OBJECTIVE To analyze the causes of abortion-related mortality in the Russian Federation.
BACKGROUND Abortion is provided on demand up to 12 weeks LMP, on specific social grounds up to 22 weeks and on specific medical grounds during the whole period of gestation. Although the birth rate has recently dropped dramatically, 2.3 million abortions were reported in 1999. These figures do not include the rapidly expanding private sector. In 1999 the level of maternal mortality was 44.2 per 100000 live births and abortion complications contribute about a quarter (24.4%) of reported maternal deaths.
METHOD Hospital notes and autopsy reports of all 113 women whose deaths were associated with an abortion in 1999 were obtained by the Ministry of Health. Retrospective analysis of these case notes, (including condition on admission, associated complications and the quality of care provided by the facility) were analyzed by two independent researchers. An expert panel attributed principal and contributing cause of death and associated factors.
RESULTS Client reluctance to seek help locally, practitioner failure to recognize the severity of the problem and inadequacy of care and referral procedures are suggested as contributing factors to these deaths. Analysis of attributable causes of maternal death and proposals for their future reduction will be presented.
CONCLUSIONS Recommendations for improving the quality of and access to abortion services in the public and private health care sectors to decrease the level of mortality will be made to key stakeholders. Further interventions are planned to promote appropriate and sustainable best practice standards.
This work was supported by The Open Society Institute.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: - Identify the main causes of abortion-related death in Russia - Examine the role played by the quality of care of Russian abortion providers - Discuss and develop strategies for the reduction of abortion-related mortality in Russia
Keywords: Abortion, Quality of Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.