Cost of unsafe abortion: A prospective study among women identified with post-abortion complications in selected hospitals of Madhya Pradesh, India

While much is known about health effects of unsafe abortion, less attention has been paid to economic impact. This study describes 381 patients presenting for complications of unsafe abortion at ten selected hospitals in Madhya Pradesh, India. Many women accessing post abortion care (PAC) first attempted pregnancy induction at home by themselves or with the help of a family member or friend. Women report as many as four visits to health care providers (either legal or illegal) in resolving their induced abortion. Median direct costs (travel plus medical care) of all visits associated with unsafe abortion ranges from Rs 0 to 10250, with a median of Rs 215. The primary contributors to overall costs are travel/transport to facilities and medicines. Costs were relatively stable across sociodemographic characteristics with a few exceptions: higher among older women and working women, while lower among unmarried women and those from the scheduled tribe caste. Higher costs are observed among second trimester patients and women who first attempted to induce their abortion at home. Costs increase with increasing number of visits and severity of complications. Additional analysis will provide expanded examination of the cost components of each visit, bivariate analysis using nonparametric methods, and consideration of lost wages to the patients and their families as a result of seeking care.