by Kavuma Sharif

1. INTRODUCTION TO
REPRODUCTIVE HEALTH
TOPIC; ABORTION
GROUP 3;
• KAVUMA SHARIF
• KATENYA RICHARD
• NAGAWA LYDIA KULA
• GLORIA ALINAITWE

2. OBJECTIVES
1. Introduction
2. Causes
3. How is abortion a problem
4. Impact of abortion on the community
5. Mitigation of abortion in community
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3. INTRODUCTION
• Abortion is the termination of the fetus from the uterus before viability that is
<20 weeks of gestation or <500g(WHO)
• Abortion is termination of fetus before 28 weeks of gestation (UCG)
• Its also known as miscarriage in cases of spontaneous abortion
• Abortion is a common health intervention included as one of essential health care
services, though unsafe abortion is very high mostly reported in Africa.
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4. CONTI…
• Globally 60% of pregnancies are unintended pregnancies, 29% of total
pregnancies end in induced abortion. 97% of all abortions happen in developing
countries with 45% of total abortions Worldwide being unsafe. (WHO, 2021)
• There is no universally safe and effective method which is applicable to all cases.
• Complications are much less (5%) if termination is done before 8 weeks by
Manual Vacuum Aspiration or suction evacuation.
• Its risky about five times more in mid-trimester termination, here drugs used are
PG analogues and mifepristone.
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5. CONTI…
• About 73 million induced abortions take place worldwide each year, where Six
out of 10 of all unintended pregnancies, and 3 out of 10 of all pregnancies(WHO)
• In developed regions, it is estimated that 30 women die for every 100 000 unsafe
abortions. In developing regions, that number rises to 220 deaths per 100 000
unsafe abortions
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6. • East Africa allows abortion under at least one legal exception though limited
access to safe procedures due to stigma and unnecessary administrative hurdles,
lack of regulation and coordination.
• In Uganda access to legal safe abortion services is limited only being legal in
cases where the life or health of the mother is at risk
• About (5.3%) maternal mortality rate is contributed by abortion. So due the
restrictions many women with unintended pregnancies have resorted to unsafe
abortion in Uganda.
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7. Factors causing unsafe abortion
• Financial barriers- Money asked by facilities or medical personnel that may carry
out safe illegal abortion where
• Stigma and cultural norms
• Limited access to healthcare in underserved areas such as remote villages
• Insufficient awareness on health
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8. CLASSIFICATION
1. Spontaneous abortion
Abortion is the expulsion or extraction from its mother of an embryo or fetus
weighing 500g or less when it is not capable of independent survival
2. Induced abortion.
Deliberate termination of pregnancy
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10. CAUSES
• Not known in the majority of patients (mostly in spontaneous abortion)
• Genetic factors (Autosomal trisomy, Structural chromosomal rearrangements).
• Endocrine and metabolic factors eg Luteal phase defects, Diabetes mellitus
• Infections Eg Viral-rubella, cytomegallo, Parasitic-Malaria, Toxoplasm
• Immunological disorders Eg Autoimmune disease, Maternal medical illness
• Anatomical abnormalities Eg Cervical incompetence, Congenital malformation of the
uterus, Uterine fibroids, Intrauterine adhesions
• Blood group incompatibility (Incompatible ABO group and Rh incompatibility)
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11. • May be intentional (induced abortion/illegal)
• Financial status
• Relationship issues
• Unwanted pregnancy (early pregnancy in school going
teenagers)
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12. • Environmental factors
• Cigarette smoking; increases the risk due to formation of
carboxy hemoglobin and decreases oxygen
• Alcohol
• Contraceptives ie, IUD
• Drugs/chemicals; anaesthetic gases, lead, formaldehyde
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13. INDUCED ABORTION;
• They are classified into;
1. Legal (safe)
2. Illegal (unsafe)
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14. SAFE ABORTION (LEGAL)
• Safe abortion is the termination of pregnancy with in the right
duration by a medical professional with use of acceptable methods
recommended by WHO.
• Acceptable Methods;
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15. Deliberate induction of abortion by a registered medical practitioner in the interest
of mother’s health and life is protected under the MTP Act. The following provisions
are laid down:
• The continuation of pregnancy would involve serious risk of life or grave injury to
the physical and mental health of the pregnant woman.
• There is a substantial risk of the child being born with serious physical and mental
abnormalities so as to be handicapped in life.
• When the pregnancy is caused by rape, both in cases of major and minor girl and
in mentally imbalanced women.
• Pregnancy caused as a result of failure of a contraceptive.
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16. UNSAFE ABORTION(ILLEGAL)
• This is abortion carried out by unskilled people or in settings with
little or no resources and using a using dangerous and invasive
methods
• Lack of access to safe, affordable and respectful abortion care, pose
risks to women as each year, 4.7–13.2% of maternal deaths can be
attributed to unsafe abortion
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17. Recommended weeks for safe abortion
Method of safe abortion
Africa; Zambia, cape vade, Tunisia and South Africa
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18. PHYSICAL HEALTH RISKS ASSOCIATED WITH UNSAFE
ABORTION(COMPLICATION):
• incomplete abortion (failure to remove or expel all pregnancy tissue from the
uterus);
• haemorrhage (heavy bleeding);
• infection;
• uterine perforation (caused when the uterus is pierced by a sharp object); and
• damage to the genital tract and internal organs as a consequence of inserting
dangerous objects into the vagina or anus.
• Death
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19. COMPLICATIONS AND IMPACT ON HEALTH
• Immediate;
• Injury to the cervix (cervical lacerations)
• Uterine perforation during Dilation and Evacuation
• Hemorrhage and shock due to trauma, incomplete abortion, atonic
uterus or rarely coagulation failure
• Thrombosis or embolism
• Postabortal triad of pain, bleeding and low grade fever due to retained
clots or products
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20. • Gynecological complications include
• menstrual disturbances
• chronic pelvic inflammation
• infertility due to cornual block
• scar endometriosis and
• uterine synechiae leading to secondary amenorrhea.
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21. • Obstetrical complications
• recurrent midtrimester abortion due to cervical incompetence
• preterm labor
• Dysmaturity
• increased perinatal loss,
• rupture uterus,
• Rh isoimmunization in Rh-negative women, if not prophylactically protected with
immunoglobulin,
• failed abortion and continued pregnancy.
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22. IMPACT ON COMMUNTIY
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