Maternal Near-Miss Due to Unsafe Abortion and Associated Short-Term Health and Socio-Economic Consequences in Nigeria

Elena Prada, Akinrinola Bankole, Olufemi T. Oladapo, Olutosin A. Awolude, Isaac F. Adewole, Tsuyoshi Onda

Abstract

Little is known about maternal near-miss (MNM) due to unsafe abortion in Nigeria. We used the WHO criteria to identify near-miss events and the proportion due to unsafe abortion among women of childbearing age in eight large secondary and tertiary hospitals across the six geo-political zones. We also explored the characteristics of women with these events, delays in seeking care and the short-term socioeconomic and health impacts on women and their families. Between July 2011 and January 2012, 137 MNM cases were identified of which 13 or 9.5% were due to unsafe abortions. Severe bleeding, pain and fever were the most common immediate abortion complications. On average, treatment of MNM due to abortion costs six times more than induced abortion procedures. Unsafe abortion and delays in care seeking are important contributors to MNM. Programs to prevent unsafe abortion and delays in seeking postabortion care are urgently needed to reduce abortion related MNM in Nigeria. (Afr J Reprod Health 2015; 19[2]: 52-62).

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References

Center for Reproductive Rights (CRR) The World’s

Abortion Laws. Available at http:// worldabortionlaws.com/.Accessed 5 February 2014.

Bankole A, Adewole I, Hussain R, Awolude O,

Singh S and Akinyemi J. The incidence of abortion in Nigeria. Int Perspect Sex Reprod Health (Forthcoming).

Henshaw S. Severity and cost of unsafe abortion

complications treated in Nigerian hospitals. Int Fam Plan Perspect 2008; 34(1): 40–50.

Oladapo OT, Sule-Odu AO, Olatunji AO and

Daniel OJ. ‘Near-miss’ obstetric events and maternal deaths in Sagamu, Nigeria: a retrospective study. Reprod Health 2005; 2(9): 1-9.

Jabir M, Abdul-Salam I, Suheil DM, Al-Hilli W,

Abul-Hassan S, Al-Zuheiri A, et al. Maternal near-miss and quality of maternal health care in Baghdad, Iraq. BMC Pregnancy and Childbirth 2013; 13(11): 1-9.

Lotufo F, Parpinelli MA, Haddad SM, Surita FG

and Cecatti JG. Applying the new concept of maternal near-miss in an intensive care unit. Clinics 2012; 67(3): 225-230.

Oladapo O, Adetoro OO, Fakeye O, Ekele BA,

Fawole AO, Abasiattai A, et al. National data system on near-miss and maternal death: shifting from maternal risk to public health impact in Nigeria. Reprod Health 2009; 6(8): 1-11.

Pattison RC and Hall M. Near-misses: a useful

adjunct to maternal death enquiries. Br Med Bull 2003; 67: 231–243.

Prual A, Bouvier-Colle MH, de Bernis L and Bréart

G. Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates. Bull World Health Organ 2000; 78(5): 593-602.

Filippi V, Ganaba R, Baggaley RF, Marshall T,

Storeng KT, Sombié I, et al. Health of women after severe obstetric complications in Burkina Faso: a longitudinal study. Lancet 2007;370(9595):1329-37.

Filippi V, Alihonou E, Mukantaganda S, Graham

WJ and Ronsmans C. Near-misses: maternal morbidity and mortality. Lancet 1998; 351(9096): 145-146.

Filippi V, Ronsmans C, Graham WJ, Gandaho T

and Alihonou E. Near-misses: Are Life Threatening Complications Practical Indicators for Safe Motherhood Programmes? Proceedings of the IUSSP Seminar on Innovative Approaches to the Assessment of Reproductive Health; 1996 Sept 24-27; Manila, Philippines: IUSSP.

Weeks A, Lavender T, Nazziwa E and Mirembe F.

Personal accounts of ‘near-miss’ maternal mortalities in Kampala, Uganda. BJOG 2005; 112(9): 1302–1307.

Say L, Souza JP, Pattinson RC for the WHO

working group on maternal mortality and morbidity classification: Maternal near miss –towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clin Obstet Gynaecol 2009, 23:287-296.

McCarthy J and Maine D. A framework for

analyzing the determinants of maternal mortality. Stud Fam Plann 1992; 23(1): 23–33.

Exchange rate at the time was US$ 1 = 152.498

NGN, http://www.xe.com/currencytables/? from= USD&date=2011-07-15.

CSR West Africa. Nigeria: Minimum Wage In

Nigeria 2011. Available at http://csrwestafrica. com/2011/07/08/nigeria-minimum-wage-in-nigeria. Accessed 9 July 2013.

WHO. Unsafe abortion: global and regional

Prada et al. MNM-Abortion Related in Nigeria

African Journal of Reproductive Health March 2015; 19 (2): 62

estimates of the incidence of unsafe abortion and associated mortality in 2008, 6th ed. Geneva: Department of Reproductive Health and Research, World Health Organization, 2011.

Shah IH and Ahman E. Unsafe abortion in 2008:

global and regional levels and trends. Reprod

Health Matters 2010; 18(36): 90–101.

Bankole A, Oye-Adeniran B, Singh S, Adewole I,

Wulf D, Sedgh G, et al. Unwanted Pregnancy and Induced Abortion in Nigeria: Causes and Consequences. New York: Guttmacher Institute, 2006.

Sedgh G, Bankole A, Oye-Adeniran B, Adewole IF,

Singh S and Hussain R. Unwanted Pregnancy and Associated Factors Among Nigerian Women. Int Fam Plan Perspect 2006; 32(4): 175-184.

Okonofua FE, Onwudiegwu U and Odunsi OA.

Illegal induced abortion: a study of 74 cases in Ile Ife, Nigeria. Trop Doct 1992; 22(2): 75-78.

Bankole A, Singh S, Vlassoff M and Woog V.

Estimating the cost of post-abortion care in Nigeria: a case study. In Lule E, Singh S, Chowdhury SA (Ed.). Fertility Regulation Behaviors and Their Costs. Washington, DC: World Bank, 2007.

Lanre-Abass BA. Poverty and maternal mortality in

Nigeria: towards a more viable ethics of modern medical practice. Int J Equity in Health 2008; 7(11) 1-9.

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