Abstract
Abortion complications remain a major cause of maternal mortality worldwide and abortion-related mortality has decreased very little over the last decade, unlike maternal mortality linked to other main causes such as haemorrhage, infection or obstructed labour. Global estimates suggest that most abortion-related deaths are the result of unsafe induced abortions, 97% of which occur in low- and middle-income countries which can be largely prevented by providing comprehensive abortion care, including post- abortion care, contraceptive services, and safe abortion care.
At 829 deaths for every 100,000 live births, the Central African Republic (CAR) has one of the world’s highest maternal mortality ratios. Abortion-related complications are a major contributor to maternal mortality, estimated at almost one in four (24%) of the maternal deaths in one study led by the Central African Ministry of Health and UNFPA. Further, CAR is one of the most fragile countries in the world, rating 174th out of the 178 countries in the Fund for Peace Fragility Index with different parts of the country regularly affected by decades-long armed conflict.
A lack of evidence on abortion complications in fragile settings limits the understanding of women’s needs in access to comprehensive abortion care in this context. This study describes the burden of abortion-related complications and their contributing factors in the maternity of Castors in Bangui, CAR. This evidence brief presents selected results of two components of the AMoCo Study (Abortion-related Morbidity and Mortality in Conflict-affected and Fragile Settings): 1) A quantitative observational study of clinical characteristics of women presenting with any type of abortion complications, and 2) A quantitative survey with a sub-group of these women who were hospitalized.