accompaniment of a male relative in some cultural and religious settings. Medication abortion has been in use for at least two decades, with current regimens including misoprostol alone and misoprostol and mifepristone in combination. Evidence supports the effectiveness and efficiency of medication abortion, especially in pregnancies of less than 10 weeks, which was further affirmed by the findings from Moseson and colleagues.

“ Medication abortion is also associated with lower risks of cervical injuries, uterine perforations, and post-abortion sepsis than is surgical abortion, and might therefore reduce abortion-related morbidity and maternal mortality.

 “However, conventional medication abortion is physician supervised, and initially involves hospital admission. The cost of health facility visits can be prohibitive in LMICs, where people pay out-of-pocket for health care and might be living on less than US$1 per day,” said Lancet.

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