Abstract
Available data indicate that the incidence of spontaneous and induced abortion is high in developing countries. This chapter describes the genetic and environmental causes of spontaneous abortion, and explains the reasons that women resort to induced abortion, including describing the prevalence of restrictive abortion laws in many developing countries. Induced abortion was divided into safe and unsafe categories, with unsafe abortion reported as more common in developing countries as compared to developing countries. We also present information indicating that unsafe abortion is a leading cause of maternal mortality in developing countries and its prevention one of the most important interventions needed to prevent maternal mortality in these countries.
We report the short- and long-term medical and social complications associated with unsafe abortion and identify ways for addressing them. This chapter concludes by explaining the various primary, secondary and tertiary preventive measures for reducing the incidence of unsafe abortion in developing countries. These include family planning, safe abortion care, post-abortion care, post-abortion family planning, the liberalisation of abortion laws and the socio-economic empowerment of women. Preventing unsafe abortion is one of the most important responsibilities of obstetricians and gynaecologists, and women have inalienable rights to safe abortion care based on choice.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
LFY H. Prenatal diagnosis of chromosomal anomalies through amniocentesis. In: Milunsky A, editor. Genetic disorders and the fetus. 4th ed. Baltimore: The Johns Hopkins University Press; 1998. p. 179.
Nybo Andersen AM, et al. Maternal age and fetal loss: population-based register linkage study. Br Med J. 2000;320:1708.
Regan L, Brande PR, Trembath PL. Influence of past reproductive performance on risk of spontaneous abortion. Br Med J. 1989;299:541.
Kline J, Stein Z, et al. Fever during pregnancy and spontaneous abortion. Am J Epidemiol. 1985;121:832.
Andersen AM, Vastrup P, et al. Fever in pregnancy and the risk of fetal death: a cohort study. Lancet. 2002;360:1552.
Axmon A, Hagner L. Time to pregnancy and pregnancy outcome. Fertil Steril. 2005;84:966.
George L, Mills L, et al. Plasma folate levels and the risk of spontaneous abortion. J Am Med Assoc. 2002;288:1867.
Landres N, Milki AA, Lathi RB. Karyotype of miscarriages in relation to maternal weight. Hum Reprod. 2010;25:1123.
Templeton Sarah-Kate. New test for risk of pregnancy failing. The Sunday Times of London, UK, 2017, 14.
Weeks A, Alia G, Blum J, et al. A randomised trial of misoprostol compared with manual vacuum aspiration for incomplete abortion. Obstet Gynecol. 2005;106(3):540–7.
Zhang J, Gilles JM, Barnhart K, et al. A comparison of medical management with misoprostol and surgical management for early pregnancy failure. N Engl J Med. 2005;353(8):761–9.
Okonofua FE, Menakaya U, Otoide V, Omo-Aghoja L, Odunsi K. Experience with misoprostol in the management of missed abortion in the second trimester. J Obstet Gynecol. 2005;25(6):583–5.
World Health Organization. Safe abortion: technical and policy guidance for health systems. 2nd ed; 2008. ISBN 978 92 4 154843 4 (NLM Classification: WQ 440).
Bearak J, Popinchalk A, Ganatra B, et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1999–2019. Lancet Global Health. 2020; https://doi.org/10.1016/s2214-109x(20)30342-6.
Henshaw SK, et al. The incidence of induced abortion in Nigeria. Int Fam Plan Perspect. 1998;24(4):156–64.
Okonofua FE, Odimegwu C, Ajabor H, Daru H, Johnson A. Assessing the prevalence and determinants of unwanted pregnancy and induced abortion in South West Nigeria. Stud Fam Plan. 1999;30(1):67–77.
Sedgh C, et al. Unwanted and associated factors among Nigerian women. Int Fam Plan Perspect. 2006;32(4):175–84.
Bankole A, Adewole IF, Hussain R, Awolude V, Singh S, Akinyemi JO. The incidence of abortion in Nigeria. Int Perspect Sex Reprod Health. 2015;41(4):170–81.
Okonofua FE. Is abortion incidence rising in Nigeria? Afr J Reprod Health. 2015;19(4):9–13.
Okonofua FE, Omo-Aghoja L, Bello Z, Osughe M, Agholor K. Self-reporting of induced abortion by women attending antenatal clinics in urban Nigeria. Int J Obstetrics Gynaecol. 2010;111:122–5.
Marge B. Abortion law and policy around the world. Health Hum Rights. 2017;19(1):13–27.
Centre for Reproductive Rights. The abortion laws, 2012. https://www.worldabortionlaws.com. Accessed 8 Jul 2017.
Centre for Reproductive Rights. The world’s abortion laws, 2011 (New York, 2011).
World Health Organization, 2011: whqlibdoc.who.int/publications/2011/97892415011118_eng.pdf
Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah I. Unsafe abortion: the preventable pandemic. Lancet. 2006:65–76.
Bradley SEK, Croft TN, Rutstein SO. The impact of contraceptive failure on unwanted births and induced abortion estimates and strategies for reduction. Demographic and Health Research Division, ICF Macro, 11785, Beltsville Drive, Calverton, Maryland 20705, USA. https://iussp.org/sites/default/files/event_call_for_papers/contraceptives. Accessed 12 Jul 2017.
Mitsunaga TM, Larsen UM, Okonofua FE. Risk factors for complications of induced abortions in Nigeria. J Womens Health (Larchmt). 2005;14(6):515–28.
World Health Organization. Unsafe abortion – global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008. 6th ed. WHO; 2008. ISBN 978 92 4 150111 8.
Okonofua FE, Ilumoka T. Prevention of morbidity and mortality from induced and unsafe abortion in Nigeria. New York: Report of a seminar presented to the Population Council; 1992.
Oye-Adeniran BA, Umoh AV, Nnatu SNN. Complications of unsafe abortion: a case study and the need for abortion law reform in Nigeria. Reprod Health Matters. 2002;10(19):18–21.
Okonofua FE. Induced abortion: a risk factor for infertility in Nigerian women. J Obstet Gynaecol. 1994;12:272–6.
World Health Organization. Safe abortion: technical and policy guidance for health systems. 2nd ed; 2012. ISBN 978 92 4154843 4.
World Health Organization. Clinical practice handbook for safe abortion. WHO; 2014. ISBN 978 92 4 154871 7.
World Health Organization. Health worker roles in providing safe abortion care and post-abortion family planning. WHO; 2015. ISBN 978 92 4 154926 4.
African Commission on Human and Peoples’ Rights. Protocol to the African charter on human and peoples’ rights on the rights of women in Africa, 2014. http://www.achpr.org/instruments/women-protocol/
Cook RJ, Dickens BM. Upholding pregnant women’s right to life. Int J Gynecol Obstet. 2012;117:90–4.
Ipas. Maternal mortality, unwanted pregnancy and abortion as addressed by international human rights bodies – part one. Chapel Hill: Ipas; 2013. http://www.ipas.org/en/Resources/Ipas%20Publications/Maternal-mortality%2D%2Dunwanted-pregnancy-and-abortion-as-addressed-by-international-human-ri-2.aspx;
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Okonofua, F. (2021). Abortion. In: Okonofua, F., Balogun, J.A., Odunsi, K., Chilaka, V.N. (eds) Contemporary Obstetrics and Gynecology for Developing Countries . Springer, Cham. https://doi.org/10.1007/978-3-030-75385-6_5
Download citation
DOI: https://doi.org/10.1007/978-3-030-75385-6_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-75384-9
Online ISBN: 978-3-030-75385-6
eBook Packages: MedicineMedicine (R0)