Delay in the provision of adequate care to women who died from abortion-related complications in the principal maternity hospital of Gabon

Abstract

Deaths resulting from unsafe induced abortions represent a major component of maternal mortality in countries with restrictive abortion laws. Delays in obtaining care for maternal complications constitute a known determinant of a woman's risk of death. However, data on the role of delays in providing care at health care facilities are sparse. The association between the cause of maternal death (abortion versus post-partum haemorrhage or eclampsia) and the time interval between admission to hospital and the initiation of treatment were evaluated among women who died at the Maternité du Centre Hospitalier de Libreville, Gabon, between 1 January 2005 and 31 December 2007. The women's characteristics and the time between diagnosis of the condition that led to death and the initiation of treatment were compared for each cause of death. After controlling for selected variables, the mean time between admission and treatment was 1.2 hours (95% CI: 0.0-5.6) in the case of women who died from post-partum haemorrhage or eclampsia and 23.7 hours (95% CI: 21.1-26.3) in the case of women who died of abortion-related complications. In conclusion, delay in initiating care was far greater in cases of women with complications of unsafe abortion compared to other pregnancy-related complications. Such delays may constitute an important determinant of the risk of death in women with abortion-related complications.