Abstract
BackgroundOne of the leading cause of maternal mortality and morbidity is unsafe abortion. Globally 55.7million of abortions occurred each year between 2010 and 2014. In lower resource countries 24.3 million abortions were unsafe which is significantly higher. Nepal is one of the lower resource countries among others. Comprehensive abortion care (CAC) service can reduce this burden among women.MethodsA retrospective review of CAC service register at Tribhuvan University Teaching Hospital (TUTH) was conducted to collect data from 2006 to2015 with approval from the Nursing Department to identify the trends of CAC service delivery, client characteristics, category of service providers, and reason for seeking CAC services, its effectiveness and complications. The data was entered in SPSS software and descriptive analysis was performed.ResultsA total of 2367 women received CAC in ten years period showing similar trend as 272–275 cases per year. Women’s mean age was 28.4 years, 34% attained secondary level education and 98.9% were married. 70% were house wives and 84% multi gravid. The gestational period varied from 5 to 12 weeks. 85.6% had Manual Vacuum Aspiration (MVA) and 14.4% had Medical Abortion (MA). Only 37.6% women used any method of post abortion contraception. Unwanted pregnancy was the commonest reason for CAC. A majority of service providers were doctors (62.4%). The nurses were equally competent to provide CAC service as doctors.ConclusionsThe number of women receiving CAC was relatively constant over the ten-year period. Nurses should be promoted for providing CAC services to cover a larger population in need.
Highlights
One of the leading cause of maternal mortality and morbidity is unsafe abortion
There was a sharp decline in maternal mortality, which fell from 580 maternal death per 100,000 live births in 1995 to 190 per 100,000 in 2013 with the abortion legalization [2]
In Nepal nearly 80% of maternal mortality was due to direct causes and out of which 13% were due to unsafe abortion [4]
Summary
One of the leading cause of maternal mortality and morbidity is unsafe abortion. In lower resource countries 24.3 million abortions were unsafe which is significantly higher. In 2014 about 137,000 legal abortions were provided in Nepal. In 2014 an estimated 80,500 women were treated in health facilities for complications of miscarriage or induced abortion. Among the facilities providing post abortion care, the largest proportion was covered by the private sector [3]. In Nepal nearly 80% of maternal mortality was due to direct causes and out of which 13% were due to unsafe abortion [4]. A retrospective medical chart review of all gynecological cases was done at four large public hospitals in Nepal from 2001 to 2010; all cases of spontaneous and induced abortion complications were identified. The amendment of Muluki Ain (Civil Service Act) in September
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