Preventing Unsafe Abortion and its Consequences: Priorities for Research and Action

Author(s)

Ina K. Warriner

Unsafe abortion is a significant yet preventable cause of maternal mortality and morbidity in developing countries. This report contains the papers submitted to an interdisciplinary consultation convened by WHO to assess the problem of unsafe abortion globally and to identify a research agenda aimed at reducing unintended pregnancy, unsafe abortion, and the resultant burden on women, their families, and public health systems. Experts at the consultation reviewed the available evidence on unsafe abortion, examined the factors that perpetuate the problem, and identified both opportunities for preventing unsafe abortion and constraints on prevention. Participants addressed the theoretical and medical issues relating to research on unsafe abortion and outlined regional priorities for the prevention of unsafe abortion. Both long-standing and emerging issues relating to research on unsafe abortion were discussed.

Reproductive rights are under attack. Will you help us fight back with facts?

References 1. United Nations. Report of the International Conference on Population and Development. New York: United Nations, 1994 (Doc. A/Conf.171/13). 2. Mann J.-M. Medicine and public health, ethics and human rights. Hastings Center Report, May-June 1997: 6-13. 3. Acosta MC. Overcoming the discrimination of women in Mexico: a task for Sisyphus. In: O’Donnell G, Mendez J, Pinheiro PS, eds. Rule of law and the underprivileged in Latin America. Notre Dame, Indiana: University of Notre Dame Press, 1999. 4. Grupo de Informacion en Reproduccion Elegida (GIRE). Paulina: In the name of the law. Mexico City: GIRE, 2000. 5. Pitanguy J, Sarmento Garbayo L. Relatorio do Seminario a Implementacao do Aborto Legal no Servico Publico de Saude [Report of a Seminar on the Implementation of Legal Abortion with the Public Health Service]. Rio de Janiero: Cicadania, Estudo, Pesquisa, Infomacao e Acao, 1995. 6. Brazilian Ministerio de Salud. Prevencion y tratamiento do los agravios resultantes de la violencia sexual contra las mujeres y adolescentes [Prevention and treatment of the serious consequences of sexual violence against women and adolescents ]. Brasilia: Ministry of Health, 1999 (available from IPAS/Mexico). 7. Report of the Committee on the Operation of the Abortion Law [in Canada ]. Ottawa: Supplies and Services Canada, 1997 (This Committee was chaired by Robin F. Badgley, so it is hereafter called the Badgley Report). 8. Criminal Code Revised Statutes of Canada 1970, Chap c-34, Section 251 (4). 9. Morgentaler et al. v. The Queen. 44 D.L.R. (4th) 385, 402 (1988). 10. Inter-American Commission on Human Rights. Annual Report, 1980-81: 125, cited in Annual Report, 1989-90: 187. 11. United Nations, Human Rights Committee. Concluding Observations on Peru: 11/18/96. New York, 1996 (Doc. CCPR/C/79/Add.72) : para. 15. 12. United Nations, Human Rights Committee. Concluding Observations on Peru: 11/18/96. New York, 1996 (Doc. CCPR/C/79/Add.72) : para. 19. 13. United Nations, Human Rights Committee. Concluding Observations on Peru: 11/18/96. New York, 1996 (Doc. CCPR/C/79/Add.72) : para. 22. 14. United Nations. Report of the International Conference on Population and Development. New York, 1994 (Doc. A/Conf.171/13) : para. 7.2. 32 REBECCA J. COOK Book ch.02.qxd 11.2.2005 10:36 Page 32 15. United Nations. General Assembly Official Records (GAOR), 1999. New York, 1999 (Doc. A/54/38/Rev 1) : pp. 3-7. 16. United Nations. The right to the highest attainable standard of health. Document E/C.12/2000/4. New York, 11 August 2000: para. 12. 17. Ngwena C. South Africa’s new abortion law: a break with the past. IAB News: the Newsletter of the International Association of Bioethics (IAB), 1997, 6 : 4. 18. Gostin LO, Lazzarini Z. Human rights and public health in the AIDS pandemic. New York: Oxford University Press, 1997: Chap. 3 (Human rights impact assessment). 19. Dickens BM, Cook RJ. Law and ethics in conflict over confidentiality? International Journal of Gynecology and Obstetrics, 2000, 70 (3) : 385-391. 20. Cook R, Maine D. Spousal veto over family planning services. American Journal of Public Health, 1987, 77 (3) : 339-344. 21. Cook RJ, Dickens BM. Recognizing adolescents’ “evolving capacities” to exercise choice in reproductive health care. International Journal of Gynecology and Obstetrics, 2000, 70 (1): 13-21 (World Report on Women’s Health). 22. Gulcur L. Evaluating the role of gender inequalities and rights violations in women’s mental health. Health and Human Rights, 2000, 5 (1) : 47-66. 23. Nowicka W, ed. The anti-abortion law in Poland: the functioning social effects, attitudes and behaviors. Warsaw: The Federation for Women and Family Planning, 2000. 24. Bermudez V. La Regulacion Judica del Abortio en America Latina y el Caribe. Lima: CLADEM, 1997. 25. Center for Reproductive Law and Policy (CRLP) and Demus, Estudio para la Defensa de los Derechos de la Mujer. Women of the world: Laws and policies affecting their reproductive lives – Latin America and the Caribbean. New York: CRLP, 1997. 26. CRLP and International Federation of Women Lawyers – Kenya Chapter. Women of the world: Laws and policies affecting their reproductive lives – anglophone Africa. New York: CRLP, 1997. 27. Center for Reproductive Law and Policy. Reproductive rights 2000: Moving forward. New York: Center for Reproductive Law and Policy, 2000. 28. Heise L, Ellsberg M, Gottemoeller M. Ending violence against women. Population Reports, Series I, 1999, 11: 9-18.1. World Health Organization, Division of Reproductive Health. Unsafe abortion:
global and regional estimates of incidence of and mortality due to abortion, with a
listing of available country data. Third edition. Geneva, World Health Organization,
1998.
 2. Henshaw SK, Singh S, Haas T. The incidence of abortion worldwide. International
Family Planning Perspectives 1999, 25 (Supplement): S30-S38.
 3. Henshaw SK, Singh S, Oye-Adeniran BA, Adewole IF, Iwere N, Cuca Y. The
incidence of induced abortion in Nigeria. International Family Planning Perspectives
1998, 24 (4): 156-164.
 4. Huntington D, Nawar L, Hassan EO, Youssef H, Abdel-Tawab N. The post-abortion
caseload in Egyptian hospitals: a descriptive study. International Family Planning
Perspectives 1998, 24 (1): 25-31.
 5. Singh S, Cabigon JV, Hossain A, Kamal H, Perez AE. Estimating the level of abortion
in the Philippines and Bangladesh. International Family Planning Perspectives
1997, 23 (3): 100-107.
 6. Singh S, Wulf D. Estimating levels of induced abortion in six Latin American
countries. International Family Planning Perspectives 1994, 20 (1): 4-13.
 7. Alan Guttmacher Institute (AGI). Clandestine abortion: a Latin American reality.
New York, AGI, 1994.
 8. Singh S, Wulf D, Jones H. Health professionals’ perceptions about induced abortion
in South Central and Southeast Asia. International Family Planning Perspectives
1997, 23 (2): 59–67.
 9. University of the Philippine Population Institute and AGI. Clandestine abortion:
a Philippine reality. Manila, 1997.
 10. Makina-Adebusoye P, Singh S, Audam S. Nigerian health professionals’ perceptions
about abortion. International Family Planning Perspectives 1997, 23 (4):
148–154.
 11. Alan Guttmacher Institute (AGI). Sharing responsibilities: women, society and
abortion worldwide. New York, AGI, 1999: Chart 6.1, p. 43.
 12. Alan Guttmacher Institute (AGI). Sharing responsibilities: women, society and
abortion worldwide. New York, AGI, 1999: Table 5c, p. 38.
 13. Zamudio L, Rubiano N, Wartenberg L. The incidence and social and demographic
characteristics of abortion in Colombia. In: Mundigo A, Indriso C, eds.
Abortion in the developing world. New Delhi, Vistaar Publications, 1999: Chapter
22, pp. 407-446.
49
THE INCIDENCE OF UNSAFE ABORTION: A GLOBAL REVIEW
 14. Population Council, Mexico. Information provided at meeting of Advisory Panel
on Abortion Research, 21 November 2000.
 15. Faúndes A, Faculty of Medical Science, University of Campinas, Campinas,
Brazil. Special calculations of data from Sistema de Informações Hospitalares do
Sistema Unificado de Saúde, 28 August 1998.
 16. Alan Guttmacher Institute (AGI). Sharing responsibilities: women, society and
abortion worldwide. New York, AGI, 1999: Table 5b, p. 35.1. Bongaarts J, Westoff CF. The potential role of contraception in reducing abortion.
New York, Population Council, 2000 (Population Council Working Papers, No. 134).
2. Chandrasekhar S. India’s abortion experience. Denton, University of North Texas
Press, 1994.
3. Center for Reproductive Law and Policy. The world’s abortion laws 1998.
[Wallchart]. New York, Center for Reproductive Law and Policy, 1998.
69
DETERMINANTS OF UNSAFE INDUCED ABORTION IN DEVELOPING COUNTRIES
Book ch.04.qxd 11.2.2005 10:38 Page 69
4. World Conference on Women, (4th :1995 : Beijing) The Beijing Declaration and the
Platform for Action on Women and Health. Population and Development Review,
1995, 21 (4): 907-913.
5. United Nations. Population and Development: Programme of Action adopted at the
International Conference on Population and Development, Cairo, 5-13 September
1994. New York, United Nations, 1994 (ST/ESA/SER. A/149).
6. Alan Guttmacher Institute. Sharing responsibility: women, society and abortion
worldwide. New York, Alan Guttmacher Institute, 1999.
7. Mundigo AI, Indriso C, eds. Abortion in the developing world. New Delhi, Vistaar
Publications, and London, Zed Books, 1999.
8. Djohan E, Indrawasih R, Adenan M, Yudomustopo H, Tan MG. The attitudes of health
care providers towards abortion in Indonesia. In: Mundigo AI, Indriso C, eds. Abortion
in the developing world. New Delhi, Vistaar Publications, and London, Zed
Books, 1999: 281-292.
9. CRLP – Centro Legal para Derechos Reproductivos y Políticas Públicas. Mujeres del
Mundo: Leyes y Políticas que Afectan sus Vidas Reproductivas – América Latina y el
Caribe. New York, 1997.
10. Pick S, Givaudan M, Cohen S, Alvarez M, Collado ME. Pharmacists and market herb
vendors: abortifacient providers in Mexico City. In: Mundigo AI, Indriso C, eds.
Abortion in the developing world. New Delhi, Vistaar Publications, and London, Zed
Books, 1999: 293-310.
11. Misago C, Fonseca W. Determinants and medical characteristics of induced abortion
among poor urban women in north-east Brazil. In: Mundigo AI, Indriso C, eds. Abortion
in the developing world. New Delhi, Vistaar Publications, and London, Zed
Books, 1999: 217-227.
12. Molina R, Pereda C, Cumsille F, Oliva LM, Miranda E, Molina T. Prevention of
pregnancy in high-risk women: community intervention in Chile. In: Mundigo AI,
Indriso C, eds. Abortion in the developing world. New Delhi, Vistaar Publications,
and London, Zed Books, 1999: 57-77.
13. Luo Lin, Wu Shi-zhong, Chen Xiao-qing, Li Min-xiang. Induced abortion among
unmarried women in Sichuan Province, China. In: Mundigo AI, Indriso C, eds. Abortion
in the developing world. New Delhi, Vistaar Publications, and London, Zed
Books, 1999: 98-116.
14. Mpangile GS, Lesahabari MT, Kihhwele DJ. Induced abortion in Dar-es-Salaam,
Tanzania: the plight of adolescents. In: Mundigo AI, Indriso C, eds. Abortion in
the developing world. New Delhi, Vistaar Publications, and London, Zed Books,
1999: 387-405.
70
AXEL I. MUNDIGO
Book ch.04.qxd 11.2.2005 10:38 Page 70
15. Paiewonsky D. Social determinants of induced abortion in the Dominican Republic. In:
Mundigo AI, Indriso C, eds. Abortion in the developing world. New Delhi, Vistaar
Publications, and London, Zed Books, 1999: 131-150.
16. Bulut A, Toubia N. Abortion services in two public sector hospitals in Istanbul,
Turkey: how well do they meet women’s needs? In: Mundigo AI, Indriso C, eds. Abortion
in the developing world. New Delhi, Vistaar Publications, and London, Zed
Books, 1999: 259-278 .
17. Akin A. Cultural and psychological factors affecting contraceptive use and abortion
in two provinces in Turkey. In: Mundigo AI, Indriso C, eds. Abortion in the developing
world. New Delhi, Vistaar Publications, and London, Zed Books, 1999: 191-211.
18. Elu MC. Between political debate and women’s suffering: abortion in Mexico. In:
Mundigo AI, Indriso C, eds. Abortion in the developing world. New Delhi, Vistaar
Publications, and London: Zed Books, 1999: 245-258.
19. Ehrenfeld N. Female adolescents at the crossroads: sexuality, contraception and abortion
in Mexico. In: Mundigo AI, Indriso C, eds. Abortion in the developing world.
New Delhi, Vistaar Publications, and London: Zed Books, 1999: 368-386.
20. Kwon Tai-Hwan, Kwang Hee J, Sung-nam C. Sexuality, contraception, and abortion
among unmarried adolescents and young adults: the case of Korea. In: Mundigo AI,
Indriso C, eds. Abortion in the developing world. New Delhi, Vistaar Publications,
and London: Zed Books, 1999: 346-367.
21. Cohen SA, Richards CL. The Cairo consensus: population, development and women.
International Family Planning Perspectives, 1994, 20 (4): 150-155.
22. Zamudio L, Rubiano N, Wartenberg L. The incidence and social and demographic
characteristics of abortion in Colombia. In: Mundigo AI, Indriso C, eds. Abortion in
the developing world. New Delhi, Vistaar Publications, and London: Zed Books,
1999: 407-446.
23. Alvarez Vasquez L, Garcia CT, Catasus S, Benitez ME, Martinez MT. Abortion practice
in a municipality of Havana, Cuba. In: Mundigo AI, Indriso C, eds. Abortion in
the developing world. New Delhi, Vistaar Publications, and London: Zed Books,
1999: 117-130.
24. Columbia University – Development Law and Policy Program. Declaration of Ethical
Principles of the Roundtable on Ethics, Population and Reproductive Health. New
York, 8-10 March 1994: 1-6. New York, Columbia University, 1994.1. Salter C, Johnston HB, Hengen N. Care for postabortion complications: saving
women’s lives. Population Report 1997, XXV: 1-31.
2. Rogo KO. Induced abortion in sub-Saharan Africa. East African Medical Journal
1993, 70: 386-395.
3. Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC. A comparison of results of
meta-analyses of randomized control trials and recommendations of clinical experts.
Treatments for myocardial infarction [see comments]. Journal of the American Medical
Association 1992, 268: 240-248.
Book ch.05.qxd 11.2.2005 10:39 Page 86
4. De Jonge ET, Pattinson RC, Makin JD, Venter CP. Is ward evacuation for uncomplicated
incomplete abortion under systemic analgesia safe and effective? A randomised
clinical trial [see comments]. South African Medical Journal 1994, 84: 481-483.
5. Dolian G, Ludicke F, Katchatrian N, Campana A, Morabia A. Contraception and
induced abortion in Armenia: a critical need for family planning programs in eastern
Europe [see comments] [published erratum appears in American Journal of Public
Health 1998, 88 (7): 1122]. American Journal of Public Health 1998, 88: 803-805.
6. Koster-Oyekan W. Why resort to illegal abortion in Zambia? Findings of a community-based
study in Western Province. Social Science and Medicine 1998, 46: 1303-
1312.
7. World Health Organization. Medical methods for termination of pregnancy. Geneva,
World Health Organization, 1997.
8. Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, eds. A clinician’s
guide to medical and surgical abortion. New York, Churchill Livingstone, 1999.
9. MacIsaac L, Grossman D, Balistreri E, Darney P. A randomized controlled trial of
laminaria, oral misoprostol, and vaginal misoprostol before abortion. Obstetrics and
Gynecology 1999, 93: 766-770.
10. Singh K, Fong YF, Prasad RN, Dong F. Randomized trial to determine optimal dose of
vaginal misoprostol for preabortion cervical priming. Obstetrics and Gynecology 1998,
92: 795-798.
11. Singh K, Fong YF, Prasad RN, Dong F. Evacuation interval after vaginal misoprostol
for preabortion cervical priming: a randomized trial. Obstetrics and Gynecology
1999, 94: 431-434.
12. Ngai SW, Chan YM, Tang OS, Ho PC. The use of misoprostol for pre-operative cervical
dilatation prior to vacuum aspiration: a randomized trial. Human Reproduction
1999, 14: 2139-2142.
13. Rubin GL, Cates W Jr, Gold J, Rochat RW, Tyler CW Jr. Fatal ectopic pregnancy after
attempted legally induced abortion. Journal of the American Medical Association
1980, 244: 1705-1708.
14. Sawaya GF, Grady D, Kerlikowske K, Grimes DA. Antibiotics at the time of induced
abortion: the case for universal prophylaxis based on a meta-analysis. Obstetrics and
Gynecology 1996, 87: 884-890.
15. Cates W Jr, Schulz KF, Grimes DA. Dilatation and evacuation for induced abortion in
developing countries: advantages and disadvantages. Studies in Family Planning 1980,
11: 128-133.
87
THE ROLE OF MEDICAL TECHNOLOGY
Book ch.05.qxd 11.2.2005 10:39 Page 87
16. MacKay HT, Schulz KF, Grimes DA. Safety of local versus general anesthesia for
second-trimester dilatation and evacuation abortion. Obstetrics and Gynecology
1985, 66: 661-665.
17. Liskin L. Complications of abortion in developing countries. Population Report 1980,
VIII: F105-F155.
18. Polgar S, Fried ES. The bad old days: clandestine abortions among the poor in New
York City before liberalization of the abortion law. Family Planning Perspectives
1976, 8: 125-127.
19. Goyaux N, Yace-Soumah F, Welffens-Ekra C, Thonneau P. Abortion complications in
Abidjan (Ivory Coast). Contraception 1999, 60: 107-109.
20. Costa SH. Commercial availability of misoprostol and induced abortion in Brazil.
International Journal of Gynaecology and Obstetrics 1998, 63 Suppl 1: S131-S139.
21. Coelho HL, Teixeira AC, Santos AP, Forte EB, Morais SM, La Vecchia C, et al. Misoprostol
and illegal abortion in Fortaleza, Brazil [published erratum appears in Lancet
1993, 341: 1486]. Lancet 1993, 341: 1261-1263.
22. Misago C, Fonseca W, Correia L, Fernandes LM, Campbell O. Determinants of abortion
among women admitted to hospitals in Fortaleza, North-Eastern Brazil. International
Journal of Epidemiology 1998, 27: 833-839.
23. Faundes A, Santos LC, Carvalho M, Gras C. Post-abortion complications after interruption
of pregnancy with misoprostol. Advances in Contraception 1996, 12: 1-9.
24. Stephenson P, Wagner M, Badea M, Serbanescu F. Commentary: the public health
consequences of restricted induced abortion – lessons from Romania [see comments].
American Journal of Public Health 1992, 82: 1328-1331.
25. Schuler L, Pastuszak A, Sanseverino TV, Orioli IM, Brunoni D, Ashton-Prolla P, et al.
Pregnancy outcome after exposure to misoprostol in Brazil: a prospective, controlled
study. Reproductive Toxicology 1999, 13: 147-151.
26. Blanchard K, Winikoff B, Ellertson C. Misoprostol used alone for the termination of
early pregnancy. A review of the evidence. Contraception 1999, 59: 209-217.
27. Thapa PJ, Thapa S, Shrestha N. A hospital-based study of abortion in Nepal. Studies
in Family Planning 1992, 23: 311-318.
28. Karman H. The paramedic abortionist. Clinical Obstetrics and Gynecology 1972, 15:
379-387.
29. Hord CE, Delano GE. The midwife’s role in abortion care. Midwifery 1994, 10: 131-141.
88
DAVID A. GRIMES
Book ch.05.qxd 11.2.2005 10:39 Page 88
30. Freedman MA, Jillson DA, Coffin RR, Novick LF. Comparison of complication rates
in first trimester abortions performed by physician assistants and physicians. American
Journal of Public Health 1986, 76: 550-554.
31. Grimes DA, Schulz KF, Cates W Jr. Prophylactic antibiotics for curettage abortion.
American Journal of Obstetrics and Gynecology 1984, 150: 689-694.
32. Prieto JA, Eriksen NL, Blanco JD. A randomized trial of prophylactic doxycycline for
curettage in incomplete abortion. Obstetrics and Gynecology 1995, 85: 692-696.
33. Seeras R. Evaluation of prophylactic use of tetracycline after evacuation in abortion
in Harare Central Hospital. East African Medical Journal 1989, 66: 607-610.
34. Nielsen S, Hahlin M. Expectant management of first-trimester spontaneous abortion
[see comments]. Lancet 1995, 345: 84-86.
35. Henshaw RC, Cooper K, el-Refaey H, Smith NC, Templeton AA. Medical management
of miscarriage: non-surgical uterine evacuation of incomplete and inevitable
spontaneous abortion [published erratum appears in British Medical Journal 1993,
306: 1303] [see comments]. British Medical Journal 1993, 306: 894-895.
36. Chung TK, Lee DT, Cheung LP, Haines CJ, Chang AM. Spontaneous abortion: a randomized,
controlled trial comparing surgical evacuation with conservative management
using misoprostol [see comments]. Fertility and Sterility 1999, 71: 1054-1059.
37. Cates W Jr. Legal abortion: the public health record. Science 1982, 215: 1586-1590.
38. Hale RW, Reich LA, Joiner JM, Pion RJ, Kobara T. Histopathologic evaluation of uteri
curetted by flexible suction cannula. American Journal of Obstetrics and Gynecology
1976, 125: 805-808.
39. Tan PM, Ratnam SS, Quek SP. Vacuum aspiration in the treatment of incomplete
abortion. Journal of Obstetrics and Gynaecology of the British Commonwealth 1969,
76: 834-836.
40. Verkuyl DA, Crowther CA. Suction v. conventional curettage in incomplete abortion.
A randomised controlled trial [see comments]. South African Medical Journal 1993,
83: 13-15.
41. Mahomed K, Healy J, Tandon S. A comparison of manual vacuum aspiration (MVA)
and sharp curettage in the management of incomplete abortion. International Journal
of Gynaecology and Obstetrics 1994, 46: 27-32.
42. Gupta U, Chitra R. Destructive operations still have a place in developing countries.
International Journal of Gynaecology and Obstetrics 1994, 44: 15-19.
89
THE ROLE OF MEDICAL TECHNOLOGY
Book ch.05.qxd 11.2.2005 10:39 Page 89
43. Lundsgaard-Hansen P, Collins JA, David-West AS, Lopez CG, Hantchef ZS, Lothe F,
et al. Use of plasma volume substitutes and plasma in developing countries. Bulletin
of the World Health Organization 1983, 61: 7-22.
44. Schulz KF, Grimes DA, Christensen DD. Vasopressin reduces blood loss from second-trimester
dilatation and evacuation abortion. Lancet 1985, 2: 353-356.
45. O’Brien P, el-Refaey H, Gordon A, Geary M, Rodeck CH. Rectally administered misoprostol
for the treatment of postpartum hemorrhage unresponsive to oxytocin and
ergometrine: a descriptive study [see comments]. Obstetrics and Gynecology 1998, 92:
212-214.
46. Burkman RT, Atienza MF, King TM. Culture and treatment results in endometritis following
elective abortion. American Journal of Obstetrics and Gynecology 1977, 128:
556-559.
47. Grimes DA, Cates W Jr, Selik RM. Fatal septic abortion in the United States, 1975-
1977. Obstetrics and Gynecology 1981, 57: 739-744.
48. Stubblefield PG, Grimes DA. Septic abortion [see comments]. New England Journal
of Medicine 1994, 331: 310-314.
49. Imoedemhe DA, Ezimokhai M, Okpere EE, Aboh IF. Intestinal injuries following
induced abortion. International Journal of Gynaecology and Obstetrics 1984, 22:
303-306.
50. Soderstrom RM. Bowel injury litigation after laparoscopy. Journal of the American
Association of Gynecologic Laparoscopists 1993, 1: 74-77.
51. Baako BN. Colostomy: its place in the management of colorectal injuries in civilian
practice. West African Journal of Medicine 1998, 17: 109-112.
52. Jha V, Malhotra HS, Sakhuja V, Chugh KS. Spectrum of hospital-acquired acute renal
failure in the developing countries – Chandigarh study. Quarterly Journal of Medicine
1992, 83: 497-505.
53. Burnhill MS. Treatment of women who have undergone chemically induced abortions.
Journal of Reproductive Medicine 1985, 30: 610-614.
54. Naqvi R, Akhtar F, Ahmed E, Shaikh R, Ahmed Z, Naqvi A, et al. Acute renal failure
of obstetrical origin during 1994 at one center. Renal Failure 1996, 18: 681-683.
55. Mate-Kole MO, Yeboah ED, Affram RK, Ofori-Adjei D, Adu D. Hemodialysis in the
treatment of acute renal failure in tropical Africa: a 20-year review at the Korle Bu
Teaching Hospital, Accra. Renal Failure 1996, 18: 517-524.
90
DAVID A. GRIMES
Book ch.05.qxd 11.2.2005 10:39 Page 90
56. Cate TR. Clostridium tetani (tetanus). In: Mandell GL, Douglas RG Jr, Bennett JE.
Principles and practice of infectious diseases. 3rd edition. New York, Churchill Livingstone,
1990: 1842-1846.
57. Ankomah A, Aloo-Obunga C, Chu M, Manlagnit A. Unsafe abortions: methods used
and characteristics of patients attending hospitals in Nairobi, Lima, and Manila.
Health Care for Women International 1997, 18: 43-53.
58. Okonofua F. Preventing unsafe abortion in Nigeria. African Journal of Reproductive
Health 1997, 1: 25-36. 1. Huntington D, Piet-Pelon NJ, eds. Postabortion care: lessons from operations
research. New York, Population Council, 1999.
2. Greenslade FC, Winkler J, Leonard AH. A framework for evaluating the quality
of postabortion care services. In: Huntington D, ed. Advances and challenges
in postabortion care: summary report of a global meeting. New York, Population
Council, 1998.
 3. Greenslade FC et al. Manual vacuum aspiration: a summary of clinical and programmatic
experience worldwide. Carrboro, NC, Ipas, 1993.
111
MEETING WOMEN’S HEALTH CARE NEEDS AFTER ABORTION
4. Huntington D et al. Improving the medical care and counseling of postabortion
patients in Egypt. Studies in Family Planning 1995, 26 (6): 350-362.
 5. Population Council/INOPAL III. Reproductive health operations research: 1995-
1998. Mexico City, Population Council/INOPAL III, 1998.
 6. Population Council/Africa OR/TA. Strengthening reproductive health services in
Africa through operations research: final report of the Africa Operations Research
and Technical Assistance Project II. Nairobi, Population Council, 1999: 63.
 7. Fuentes Valásquez J et al. A comparison of three models of postabortion care in
Mexico: final report. Mexico City, IMSS, Ipas, and Population Council, 1998.
 8. Huntington D, Nawar L, Abdel-Hady D. Women’s perceptions of abortion in Egypt.
Reproductive Health Matters 1997, 5 (9): 101-107.
 9. Solo J et al. Creating linkages between incomplete abortion treatment and family planning
services in Kenya. Studies in Family Planning 1999, 30 (1): 17-27.
 10. King T et al. Postabortion care in Latin America: a summary of operations research.
In: Reproductive health operations research. Mexico City, Population Council/
INOPAL III, 1998: 59-79.
 11. Margolis A, Leonard AH, Yordy L. Pain control for the treatment of incomplete
abortion with MVA. Advances in Abortion Care 1993, 3 (1): 1-8.
 12. Langer A et al. Improving postabortion care with limited resources in a public
hospital in Oaxaca, Mexico. In: Huntington D, Piet-Pelon NJ, eds. Postabortion care:
lessons from operations research. New York, Population Council, 1999: 81-107.
 13. Ministry of Health, Burkina Faso. Introduction of emergency medical treatment
and family planning services for women with complications from abortion in Burkina
Faso. Ougadougou, Population Council, 1998.
 14. Benson J et al. Improving quality and lowering costs in an integrated postabortion
care model in Peru: final report. Lima, Ipas and Population Council, 1998.
 15. Centre de Formation et de Recherche en Santé de la Reproduction (CEFOREP)
et Clinique Gynécologique et Obstétricale Chu A. le Dantec. Introduction des soins
obstétricaux d’urgence et de la planification familiale pour les patientes présentant
des complications liées à un avortement incomplet. Dakar, Senegal, Population Council,
1998 (in French).
 16. United Nations. Report of the International Conference on Population and Development,
Cairo, 5-13 September 1994. New York, United Nations, 1994.
 17. Billings D et al. Midwives and comprehensive postabortion care in Ghana. In:
Huntington D, Piet-Pelon NJ, eds. Postabortion care: lessons from operations
research. New York, Population Council, 1999: 141-156.
112
DALE HUNTINGTON
 18. Bashir A. Maternal mortality in Pakistan: a success story of the Faisalabad District.
IPPF Medical Bulletin 1991, 25 (2): 1-3.
 19. Girven S, Pollack A. Commentary on decentralization and scaling-up postabortion
care. Presentation at the 1998 Global Meeting on Postabortion Care Operations Research,
cited in Huntington D. Advances and challenges in postabortion care: summary report of
a global meeting. New York, Population Council, 1998.
 20. Huntington D et al. The postabortion caseload in Egyptian hospitals: a descriptive
study. International Family Planning Perspectives 1998, 24 (1): 25-31.
 21. Friedman A et al. An assessment of postabortion care (PAC) services in the Bolivian
public health system. Mexico City, Population Council, 1999.
 22. King T, Benson J, Stein K. Comparing the cost of postabortion care in Africa
and Latin America: the DATAPAC Project. Paper presented at the Global Meeting on
Postabortion Care Operations Research, New York, Population Council, 1998.
 23. Brambila C et al. Estimating costs of postabortion services at Dr. Aurelio Valdivieso
General Hospital, Oaxaca, Mexico. In: Huntington D, Piet-Pelon NJ, eds. Postabortion
care: lessons from operations research. New York, Population Council, 1999: 108-
124.
 24. Nawar L, Huntington D, Abdel Fattah MN. Cost analysis of postabortion services
in Egypt. In: Huntington D, Piet-Pelon NJ, eds. Postabortion care: lessons from
operations research. New York, Population Council, 1999: 125-140.
 25. Abdel-Tawab N et al. Effects of husband involvement on postabortion patients'
recovery and use of contraception in Egypt. In: Huntington D, Piet-Pelon NJ, eds.
Postabortion care: lessons from operations research. New York, Population Council,
1999: 16-37.
 26. Blaney CL. Involving men after pregnancy. FHI Network, 1997, 17 (4): 22-25.
 27. Huntington D. Advances and challenges in postabortion care: summary report of
a global meeting. New York, Population Council, 1998: 22-27.1. World Health Organization. Unsafe abortion. Global and regional estimates of
incidence of and mortality due to unsafe abortion with a listing of available country
data. Geneva, World Health Organization (forthcoming).
 2. Cook RJ, Dickens BM, Bliss LE. International developments in abortion law from
1988 to 1998. American Journal of Public Health 1999, 89 (4): 579-586.
 3. Rahman A, Katzive L, Henshaw SK. A global review of laws on induced abortion,
1985-1997. International Family Planning Perspectives 1998, 24 (2): 56-64.
 4. Boland, R. Abortion law and practice in Africa. Unpublished manuscript, 2002.
 5. Population Reference Bureau. Women of our world (Poster). Washington, DC,
Population Reference Bureau, 2002.
 6. UNICEF. Women’s health: An overview. UNICEF, 2000 [On-line]. http://www.
unicef.org/programme/health/index.htm.
 7. Archibong EI. Illegal induced abortion – a continuing problem in Nigeria. International
Journal of Gynecology and Obstetrics 1991, 34 (3): 261-265.
 8. Huntington D, Nawar L, Osman Hassan E, Youssef H, Abdel-Tawab N. The
postabortion caseload in Egyptian hospitals: a descriptive study. International Family
Planning Perspectives 1998, 24 (1): 25-31.
142
CHARLOTTE E. HORD, JANIE BENSON, JENNIFER L. POTTS & DEBORAH L. BILLINGS
 9. Konje J, Obisean KA, Ladipo O. Health and economic consequences of septic
induced abortion. International Journal of Gynecology and Obstetrics 1992, 37 (3):
193-197.
 10. Postabortion Care Consortium Community Task Force. Essential elements of
postabortion care: An expanded and updated model. PAC in Action # 2, Special Supplement,
September-2002.
 11. Ahiadeke C. Incidence of induced abortion in southern Ghana. International Family
Planning Perspectives 2001, 27 (2): 96-101,108.
 12. The Alan Guttmacher Institute. Sharing responsibility: Women, society and abortion
worldwide. New York, The Alan Guttmacher Institute, 1999.
 13. Rogo KO. Induced abortion in Sub-Saharan Africa. East African Medical Journal
1993, 70 (6): 386-395.
 14. Rogo KO, Lema VM, Rae GO. Postabortion care: Policies and standards for
delivering services in sub-Saharan Africa. Chapel Hill, NC, Ipas, 1999.
 15. Olukoya AA. Unsafe abortion in adolescents. Presentation made at Action to
Reduce Maternal Mortality in Africa: A regional consultation on unsafe abortion, 5-
7-March 2003, Addis Ababa, Ethiopia.
 16. The Population Council. Train more providers in postabortion care. OR Summaries
4, Senegal. Washington, DC, The Population Council, 2000.
 17. Rogo K, Bohmer L, Ombaka C. Community level dynamics of unsafe abortion in
western Kenya and opportunities for prevention: Summary of findings and recommendations
from pre-intervention research. Nairobi, Pacific Institute for Women’s Health
and Center for the Study of Adolescence, 1999.
 18. Kinoti SN, Gaffikin L, Benson J, Nicholson LA. Monograph on complications of
unsafe abortion in Africa. Arusha, Tanzania, Commonwealth Regional Health Community
Secretariat for East, Central and Southern Africa, 1995.
 19. Action to reduce maternal mortality in Africa. Communiqué from the regional
consultation on unsafe abortion, 5–7-March 2003, Addis Ababa, Ethiopia, 2003.
 20. Barometer. Johannesburg, South Africa, Reproductive Rights Alliance, 1999.
 21. Dickson-Tetteh K, Mavuya L, Mosotho G, Rees H, Billings DL, King TDN. Abortion
care services provided by registered midwives in South Africa: A report on the
midwifery training program. Bertsham, Reproductive Health Research Unit, Department
of Obstetrics and Gynaecology, Chris Hani Baragwanath Hospital, 2000.
 22. Republic of South Africa. Choice on Termination of Pregnancy Act, 1996. Government
Gazette, Vol. 377, No. 17602.
143
 UNSAFE ABORTION IN AFRICA: AN OVERVIEW AND RECOMMENDATIONS FOR ACTION
 23. Varkey SJ. Abortion services in South Africa: Available yet not accessible to all.
International Family Planning Perspectives 2000, 26 (2): 87-89.
 24. The Population Council. Upgrading postabortion care benefits patients and providers.
OR Summaries 3, Burkina Faso. Washington, DC, The Population Council,
2000.
25. Solo J, Billings DL, Aloo-Obunga C, Ominde A, Makumi M. Creating linkages
between incomplete abortion treatment and family planning services in Kenya. Studies
in Family Planning 1999, 30 (1): 17-27.
 26. Johnson BR, Ndhlovu S, Farr SL, Chipato T. Reducing unplanned pregnancy and
abortion in Zimbabwe through postabortion contraception. Studies in Family Planning
2002, 33 (2): 195-202.
 27. Billings DL, Ankrah V, Baird TL, Taylor JE, Ababio KPP, Ntow S. Midwives
and comprehensive postabortion care in Ghana. In: HuntingtonD, Piet-PelonN, eds.
Postabortion care: Lessons learned from operations research. New York, The Population
Council, 1999.
 28. PRIME. Postabortion care: Midwives expand service availability in sub-Saharan
Africa. Chapel Hill, NC, PRIME, 1999.
 29. Kiggundu C. Decentralising integrated postabortion care in Uganda: A pilot
training and support initiative for improving the quality and availability of integrated
reproductive health service. Chapel Hill, NC, PRIME, 1999.
 30. UNAIDS and WHO. AIDS Epidemic Update. Geneva, UNAIDS, December-2002.
 31. UNAIDS. Report on the global HIV/AIDS epidemic. Geneva, UNAIDS, 2000.
 32. United Nations Development Programme. Levels and trends of contraceptive use
as assessed in 1998. New York, UNDP, 1998.
 33. Westoff CF, Bankole A. Trends in the demand for family limitation in developing
countries. International Family Planning Perspectives 2000, 26 (2): 56-62 & 97.
 34. United Nations Development Programme. World Population 1998. Wallchart.
New York, UNDP, 1998.
 35. The Alan Guttmacher Institute. Into a new world. Young women’s sexual and
reproductive lives. New York and Washington, The Alan Guttmacher Institute, 1998.
 36. Radhakrishna A, Gringle RE, Greenslade FC. Identifying the intersection: Adolescent
unwanted pregnancy, HIV/AIDS and unsafe abortion. Issues in Abortion Care
4. Carrboro, NC, Ipas, 1997.
144
CHARLOTTE E. HORD, JANIE BENSON, JENNIFER L. POTTS & DEBORAH L. BILLINGS
 37. Mpangile GS, Leshabari MT, Kihwele DJ. Induced abortion in Dar es Salaam,
Tanzania: The plight of adolescents. In: Mundigo AI, Indriso C, eds. Abortion in the
developing world. London and New York, Zed Books, 1999: 387-403.
 38. Federal Ministry of Health and Social Services, Federal Government of Nigeria.
Nigeria country report for International Conference on Population and Development,
Cairo 1994. Lagos, Federal Ministry of Health and Social Services, 1994.
 39. Unuigbe JA, Oronsaye AU, Orhue AAE. Abortion-related morbidity and mortality
in Benin City, Nigeria: 1973-1985. International Journal of Gynecology and Obstetrics
1988, 26 (3): 435-439.
 40. Odejide TO. Offering an alternative to illegal abortion in Nigeria. New Nursing
Image International 1986, 2 (2): 39-42.
 41. Koster-Oyekan W. Why resort to illegal abortion in Zambia? Findings of a community-based
study in Western Province. Social Science and Medicine 1998, 46 (10):
1303-1312.
 42. United Nations High Commissioner for Refugees. Refugees and others of concern
to UNHCR-1998 statistical overview. Geneva, UNHCR, 1998.
 43. Reproductive Health for Refugees Consortium. Reproductive health care in refugee
settings. Factsheet. London, Marie Stopes International, 1998.
44. United Nations High Commissioner for Refugees. Reproductive health in refugee
situations, an inter-agency field manual. Geneva, UNHCR, 1999.
 45. United Nations Population Fund. Reproductive health for refugees and displaced
persons. The state of the world population. New York, UNFPA, 1999.
 46. EngenderHealth and Ipas. Taking postabortion care services to scale: quality, access,
sustainability. Report of an international workshop held in Mombasa, Kenya, 15-18-May
2000. Chapel Hill, NC, EngenderHealth and Ipas, 2000.
 47. World Health Organization. Safe abortion: technical and policy guidance for
health systems. Geneva, WHO, 2003.
 48. Fawcus S, McIntyre J, Jewkes RK, Rees H, Katzenellenbogen JM, Shabodien R,
Lombard CJ, Truter T, and the National Incomplete Abortion Study Reference Group.
Management of incomplete abortions at South African public hospitals. South African
Medical Journal 1997, 87 (4): 438-442.
 49. Kaseba C, Phiri D, Camlin C, Sanglivi H, Smith T, Chibuye P, Folsom M. The situation
of postabortion care in Zambia. Research Triangle Park, NC, Research Triangle
Institute, 1998.
145
 UNSAFE ABORTION IN AFRICA: AN OVERVIEW AND RECOMMENDATIONS FOR ACTION
 50. Mirembe F, Settergren S, Matatu T, Otto A, Folsom M. The situation of postabortion
care in Uganda. An assessment and recommendations. Research Triangle Park,
NC, Research Triangle Institute, 1997.
 51. Coyaji K. Early medical abortion in India: three studies and their implications for
abortion services. Journal of American Medical Women’s Association (Supplement)
2000: 191-194.
 52. Ngoc NTN, Winikoff B, Clark S, Ellertson C, Am KN, Hieu DT, Elul B. Safety,
efficacy and acceptability of mifepristone-misoprostol medical abortion in Vietnam.
International Family Planning Perspectives 1999, 25 (1): 10-14 & 33.
53. Winikoff B, Sivin I, Coyaji KJ, Cabezas E, Xiao B, Gu S, Du MK, Krishna
UR, Eschen A, Ellertson C. Safety, efficacy, and acceptability of medical abortion
in China, Cuba, and India: a comparative trial of mifepristone-misoprostol versus
surgical abortion. American Journal of Obstetrics and Gynecology 1997, 176 (2):
431-437.
 54. Hord C, Baird T, Billings DL. Advancing the role of midlevel providers in abortion
and postabortion care: a global review and key future actions. Issues in Abortion
Care 6. Chapel Hill, NC, Ipas, 1999.
 55. Ipas and IHCAR. Deciding women’s lives are worth saving: Expanding the role of
midlevel providers in safe abortion care. Issues in Abortion Care 7. Chapel Hill, NC,
Ipas, 2002.
 56. Billings DL, Baird TL, Ankrah V, Taylor JE, Ababio K. Training midwives to
improve postabortion care in Ghana: Major findings and recommendations from an
operations research project. Carrboro, NC, Ipas, 1999.
 57. Dickson-Tetteh K, Billings DL. Abortion care services provided by registered
midwives in South Africa. International Family Planning Perspectives 2002, 28 (3):
144-150.
 58. Baird T, Plewman C, Booth R, Tubi AM. Christian hospitals in Nigeria provide
postabortion care and STD management. Dialogue 1 (2). Chapel Hill, NC, Ipas,
1997.
 59. Otsea K. Prioritizing reproductive health for refugees. Initiatives in Reproductive
Health Policy 3 (1). Chapel Hill, NC, Ipas, 1999.
 60. United Nations High Commissioner for Refugees. Statistical Yearbook 2001.
Refugees, asylum-seekers and other persons of concern – Trends in displacement,
protection and solutions. Geneva, UNCHR, October-2002. Last accessed 6-May
2003 at http://www.unhcr.ch
 61. United Nations Population Division. Abortion policies. A global review, Vol. 3.
New York, UN Population Division, 2002.
146
CHARLOTTE E. HORD, JANIE BENSON, JENNIFER L. POTTS & DEBORAH L. BILLINGS
 62. Kay BJ, Katzenellenbogen J, Fawcus F, Karim S. An analysis of the cost of incomplete
abortion to the public health sector in South Africa - 1994. South African Medical
Journal 1997, 87(4): 442-447.
 63. Johnson BR, Benson J, Bradley J, Rábago Ordoñez A. Costs and resource utilization
for the treatment of incomplete abortion in Kenya and Mexico. Social Science
and Medicine 1993, 36 (11): 1443-1453.
64. De Pinho H, McIntyre DI. Cost analysis of abortions performed in the public health
sector. Cape Town, Department of Community Health, University of Cape Town,
1997.
 65. Republic of Ghana. National reproductive health service protocols. Accra, Ministry
of Health, 1996.
 66. Lassey AT. Complications of induced abortions and their preventions in Ghana.
East African Medical Journal 1995, 72 (12): 774-777.
 67. World Health Organization. Considerations for formulating reproductive health
laws. Second edition. Geneva, World Health Organization, document WHO/RHR/00.1,
2000.
 68. Marais T. Provisional overall results from abortion values clarification workshop
pilot study. Cape Town, Planned Parenthood Association, 1996.
 69. Stevens M. Abortion reform in South Africa. Initiatives in Reproductive Health
Policy 3 (2). Chapel Hill, NC, Ipas, 2000.
 70. Settergren S, Mhlanga C, Mpofu J, Ncube D, Woodsong C. Community perspectives
on unsafe abortion and postabortion care, Bulawayo and Hwange Districts, Zimbabwe.
Research Triangle Park, NC, Research Triangle Institute, 1999.
 71. Huntington D, Hassan EO, Attallah N, Toubia N, Naguib M, Nawar L. Improving
the medical care and counseling of postabortion patients in Egypt. Studies in Family
Planning 1995, 26 (6): 350-362.
 72. Greenslade F, Jansen WH. Postabortion care services: An update from PRIME.
Resources for Women’s Health 1 (2). Chapel Hill, NC, Ipas, 1998.
 73. Greenslade F, Leonard AH, Benson J, Winkler J, HendersonVL. Manual vacuum
aspiration: A summary of clinical and programmatic experience worldwide. Carrboro,
NC, Ipas, 1993.
 74. Ominde A, Makumi M, Billings DL, Solo J. Postabortion care services in Kenya:
Baseline findings from an operations research study. Nairobi, The Population Council,
1997.
 75. JHPIEGO; AVSC International. Trainers notes. Infection prevention for family
planning service programs. Videotape. Baltimore, Maryland, JHPIEGO, 1994.
147
 UNSAFE ABORTION IN AFRICA: AN OVERVIEW AND RECOMMENDATIONS FOR ACTION
 76. World Health Organization. Managing complications in pregnancy and childbirth.
A guide for midwives and doctors. Geneva, World Health Organization, 2003.
 77. Benson J, Leonard AH, Winkler J, Wolf M, McLaurin KE. Meeting women’s needs
for post-abortion family planning: Framing the questions. Issues in Abortion Care 2.
Carrboro, NC, Ipas, 1992.
 78. Salter C, Johnston HB, Hengen N. Care for postabortion complications: Saving
women’s lives. Population Reports, Series L (10), 1997.
 79. de Bruyn M. Reproductive choice and women living with HIV. Chapel Hill, NC, Ipas,
2002. Available on-line at: http://www.ipas.org/english/publications/repro_choice_hiv_
aids.pdf.
 Last accessed 5-May 2003.
 80. World Health Organization. Pregnancy and HIV. Factsheet No. 250. Geneva, WHO,
June-2000. Available on-line at http://www.who.int/inf-fs/en/fact250.html. Last accessed
5-May 2003.
 81. Solo J, Ominde A, Billings D. Creating linkages between incomplete abortion treatment
and family planning services in Kenya: What works best? Nairobi, The Population
Council, 1998.
 82. Huntington D, Lettenmaier C, Obeng-Quaidoo I. User’s perspective of counseling
training in Ghana: The “mystery client” trial. Studies in Family Planning 1990, 21 (3):
171-177.
 83. Verme CS, Harper PB, Misra G, Neamatalla GS. Family planning counseling: An
evolving process. International Family Planning Perspectives 1993, 19 (2): 67-71.
84. Abdel-Tawab N, Huntington D, Hassan EO, Youssef H, Nawar L. Effects of
husband involvement on postabortion patients' recovery and use of contraception in
Egypt. In: Huntington D, Piet-Pelon N, eds. Postabortion care: lessons learned from
operations research. New York, The Population Council, 1999.
 85. Terefe A, Larson CP. Modern contraception use in Ethiopia: Does involving husbands
make a difference ? American Journal of Public Health 1993, 83 (11): 1567-
1571.
 86. Bott S. Unwanted pregnancy and induced abortion among adolescents in developing
countries: Findings from WHO case studies. In: Puri C, Van Look P, eds. Sexual
and reproductive health: recent advances and future directions. New Delhi, New Age
International Limited, 2001: 351-366.
 87. Advocates for Youth. Adolescent sexuality in Nigeria. Washington, DC, Advocates
for Youth, 1995.
148
CHARLOTTE E. HORD, JANIE BENSON, JENNIFER L. POTTS & DEBORAH L. BILLINGS
 88. Mutungi AK, Wango EO, Rogo KO, Kimani VN, Karanja JG. Abortion: Behaviour
of adolescents in two districts in Kenya. East African Medical Journal 1999, 76 (10):
541-546.
 89. UNAIDS. Impact of HIV and sexual health education on the sexual behaviour of
young people: A review update. Geneva, UNAIDS, 1997.
 90. Ferguson A. School girl pregnancy in Kenya: Report of a study of discontinuation
rates and associated factors. Nairobi, Ministry of Health, Division of Family Health,
GTZ Support Unit, 1988.
 91. Emuveyan E. Profile of abortion in Nigeria. Paper presented at the Conference on
Unsafe Abortion and Post Abortion Family Planning in Africa, Mauritius, 24-28-March
1994.
92. Barker GK, Rich S. Influences on adolescent sexuality in Nigeria and Kenya: Findings
from recent focus-group discussions. Studies in Family Planning 1992, 23 (3): 199-210.
 93. Kyamureku PT. Contradictions in human rights and social attitudes: Case studies of
abortion in Uganda. Initiatives in Reproductive Health Policy 3 (2). Chapel Hill, NC,
Ipas, 2000.
 94. Lema V, Njau P. Abortion in Kenya: Traditional approach to unwanted pregnancy.
Nairobi, The Center for the Study of Adolescence, 1990.
 95. Agadjanian V. ‘Quasi-legal’ abortion services in a sub-Saharan setting: Users'
profile and motivations. International Family Planning Perspectives 1998, 24 (3):
111-116.
 96. Zambia: Termination of Pregnancy Act 1972. Act 26. International Digest of
Health Legislation 1973, 24: 448-449
 97. CEDAW (Convention on the Elimination of All Forms of Discrimination Against
Women). General Recommendation No. 24 regarding CEDAW Article 12 on Women
and Health, 1999.
 98. Seyoum Y. A survey of illegal abortion in Addis Ababa, Ethiopia. Unpublished
paper, funded by UNDP/UNFPA/WHO/World Bank Special Programme of Research,
Development and Research Training in Human Reproduction (HRP), 1993.
 99. Organisation of African Unity. Draft Protocol to the African Charter on Human
and Peoples’ Rights on the Rights of Women in Africa (as adopted by the Meeting of
Government Experts in Addis Ababa on 16-November 2001), 22-November 2001.
 100. United Nations. Report of the International Conference on Population and Development.
New York: United Nations, 1994 (Doc. A/Conf.171/13).
 101. United Nations. Report of the UN General Assembly Special Session to review
progress on ICPD after 5 years. New York: United Nations, 1999.1. Henshaw S, Singh S, Haas T. The incidence of abortion worldwide. International Family
Planning Perspectives 1999, 25 (Suppl): S30-S38.
2. Ganatra BR. Induced abortions: programmatic and policy implications of data emerging
from an ongoing study in rural Maharashtra, India. In: Puri C, Van Look P, eds.
Sexual and reproductive health: recent advances, future directions. New Delhi, New
Age International, 2000: 249-261.
3. WHO. Unsafe abortion: global and regional estimates of incidence of and mortality
due to unsafe abortion with a listing of available country data. Third edition. Geneva,
WHO Division of Reproductive Health (Technical Support), 1998 (document
WHO/RHT/MSM/97.16).
4. Kissling F. Abortion: the link between legality and safety. Reproductive Health Matters
1993, 1 (2): 65-67.
5. Rameseshan G. Women imprisoned for abortion in Nepal: report of a Forum Asia
fact-finding mission. Reproductive Health Matters 1997, 5 (10): 133-138.
6. Berer M. Making abortions safe: a matter of good public health policy. Bulletin of the
World Health Organization 2000, 78 (5): 580-592.
7. Rahman A, Katzive L, Henshaw SK. A global review of laws on induced abortion,
1985-1997. International Family Planning Perspectives 1998, 24 (2): 56-64.
8. Tamang A. Preventing unsafe abortions in Nepal: the post-legalization challenges.
Katmandu, Centre for Research on Environment, Health and Population Activities
(CREHPA), 2002.
9. CREHPA. Factors behind women’s imprisonment in Nepal with special reference to
women imprisoned for abortion. Katmandu, 1998 (unpublished).
10. Thapa P, Thapa S, Shrestha N. A hospital-based study of abortion in Nepal. Studies in
Family Planning 1992, 23 (5): 311-318.
11. Abeyesekera S. Abortion in Sri Lanka in the context of women’s human rights.
Reproductive Health Matters 1997, 5 (9): 87-93.
12. De Silva WI. The silent cry: socio-cultural and political factors influencing induced
abortion in Sri Lanka. Paper presented at the IUSSP Seminar on Socio-Cultural and
Political Aspects of Abortion from an Anthropological Perspective, Trivandrum, Kerala,
India, 1996.
13. CREHPA (Centre for Research on Environment, Health and Population Activities).
Opinion poll survey on abortion rights for women. Katmandu, 1996 (unpublished).
173
UNSAFE ABORTION IN SOUTH AND SOUTH-EAST ASIA
Book ch.08.qxd 11.2.2005 10:41 Page 173
14. Hull T, Sarwono S, Widyantoro N. Induced abortion in Indonesia. Studies in Family
Planning 1993, 24 (4): 241-250.
15. Sundstrom K. Abortion across social and cultural borders. Paper presented at the
IUSSP Seminar on Socio-Cultural and Political Aspects of Abortion from an Anthropological
Perspective. Trivandrum, Kerala, India, 1996.
16. Nepal B. Abortion: perceptions and knowledge about safe conditions among rural
women in Nepal. Katmandu, CREHPA, 1998.
17. Gupte M, Bandewar S, Pisal H. Abortion needs of women in India: a case study of
rural Maharashtra. Reproductive Health Matters 1997, 5 (9): 77-86.
18. Amin S. Menstrual regulation in Bangladesh. Paper presented at an IUSSP Seminar
on Socio-Cultural and Political Aspects of Abortion from an Anthropological Perspective,
Trivandrum, Kerala, India, 1996.
19. Piet-Pelon NJ. Menstrual regulation impact on reproductive health in Bangladesh: a
literature review. Final report. Dhaka, Asia & Near East Operations Research and
Technical Assistance Project, Population Council Bangladesh, 1997.
20. Khan ME, Barge S, Kumar N, Almroth S. Abortion in India: current situation and
future challenges. In: Pachauri S, ed. Implementing a reproductive health agenda in
India: the beginning. New Delhi, Population Council, 1999: 507-529.
21. Barge S, Khan ME, Rajagopal S, Kumar N, Kumber S. Availability and quality of
MTP services in Gujarat, Maharashtra, Tamil Nadu and Uttar Pradesh: an in-depth
study. Paper presented at the International Workshop on Abortion Facilities and PostAbortion
Care in the Context of RCH Programme, New Delhi, 1998.
22. Chhabra R, Nuna C. Abortion in India: an overview. New Delhi, Ford Foundation,
1994.
23. Ankomah A, Aloo-Obunga C, Chu M, Manlagnit A. Unsafe abortions: methods used
and characteristics of patients attending hospitals in Nairobi, Lima and Manila.
Health Care for Women International 1997, 18 (1): 43-53.
24. Ahmed S, Islam A, Khanum P, Barkat-e-Khuda. Induced abortion: what’s happening
in rural Bangladesh. Reproductive Health Matters 1999, 7 (14): 19-27.
25. Ravindran TK. Women and the politics of population and development in India.
Reproductive Health Matters 1993, 1 (1): 26-38.
26. Bankole A, Singh S, Haas T. Characteristics of women who obtain induced abortion:
a worldwide review. International Family Planning Perspectives 1999, 25 (2): 68-77.
27. Bankole A, Singh S, Haas T. Reasons why women have induced abortions: evidence
from 27 countries. International Family Planning Perspectives 1998, 24 (3): 117-127.
174
BELA GANATRA
Book ch.08.qxd 11.2.2005 10:41 Page 174
28. Ganatra BR. Abortion research in India: What we know. What we need to know. In:
Jejeebhoy S, Ramasubban R, eds. Women’s reproductive health in India. New Delhi,
Rawart Publications, 2000: 186-235.
29. Trong Hieu D, Hanenberg R, Huu Vach T, Quang Vinh D, Sokal D. Maternal mortality
in Vietnam in 1994-95. Studies in Family Planning 1999, 30 (4): 329-338.
30. Belanger D, Hong KT. Young single women using abortion in Hanoi, Viet Nam. Asia
Pacific Population Journal 1998, 13 (2): 3-26.
31. Belanger D, Hong KT. Single women’s experiences of sexual relationships and abortion
in Hanoi, Vietnam. Reproductive Health Matters 1999, 7 (14): 71-82.
32. Tai-hwan K, Hee JK, Sung-nam C. Sexuality, contraception and abortion among
unmarried adolescents and young adults: the case of Korea. In: Mundigo A, Indriso
C. eds. Abortion in the developing world. New Delhi, Vistaar Publications, 1999: 346-
367.
33. Alan Guttmacher Institute. Sharing responsibility: women, society and abortion
worldwide. New York, AGI, 2000.
34. Fikree F, Rizvi N, Jamil S, Hussain T. The emerging problem of induced abortions in
squatter settlements of Karachi, Pakistan. Demography India 1996, 25 (1): 119-130.
35. Kaufman J. Cost of IUD failure in China. Studies in Family Planning 1993, 24 (3):
194-196.
36. Luo L, Wu SZ, Chen XQ, Li MX. First-trimester induced abortion: a study of Sichuan
Province, China. In: Mundigo A, Indriso C, eds. Abortion in the developing world.
New Delhi, Vistaar Publications, 1999: 98-116.
37. Gui SX. Factors affecting induced abortion behavior among married women in
Shanghai. In: Mundigo A, Indriso C. eds. Abortion in the developing world. New
Delhi, Vistaar Publications, 1999: 78-97.
38. Zhou WJ, Gao ES, Yang YY, Qin F, Tang W. Induced abortion and outcome of subsequent
pregnancy in China: client and provider perspectives. In: Mundigo A, Indriso C,
eds. Abortion in the developing world. New Delhi, Vistaar Publications, 1999: 228-
244.
39. Abeykoon A. Sex preference in South Asia: Sri Lanka an outlier. Asia-Pacific Population
Journal 1995, 10 (3): 5-16.
40. Bautista MI. Historical influences on gender preferences in the Philippines. Journal
of Comparative Family Studies 1988, 9 (1): 143-153.
41. Wongboonsin K, Prachuabmoh RV. Sex preference for children in Thailand and some
other South-East Asian countries. Asia-Pacific Population Journal 1995, 10 (3): 43-62.
175
UNSAFE ABORTION IN SOUTH AND SOUTH-EAST ASIA
Book ch.08.qxd 11.2.2005 10:41 Page 175
42. Westley SB. Evidence mounts for sex-selective abortion in Asia. Asia-Pacific Population
and Policy 1995, 34: 1-4.
43. Booth B, Verma M, Beri R. Foetal sex determination in infants in Punjab, India: correlations
and implications. British Medical Journal 1994, 309: 1259-1261.
44. Park C, Cho N. Consequences of son preference in a low-fertility society: imbalance
of the sex ratio at birth in Korea. Population and Development Review 1995, 21: 59-
84.
45. Freedman R, Chang M, Sun T. Taiwan's transition from high fertility to belowreplacement
levels. Studies in Family Planning 1994, 25 (6): 317-331.
46. Gu B, Li Y. Sex ratio at birth and son preference in China. Paper presented at the
UNFPA/KIHASA International Symposium on Issues Related to Sex Preference for
Children in the Rapidly Changing Demographic Dynamics in Asia, Seoul, Republic
of Korea, 21-24 November 1994.
47. Gu B, Roy K. Sex ratio at birth in China, with reference to other areas in East Asia:
what we know. Asia-Pacific Population Journal 1995, 10 (3): 17-42.
48. Khanna SK. Traditions and reproductive technology in an urbanizing north Indian village.
Social Science and Medicine 1997, 44 (2): 171-180.
49. Ganatra BR, Hirve SS, Rao VN. Sex-selective abortion: evidence from a communitybased
study in western India. Asia-Pacific Population Journal 2001, 16 (2): 109-124.
50. Junhong C. Prenatal sex determination and sex-selective abortion in Central China.
Population and Development Review 2001, 27 (2): 259-281.
51. Tamang A, Nepal B. Unwanted pregnancies, sex determination tests and sex-selective
abortions in urban areas of Nepal: medical practitioners’ perspectives. Katmandu,
CREHPA, 2000 (unpublished).
52. Belanger D. Sex-selective abortions: short-term and long-term perspectives. Reproductive
Health Matters 2002, 10 (9): 194-197.
53. Goodkind D. Sex preference for children in Vietnam. Paper presented at the
UNFPA/KIHASA International Symposium on Issues Related to Sex Preference for
Children in the Rapidly Changing Demographic Dynamics in Asia, Seoul, Republic
of Korea, 21-24 November 1994.
54. Miller B. Chasing equality: the politics of sex selective abortion in Asia. Paper presented
at a seminar on socio-cultural and political aspects of abortion from an anthropological
perspective. Trivandrum, Kerala, India, IUSSP, 1996.
55. Sinha R, Khan ME, Patel BC, Lakhanpal S, Khanna P. Decision-making in acceptance
and seeking abortion of unwanted pregnancies. Paper presented at the Interna-
176
BELA GANATRA
Book ch.08.qxd 11.2.2005 10:41 Page 176
tional Workshop on Abortion Facilities and Post-Abortion Care in the Context of the
RCH Programme, New Delhi, 1998.
56. Johansson A, Nga N T, Huy T Q, Du Dat D, Holmgren K. Husband’s involvement in
abortion in Vietnam. Studies in Family Planning 1998, 29 (4): 400-413.
57. Rosenberg M, Rochat R, Jabeen S, Measham A, Obaidullah M, Khan A. Attitudes of
rural Bangladesh physicians toward abortion. Studies in Family Planning 1981, 12
(8/9): 318-321.
58. Asif R, Sinha S, Yunus M, Zaheer M, Mohsin S. Contraceptive behaviour in women
carrying an unwanted pregnancy. Journal of Family Welfare 1994, 40 (2): 26-30.
59. Institute for Social Studies and Action. Women and abortion. Quezon City, Philippines,
ISSA, 1995 (unpublished monograph).
60. Johansson A, Tuyet Le Thi Nam, The Lap N, Sundstrom K. Abortion in context:
women’s experience in two villages in Thai Binh Province, Vietnam. International
Family Planning Perspectives 1996, 22 (3): 103-107.
61. Ping T, Smith H. Determinants of induced abortion and their policy implications in
four countries. Studies in Family Planning 1995, 26 (5): 279-286.
62. Ganatra BR, Hirve SS. Induced abortions among adolescent women in rural Maharashtra,
India. Reproductive Health Matters 2002, 10 (19): 76-85.
63. Fauveau V, Blanchet T. Deaths from injuries and induced abortion among rural
Bangladeshi women. Social Science and Medicine 1989, 29 (9): 1121-1127.
64. Purandare VN, Chaudhary RF, Raote V, Krishna U. A study of psychosocial factors of
out-of-wedlock pregnancies. Journal of Obstetrics and Gynaecology of India 1979,
29 (2): 303-307.
65. Yang X, Yukun H, Lijun B, Xiuhua J. Determinants of unwanted pregnancy and abortion
in Beijing. China Reproductive Matters 1995, 5: 95-103.
66. Singh S, Wulf D, Jones H. Health professionals’ perceptions about induced abortion
in South Central and South-east Asia. International Family Planning Perspectives
1997, 23 (2): 59-67.
67. Le Grande A. The abortion pill: a solution for unsafe abortions in developing countries?
Social Science and Medicine 1992, 35 (6): 767-776.
68. Lakshmi R, Pelto B. The role of village health nurses (VHNs) in mediating medical
termination of pregnancy in Tamil Nadu (unpublished, 1999).
69. Gupte M, Bandewar S, Pisal H. Women’s perspectives on the quality of health care:
evidence from rural Maharashtra. In: Koenig MA, Khan ME, eds. Quality of care
177
UNSAFE ABORTION IN SOUTH AND SOUTH-EAST ASIA
Book ch.08.qxd 11.2.2005 10:41 Page 177
within the Indian Family Welfare Programme. New York, Population Council, 1999:
117-139.
70. Ngoc N, Winikoff B, Clark S, Ellertson C, Am K, Hieu Do, Elul B. Safety, efficacy
and acceptability of mifepristone-misoprostol medical abortion in Vietnam. International
Family Planning Perspectives 1999, 25 (1): 10-14.
71. Winikoff B, Sivin I, Coyaji KJ, Cabezas E, Xiao B, Gu S, Du MK, Krishna UR,
Eschen A, Ellertson C. Safety, efficacy, and acceptability of medical abortion in
China, Cuba and India: a comparative trial of mifepristone-misoprostol versus surgical
abortion. American Journal of Obstetrics and Gynecology 1997, 176 (2): 431-437.
72. Winikoff B, Sivin I, Coyaji KJ, Cabezas E, Xiao B, Gu S, Du MK, Krishna UR,
Eschen A, Ellertson C. The acceptability of medical abortion in China, Cuba and
India. International Family Planning Perspectives 1997, 23 (2): 73-78 & 89.
73. Wu S. Medical abortion in China. Journal of the American Medical Women’s Association
2000, 55 (3) Suppl: 197-200.
74. Ellertson C, Elul B, Winikoff B. Can women use medical abortion without medical
supervision ? Reproductive Health Matters 1997, 5 (9): 149-161.
75. Coyaji K. Early medical abortion in India: three studies and their implications for
abortion services. Journal of the American Medical Women’s Association 2000, 55
(3): 191-194.
76. Ellertson C, Elul B, Ambardekar S, Wood L, Carroll J, Coyaji K. Accuracy of assessment
of pregnancy duration by women seeking early abortions. Lancet 2000, 355:
877-881.
77. Elul B, Hajri S, Ngoc N, Ellertson C, Stama C, Pearlman E, Winikoff B. Can women
in less developed countries use a simplified medical abortion regimen? Lancet 2001,
357: 1402-1405.
78. Harper C, Winikoff B, Ellertson C, Coyaji K. Blood loss with mifepristone-misoprostol
abortion: measures from a trial in China, Cuba and India. International Journal
of Gynecology and Obstetrics 1998, 63 (1): 39-49.
79. Ba-Thike K. Abortion: a public health problem in Myanmar. Reproductive Health
Matters 1997, 5 (9): 94-100.
80. Fauveau V, Mamadani M, Steinglass R, Koblinsky M. Maternal tetanus: magnitude,
epidemiology and potential control measures. International Journal of Gynecology
and Obstetrics 1993, 40 (1): 3-12.
81. Rochat R, Akhter H. Tetanus and pregnancy-related mortality in Bangladesh. Lancet
1999, 354: 565.
178
BELA GANATRA
Book ch.08.qxd 11.2.2005 10:41 Page 178
82. Khan HK, Khanam ST, Nahar S, Nasrin T, Rahman APM. Review of availability and
use of emergency obstetric care (EOC) services in Bangladesh. Prepared by Associates
for Community and Population Research, Dhaka, Bangladesh, 2000.
83. Mittal S, Misra S. Morbidity of electively induced abortion with concurrent contraception.
Journal of Obstetrics and Gynaecology of India 1985, 35 (3): 513-515.
84. Upreti A, Tamang A, Nepal B, Gurung R. Management of abortion-related complications
in hospitals of Nepal: a situation analysis. Katmandu, CREHPA, 1999.
85. Gupta J. People like you never agree to get it: an Indian family planning clinic. Reproductive
Health Matters 1993, 1 (1): 39-43.
86. Thang N, Johnson B, Landry E, Columbia R. Client perspectives on quality of reproductive
health services in Vietnam. Asia-Pacific Population Journal 1998, 13 (4): 3-
54.
87. Divekar S, Natrajan G, Purandare VN. Repeat MTPs: a psychosocial review. Health
and Population Perspectives and Issues 1981, 4 (3): 199-211.
88. Malla K, Kishore S, Padhye S. Establishment of postabortal care services in Nepal.
Baltimore, MD, JHPIEGO Corporation, 1995: 1-9.
89. Dixon-Mueller R. Abortion is a method of family planning. Four essays on birth control
needs and risks. New York, International Women’s Health Coalition, 1993.
90. United Nations. Abortion policies: a global review. Volume I: Afghanistan to France.
New York, UN Population Division, 2001.
91. United Nations. Abortion policies: a global review. Volume II: Gabon to Norway.
New York, UN Population Division, 2001.
92. United Nations. Abortion policies: a global review. Volume III: Oman to Zimbabwe.
New York, UN Population Division, 2002.
93. World Health Organization. Women of South-East Asia: a health profile. New Delhi,
SEARO, 2000.
94. Cadelina F. Induced abortions in a Province in the Philippines: the opinion, role and
experience of traditional birth attendants and government midwives. In: Mundigo A,
Indriso C. eds. Abortion in the developing world. New Delhi, Vistaar Publications,
1999: 311-320.
95. Djohan E, Indrawasih R, Adenan M, Yudomustopo H, Tan M. The attitude of health
providers towards abortion in Indonesia. Reproductive Health Matters 1993, 1 (2):
32-38.
96. Anonymous. Malaysia: changes in abortion law. Lancet 1990, 335: 1209.
179
UNSAFE ABORTION IN SOUTH AND SOUTH-EAST ASIA
Book ch.08.qxd 11.2.2005 10:41 Page 179
97. Hong NT, Huu NV, Mai Do, Ha DQ. The impact of abortion laws on maternal mortality:
a comparison of Bangladesh, Philippines and Vietnam. Hanoi, The Population
Council, 2000.
98. Luo L, Wu SZ, Chen XQ, Li MX. Induced abortion among unmarried women in
Sichuan Province, China. In: Mundigo A, Indriso C, eds. Abortion in the developing
world. New Delhi, Vistaar Publications, 1999: 337-345.
99. Koenig M, Fauveau V, Chowdhury A, Chakraborty J. Maternal mortality in Matlab,
Bangladesh: 1976-85. Studies in Family Planning 1988, 19 (2): 69-75.
100. Alauddin M. Maternal mortality in rural Bangladesh: the Tangail District. Studies in
Family Planning 1986, 17 (1): 13-21.
101. Khan AR, Rochat RW, Jahan FA, Begum SF. Induced abortion in a rural area of
Bangladesh. Studies in Family Planning 1986, 17 (2): 95-99.
102. Norbhu H. A retrospective study of maternal mortality at General Hospital, Thimphu
between 1976-87. Unpublished, 1988 (document WHE 2724)
103. Registrar General of India. Sample Registration System Bulletin 2000, 33 (1): 8 (Vital
Statistics Division, Government of India).
104. Bhatt RV. Maternal mortality in India: FOGSI/WHO study. Journal of Obstetrics and
Gynaecology of India 1997, 47 (3): 207-214.
105. Ganatra BR, Coyaji K, Rao V. Too far, too little, too late: a community-based casecontrol
study of maternal mortality in rural west Maharashtra. Bulletin of the World
Health Organization 1998, 76 (6): 591-598.
106. Kumar R, Agarwal AK. Rapid survey for measuring the level and causes of maternal
mortality. Indian Journal of Community Medicine 1997, 12 (1): 16-21.
107. Bhatia JC. Levels and causes of maternal mortality in southern India. Studies in Family
Planning 1993, 24 (5): 310-318.
108. Fortney JA. Causes of death to women of reproductive age in two developing countries.
Population Research and Policy Review 1987, 6 (2): 137-148.
109. Fauveau V. The Lao People’s Democratic Republic: maternal mortality and female
mortality: determining causes of death. World Health Statistics Quarterly 1995, 48
(1): 44-46.
110. Khin Kyi M. Maternal mortality at the Women's and Children's Hospital, South
Okkalapa (1978-1982). Australian and New Zealand Journal of Obstetrics and
Gynaecology 1988, 28 (1): 36-40.
111. Ministry of Health, His Majesty’s Government of Nepal. Maternal mortality and morbidity
study. Katmandu, Family Health Division, Dept. of Health Services, 1998.
180
BELA GANATRA
Book ch.08.qxd 11.2.2005 10:41 Page 180
112. Fikree FF, Midhet F, Sadruddin S, Berendes HW. Maternal mortality in different Pakistani
sites: ratios, clinical causes and determinants. Acta Obstetricia et Gynecologica
Scandinavica 1997, 76 (7): 637-645.
113. Bashir A, Aleem M, Mustansar M. A 5-year study of maternal mortality in Faisalabad
City, Pakistan. International Journal of Gynecology and Obstetrics 1995, 50 (Suppl
2): S93-S96.
114. Phuapradit W, Sirivongs B, Chaturachinda K. Maternal mortality in Ramathibodi
Hospital: a 14-year review. Journal of the Medical Association of Thailand 1985, 68
(12): 654-658.1. Mundigo A, Indriso C. eds. Abortion in the developing world. London, Zed Books,
1999.
2. Zamudio L, Rubiano N. Aspectos metodologicos. In: Encuentro de investigadores
sobre aborto inducido en America Latina y el Caribe. Santafe de Bogota, Colombia,
Universidad Externado de Colombia, 1994: 34-42.
3. Zamudio L, Rubiano N. Conclusiones y recomendaciones. In: Encuentro de investigadores
sobre aborto inducido en America Latina y el Caribe. Santafe de Bogota,
Colombia, Universidad Externado de Colombia, 1994: 80-92.
4. Huntington D, Piet-Pelon N. Postabortion care: lessons from operations research.
New York, The Population Council, 1999.
Book ch.09.qxd 11.2.2005 10:42 Page 201
5. Frejka T, Atkin LC, Toro OL. Research program for the prevention of unsafe induced
abortion and its adverse consequences in Latin America and the Caribbean. The Population
Council, Latin America and the Caribbean Regional Office, 1989. (Working
Papers/Documentos de Trabajo No. 23).
6. Frejka T. A conceptual framework for the study of induced abortion: defining methodological
approaches. In: Coeytaux F, Leonard A, Royston E, eds. Methodological
issues in abortion research. New York, Population Council, 1989: 3-8.
7. Weisner M. Fecundidad y aborto provocado en mujeres Chilenas de sectores populares
desde la perspectiva de la antropología medica. Enfoques 1988, 3 (3): 23-31 (in
Spanish).
8. Benson J et al. Senderos hacia el aborto en una comunidad peri-urbana Mexicana
[Paths towards abortion in a peri-urban Mexican community.] Mexico, Universidad
del Estado de Mexico, 1996 (in Spanish).
9. Palma Y, Núñez L. Encuesta sobre Salud Reproductiva 1991. Estudio realizado para
el Consejo Nacional de Poblacion (CONAPO), Mexico, 1991 (in Spanish).
10. Paz O. Algunas reflexiones sobre el aborto en Mexico. Mexico, Miguel Angel Porrua,
1976 (in Spanish).
11. Alan Guttmacher Institute. Aborto clandestino: una realidad Latinoamericana. New
York, The Alan Guttmacher Institute, 1994 (in Spanish).
12. Zamudio L, Rubiano N, Wartenberg L. The incidence and social and demographic
characteristics of abortion in Colombia. In: Mundigo A, Indriso C, eds. Abortion in
the developing world. London, England, Zed Books, 1999: 407-446.
13. Romero M, Lopez Carrillo L, Langer A. Determinantes del aborto en adolescentes
mexicanas. In: Encuentro de investigadores sobre aborto inducido en America Latina
y el Caribe. Santafe de Bogota, Colombia, Universidad Externado de Colombia,
1994: 66-79.
14. Zamudio L, Rubiano N. Determinantes del aborto y factores asociados. In: Encuentro
de investigadores sobre aborto inducido en America Latina y el Caribe. Santafe
de Bogota, Colombia, Universidad Externado de Colombia, 1994: 56-65.
15. Alvarez L, Garcia CT, Catasus S, Benitez ME, Martinez MT. Abortion practice in a
municipality of Havana, Cuba. In: Mundigo A, Indriso C, eds. Abortion in the developing
world. London, England, Zed Books, 1999: 117-130.
16. Ehrenfeld N. La atención a victimas de abuso sexual en la voz de los prestadores/as
de servicios de salud: conceptos y subjetividades. Mexico, 2000 (Working Paper) (in
Spanish).
202
YOLANDA PALMA, ELSA LINCE & RICARDO RAYA
Book ch.09.qxd 11.2.2005 10:42 Page 202
203
PRIORITIES FOR RESEARCH AND ACTION IN LATIN AMERICA AND CARIBBEAN
17. Singh S, Sedgh G. The relationship of abortion to trends in contraception and fertility
in Brazil, Colombia and Mexico. International Family Planning Perspectives 1997,
23 (1): 4-14.
18. Palma Y, Palma J. Las encuestas de fecundidad en Mexico. Trabajo presentado en la
VI Reunion de Investigadores de la Sociedad Mexicana en Demografia (SOMEDE),
Mexico, 2000 (in Spanish).
19. Casterline J. Collecting data on abortion using national surveys. In: Coeytaux F,
Leonard A, Royston E, eds. Methodological issues in abortion research. New York, Population
Council, 1989: 39-42.
20. Huntington D, Mensch B, Miller V. 1996. Survey questions for the measurement of
induced abortion. Studies in Family Planning 27(3): 155–161.
21. Weisner M. Reproductive behavior and induced abortion in Chilean women: an
anthropological perspective. Department of Anthropology, Faculty of Social Sciences,
University of Chile, Santiago, Chile, 1989 (Working Paper).
22. Wolf M, Benson J. Meeting women’s needs for post-abortion family planning. Report
of a Bellagio Technical Working Group. International Journal of Gynecology and
Obstetrics 1993, 45 (Supplement): 1-34.
23. Langer A et al. Improving post-abortion care in a public hospital in Mexico: changes
in practices and views from women and providers. New York, The Population Council,
1998 (Working Document No. 14).
24. Langer A et al. Sí se puede: cómo mejorar la calidad de atención postaborto en un
hospital público. El caso de Oaxaca, Mexico (Documento de Trabajo No. 11). New
York, The Population Council, 1998 (in Spanish).
25. Arellano E. Entorno psicosocial que dificulta la elaboracion de duelo en el aborto.
Mexico, UNAM, Faculty of Psychology, 1998 (Thesis: in Spanish).
26. Johnson BR, Benson J, Bradley J, Rabago Ordonez A, Zambrano C, Okoko L, Vazquez
Chavez L, Quiroz P, Rogo K. Costs of alternative treatments for incomplete abortion.
Washington, D.C., World Bank, Population and Human Resources Department, 1993.
27. United Nations. World Abortion Policies 1999. New York, Population Division,
Department of Economic and Social Affairs, United Nations, 1999.
28. World Health Organization. Unsafe abortion. Regional estimates of incidence and
mortality due to unsafe abortion with a listing of available country data. Third edition
Geneva, World Health Organization, 1998.
29. Henshaw S, Singh S, Haas T. The incidence of abortion worldwide. International
Family Planning Perspectives 1999, 25 (Supplement): 30-38.(1) Unless otherwise indicated in a footnote, if an abortion is authorized on request, it is presumed
that an abortion can be performed for any of the conditions listed in the table, even
if the law does not specifically mention the condition.
(2) The total fertility rate (TFR) is the average number of children that would be born alive to
a woman during her lifetime if she were to pass through all her childbearing years conforming
to the age-specific fertility rates of a given year.
(3) The maternal mortality ratio is the number of women who die as a result of childbearing
in a given year per 100 000 births in that year.
(4) Abortion deaths as a percentage of all maternal deaths (proportion of maternal deaths)
(5) The abortion laws in these countries allow abortions to be performed to preserve the health
of the woman, but do not differentiate between physical and mental health indications.
(6) The abortion laws in these countries either expressly allow abortions to be performed only
to save the life of the woman, or are governed by general principles of criminal legislation
which allow abortion to be performed for this reason on the ground of necessity. In addition,
the holding of the British case of R. v. Bourne or local applications of that decision
apply. Under the decision, the ground of necessity was interpreted to encompass abortions
performed on physical and mental health grounds.
(7) The abortion laws in these countries do not expressly allow abortions to be performed to
save the life of the woman, but general principles of criminal legislation allow abortions to
be performed for this reason on the ground of necessity.
(8) The abortion laws in these countries have been amended to remove all indications for the
legal performance of abortions; however, it is not clear whether a defence of necessity
might be allowed to justify an abortion performed to save the life of the woman.
(9) The criminal laws of these countries provide that medical and surgical treatment performed
in good faith is legal even though it involves abortion.
(10) The Honduras Penal Code makes no exceptions to the general prohibition on the performance
of abortions; the Code of Medical Ethics, however, allows abortions to be performed
for therapeutic purposes.
(11) Abortion in Mexico is determined at the state level. The grounds checked refer only to the
abortion law of the Federal District; some other states allow abortions to be performed on
grounds (2), (3), (5) and (6).
(12) Nicaragua’s abortion law allows the performance of "therapeutic abortions", but does not
specify which abortions are therapeutic.
(13) Abortions are also authorized for serious health reasons that endanger the life of the “product
of conception”.
Book ch.09.qxd 11.2.2005 10:42 Page 206
207
PRIORITIES FOR RESEARCH AND ACTION IN LATIN AMERICA AND CARIBBEAN
(14) There is controversy over whether the text of the Argentine Penal Code can be interpreted
to allow abortion to be performed for a woman who has been raped or only in the case of
the rape of a mentally retarded woman or an insane woman.
(15) Abortions are allowed to be performed on the ground of rape or incest in the case of a mentally
retarded or insane woman.
(16) In cases of severe economic hardship, the penalty for performing an abortion illegally may
be reduced or waived.
Sources:
Department of Economic and Social Affairs, United Nations, 1999 (27).
Unsafe abortion. Global and regional estimates of incidence of and mortality due to unsafe
abortion with a listing of available country data. WHO, 1998 (28).References
1. WHO Regional Office for Europe (Sexuality and Family Planning) & UNFPA (Division
for Arab States and Europe). From abortion to contraception. Family planning
and reproductive health in CCEE/NIS. Copenhagen, WHO, Regional Office for
Europe, 1997.
2. United Nations Department for Economic and Social Information and Policy Analysis,
Population Division. World contraceptive use 1994. New York, United Nations,
1994.
3. United Nations Department for Economic and Social Information and Policy Analysis,
Population Division. World Population Prospects. The 1994 Revision. New York,
United Nations, 1995: 135.
4. Shah I. Fertility and contraception in Europe. Presentation at the Fourth Meeting of
the Scientific Working Group on Reproductive Health Research in Eastern Europe,
Targu-Mures, Romania, 1996.
5. UNFPA (United Nations Population Fund). Report of the Workshop on the Implementation
of the Cairo Programme of Action in Countries with Economies in Transition,
Sinaia, Romania, 1995. New York, United Nations, 1995.
6. The Alan Guttmacher Institute. Sharing responsibility: women, society and abortion
worldwide. New York, The Alan Guttmacher Institute, 1999.
7. WHO. World Health Statistics Yearbook. Geneva, World Health Organization, 1993.
8. WHO, Division of Reproductive Health (Technical Support). Unsafe abortion. Global
and regional estimates of incidence of and mortality due to unsafe abortion with a
listing of available country data. Geneva, World Health Organization, 1998.
9. Oddens BJ. Acceptance and acceptability of modern family planning in Eastern
Europe. In: Johannisson E, Kovacs L, Resch BA, Bruyniks NP, eds. Assessment of
research and service needs in reproductive health in Eastern Europe -- concerns and
commitments. New York, Parthenon Publishing Group, 1997: 103-17.
10. David HP. Abortion in Europe, 1920-1991: a public health perspective. Studies in
Family Planning 1992, 23: 1-22.
11. Frejka T. Induced abortion and fertility: a quarter century of experience in Eastern
Europe. Population and Development Review 1983, 9: 494-520.
12. Popov AA. A short history of abortion and population policy in Russia. Planned Parenthood
in Europe 1993, 22: 23-25.
13. Popov AA, Visser AP, Ketting E. Contraceptive knowledge, attitudes, and practice in
Russia during the 1980s. Studies in Family Planning 1993, 24: 227-235.
230
MIHAI HORGA
Book ch.10.qxd 11.2.2005 10:43 Page 230
14. Ketting E, Lehert P, Uzel R, Visser A. Contraceptive practices and attitudes of women
in the Czech and Slovak Federal Republic. Planned Parenthood in Europe 1992, 22:
14-18.
15. Horga M, Alexaniants SA, Baramidze L, Sadauskas V, Prilepskaya VN, Poenariu M,
Arustamian K, Kuparadze K, Vanagyene V, Ledina AV. The determinants of the choice
and use of fertility regulating methods in Eastern European countries (WHO Study
95905). Technical Report, 1999 (unpublished).
16. Cottingham J, Mehta S. Medical barriers to contraceptive use. Reproductive Health
Matters 1993, 1: 97-100.
17. Johnson BR, Horga M, Andronache L. Contraception and abortion in Romania.
Lancet 1993, 341: 875-878.
18. Visser AP, Remenninck L, Bruyniks N. Contraception in Russia: attitude, knowledge
and practice of doctors. Planned Parenthood in Europe 1993, 22: 26-29.
19. Frejka T. Issues of reproductive health: contraception and induced abortion in Central
and Eastern Europe. Presentation at the Annual Meeting of the American Public
Health Association, 1990.
20. Helfferich C. Family planning and lifestyle in Germany. Entre Nous 1996, 33: 9-10.
21. Institute for the Care of Mother and Child, Prague, & Centers for Disease Control and
Prevention, Atlanta. Factum, non fabula. Czech Republic Reproductive Health Survey
1993 – Final report. Prague, Czech Statistical Office, 1995.
22. Horga, M. Research and service needs in reproductive health in Romania. In: E.
Johannisson, Johannisson E, Kovacs L, Resch BA, Bruyniks NP, eds. Assessment of
research and service needs in reproductive health in Eastern Europe -- concerns and
commitments. New York, Parthenon Publishing Group, 1997: 201-207.
23. Romania. Institutl de Ocrotire a Mamei si Copilului [IOMC]; United States. Centers
for Disease Control and Prevention [CDC]. Romania Reproductive Health Survey,
1993. Final report. Bucharest, Romania, IOMC, 1995.
24. Bruyniks, N. The need for education and research in reproductive health in Easter
Europe. In: Johannisson E, Kovacs L, Resch BA, Bruyniks NP, eds. Assessment of
research and service needs in reproductive health in Eastern Europe -- concerns and
commitments. New York, Parthenon Publishing Group, 1997: 119-138.
25. Grebsheva I. Abortion and the problem of family planning in Russia. Planned Parenthood
in Europe 1992, 21: 8-9.
26. Jafarova V. Azerbaijan: urgent need for family planning. Entre Nous 1995, 28-29: 12.
231
ABORTION AND PRIORITIES IN EASTERN EUROPEAN AND CENTRAL ASIAN COUNTRIES
Book ch.10.qxd 11.2.2005 10:43 Page 231
27. Serbanescu F, Morris L, Stupp P, Stanescu A. The impact of recent policy changes on
fertility, abortion, and contraceptive use in Romania. Planned Parenthood in Europe
1995, 26: 76-87.
28. WHO, Division of Reproductive Health (Technical Support). DALYs and reproductive
health. Report of an informal consultation. Geneva, World Health Organization, 1999.
29. WHO, Division of Reproductive Health. Unsafe abortion. Global and regional estimates
of incidence and mortality due to unsafe abortion, with a listing of available
country data. Geneva, World Health Organization, 1998.
30. Djusekeev A, Kajupova N. Kazakhstan: looming shadow of ecological disaster. Entre
Nous 1995, 28-29: 10.
31. WHO to discuss research results on adverse consequences of unsafe abortion in Latin
America and the Caribbean. Geneva, WHO Press Release, 15 November 1994.
32. Komyssova N. Family planning in the Russian Federation. Planned Parenthood in
Europe 1992, 21: 7-8.
33. United Nations. Programme of Action of the International Conference on Population
and Development, Cairo, 1994. New York, United Nations, 1995.
34. WHO. Women’s health. Improve our health, improve the world. WHO Position Paper.
Geneva, World Health Organization, 1995.
35. Brazier E, Rizzuto R, Wolf M. Prevention and management of unsafe abortion. A
guide for action. New York, Family Care International, 1998.
36. Romania. Institutl de Ocrotire a Mamei si Copilului [IOMC]; United States. Centers
for Disease Control and Prevention [CDC]. Romania Reproductive Health Survey,
1999. Preliminary report. Bucharest, Romania, IOMC, 2000.
37. UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and
Research Training in Human Reproduction. Annual Technical Report 1995. Geneva,
World Health Organization, 1995.
38. Timmermans D. Family planning is a family affair. Entre Nous 1996, 32: 8-9.
39. David HP, Baban A. Women’s health and reproductive rights: Romanian experience.
Patient Education and Counseling 1996, 28: 235-245.
40. Hord C, David HP, Donnay F, Wolf M. Reproductive health in Romania: reversing the
Ceausescu legacy. Studies in Family Planning 1991, 22: 231-240.
41. Stephenson P, Wagner M, Badea M, Serbanescu F. Commentary: the public health
consequences of restricted induced abortion - lessons from Romania. American Journal
of Public Health 1992, 82: 1328-1331.
232
MIHAI HORGA
Book ch.10.qxd 11.2.2005 10:43 Page 232
42. Cook RJ. From abortion to reproductive health -- the role of the law. In: Newman K, ed.
Progress postponed: abortion in Europe in the 1990s. London, International Planned
Parenthood Federation, European Region, 1993: 60-77.
43. Committee on the Elimination of All Forms of Discrimination Against Women
(CEDAW). Eighteenth Session, May 1998: paragraph 109
http://www.un.org/womenwatch/daw/cedaw.
44. Leonard AH, Ladipo OA. Post-abortion family planning: factors in individual choice
of contraceptive methods. Advances in Abortion Care 1994, 4: 1-4.
45. Mundigo A, Indriso C. Abortion in the developing world. Geneva, World Health Organization,
1999.
46. The Tbilisi Declaration issued by the International Conference on "From Abortion to
Contraception", Tbilisi, 1990.

Geography