Abstract : This report describes qualitative observations of the 1 day at the Gynecological Emergency Ward, University Teaching Hospital, Lusaka, for September, 1988; and 2 case histories of abortion patients. These women had complications of illegally induced incomplete abortions. They came to the (UTH) for medical treatment. Each day 3 out of 10 illegally induced abortion patients complete the abortions on a concrete floor with no medical care. No medication or analgesics can be given without a prescription by a physician. If it is determined that a woman has had a proper, complete abortion, she is observed for at least 8 hours and released. Only 1 physician is available to many women. Due to blood shortages, few women who need blood get it. Women who have abortion- related infections need antibiotics which they may or may not get. Hysterectomy, ectopic pregnancy, and sterility are complications of improperly performed abortions. The consent of 3 physicians is required for an abortion--1 must be a specialist in a branch of medicine related to the woman's reason for wanting an abortion. Physicians are reluctant to schedule appointments despite the legalization of abortion in 1972. Junior physicians perform the abortions in the operating room. Some private physicians insert an IUD to induce abortion and tell the women to go to the gynecology ward at the hospital when bleeding begins. Other private doctors insert a plastic cannula and tell the women to go to the hospital ward. Most women go to traditional healers or midwives who insert roots soaked in water into the cervix which act as an irritant/dilator. Traditional healers also provide herbs claimed to be abortifacients which are taken in tea or eaten. At least 114 of the women at UTH induce abortion themselves by inserting plants or twigs into the cervix. Desperate and often the youngest women drink gasoline or detergents or take large overdoses of chloroquine, aspirin, or other toxic substances. All the women are afraid of dying from abortions. Poorly performed abortion is a major cause if maternal mortality in the 3rd world. Abortion-related death rates have been guessed to be 50- 100/100,000 illegal procedures compared to 1/100,000 legal abortions in the US. A study should be planned at UTH to determine how health care delivery can be improved for abortion seekers. (author's modified)
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