Abstract

PIP: The topic of this article is the use of unsafe abortion for unwanted pregnancies among adolescents. The significance of unsafe abortion is identified as a high risk of serious health problems, such as infection, hemorrhage, infertility, and mortality, and as a strain on emergency room services. The World Health Organization estimates that at least 33% of all women seeking hospital care for abortion complications are aged under 20 years. 50 million abortions are estimated to be induced annually, of which 33% are illegal and almost 50% are performed outside the health care system. Complications are identified as occurring due to the procedure itself (perforation of the uterus, cervical lacerations, or hemorrhage) and due to incomplete abortion or introduction of bacteria into the uterus. Long-term complications include an increased risk of ectopic pregnancy, chronic pelvic infection, and infertility. Mortality from unsafe abortion is estimated at 1000/100,000 procedures. Safe abortion mortality is estimated at 0.6/100,000. When infertility results, some cultures ascribe an outcast status or marriages are prevented or prostitution is assured. The risk of complications is considered higher for adolescents. Adolescents tend to delay seeking an abortion, lack knowledge on where to go for a safe procedure, and delay seeking help for complications. Peer advice may be limited or inadequate knowledge. Five studies are cited that illustrate the impact of unsafe abortion on individuals and health care systems. Abortions may be desired due to fear of parental disapproval of the pregnancy, abandonment by the father, financial and emotional responsibilities of child rearing, expulsion from school, or inability to marry if the child is out of wedlock. Medical, legal, and social barriers may prevent women and girls from obtaining safe abortion. Parental permission is sometimes a requirement for safe abortion. Fears of judgmental or callous health personnel may be barriers to seeking safe abortion. Some countries lack adequately trained medical personnel and supplies. Mortality and morbidity declines are considered possible with legalization, more trained health personnel, and family planning programs for youth and education for parents.