Abstract : All of the 4448 abortion cases managed at the University College Hospital, Ibadan, Nigeria, between 1980-89 were assessed. Abortion is illegal in Nigeria and carries with it a penalty of 14 years imprisonment, but physicians and nonphysicians operate without prosecution, unless complications are severe. Information was obtained from hospital case records in the emergency unit, the gynecology ward, and operating room. Data included information on demography, type of abortion, pattern of morbidity, mortality, duration of hospital stay, cost of management, and qualifications and training of the physician or provider. Abortion is any interruption before a fetus has viability, which is considered as a birthweight of 500 g or less and 26 weeks' gestation. 840 of 912 cases judged to have been illegally induced and with a complete information were analyzed. The number of cases rose from 43 in 1980 to 164 in 1989. Fatality varied. 79.1% were aged 15-29 years. 57.9% were single, 39.8% were married, and 2/4% were divorced. 54.7% (460) were unemployed, housewives, or students and 37.6% were unskilled workers. 76.2% were nonusers of contraceptives and 21% were contraceptive users. Among abortions performed, 42.8% (360) were done by untrained persons, 6.4% by nurses, and 21% by chemists. 29.8% were performed by physicians, who were responsible for 66.7% of fatalities in 1989. Lack of adequate training might be responsible for the poor response. 7.4% had a hospital stay longer than 2 weeks, while 13.3% were released within 3 days. The bulk of patients were hospitalized for 3-7 days (38.3%) or 7-14 days (41%). The usual cost of hospital care was N350 or US $35, an amount in excess of the national monthly minimum wage. 13.1% spent N1000. Complications of illegally induced abortions involved sepsis in 86.2% of cases and hemorrhage in 35.2%. 25.7% had injuries to the uterus, bowel, and lower genital tract. It is felt that abortion rates reflect unwanted pregnancy and are an indicator of the urgent need for fertility control services. The danger posed by illegal abortions would be eliminated by liberalization of abortion law and increased acceptance of family planning. The findings of 20.5% illegal abortions among abortions performed is close to the estimates of 28.4% with 46% complications. As well as other legal and educational actions, family planning services need to be made available.
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