Consequences and Implications of Early Pregnancy and Induced Abortion

According to the United Nations Population Fund (UNFPA) State of World Population 2004 Report, “Pregnancy is a leading cause of death for those aged 15 to 19, with complications of childbirth and unsafe abortion being the major factors. Women aged 15-19 account for at least one fourth of the estimated 20 million unsafe abortions and nearly 70,000 abortion-related deaths each year." (p.76) (UNFPA, 2004). Several studies show the different ranges of incidence of maternal deaths associated with this practice among adolescents and young people in certain countries in the region. The State of World Population 2000 Report reports that in Chile and Argentina, over a third of maternal deaths among adolescents are a direct result of unsafe abortions, whereas in Peru, a third of the women hospitalized for abortion complications are between the ages of 15 and 24 (United Nations Population Fund, 2000).

Another study conducted in Mexico shows that the risks associated with pregnancy, abortion, childbirth and puerperium are a major cause of death among young women. In 1997, maternal deaths accounted for 5% of all deaths of women aged 15 to 19, the fifth leading cause of death within this age group (Consejo Nacional de Población, 2000).

In Brazil a study was conducted between 1980 and 1995 on deaths from induced abortion, whether on legal grounds or for unspecified reasons. According to the research, there was an increase in the total number of deaths due to abortion among women under 20, rising from 8.5% to 13% during the period considered (Gil de Carvalho Lima, 2000). In 1998 it is estimated that over 14% of deaths from abortion were of young women under the age of 19 (Rede Nacional Feminista de Saúde e Directos Reproductivos, 1999). In Fortaleza, a study analyzed deaths from abortions in two hospitals in this Brazilian city, from October 1992 to September 1993. It was found that deaths from this cause were concentrated in women aged 20 to 24 (36% of the total number of cases) and among women aged 25 to 29 (23.7%), whereas 22.6% of these deaths were of adolescents under the age of 19 (Fonseca et al., 1996; Misago et al., 1998).

In Argentina, in 1990, approximately 30% of maternal deaths among adolescents were related to abortion. It is estimated that during that year “13.5% (of a total of 53,871) of the hospital admissions for abortion corresponded to women under the age of 20” (Weller, 2000).

According to the World Health Organization, in 2004, 17% of the maternal deaths that occurred in Latin America and the Caribbean were due to unsafe abortion, the highest proportion in the world (World Health Organization, 2004). Although many studies show that this practice affects women of many ages, the incidence of unsafe abortion and the resulting mortality appear to be increasing among single adolescents in urban areas, particularly where access to fertility control services is inadequate (Population Today, 1998).

The consequences of abortions are often very serious, because adolescents find it difficult to gain access to health services. Also, “the fear of being censured leads them to postpone going to health services to seek help” in case of complications (Langer, 2002).

As Guzmán et al. point out (2001), common complications in abortions in adolescents include hemorrhaging, septicemia, anemia, vaginal tearing, pelvic abscesses, perforation of the uterus and secondary sterility. In 1995 in Latin America, between 10% and 21% of the hospitalizations due to abortion were of women aged 15 to 19. Moreover, a third of the adolescents hospitalized for abortions suffered from sepsis, in comparison with a quarter of adult women (Singh, 1998).

Other studies conducted in different countries have found that, of the total number of women hospitalized for abortion complications, women aged 15 to 19 represented 10% in Peru and 21% in the Dominican Republic, according to data available for 1995 (Singh, 1998). An increase in the relevant numbers was observed in countries such as Chile. Of all the women hospitalized for abortion complications in Chile in 1970, 36% were under 24, whereas in 1985 they constituted virtually 50% (Palma and Quilodrán 1995).

In a study on post-abortion care in 2002 in the Dominican Republic, where access to abortion is extremely restricted, Girvin (2004) shows that 41% of the women admitted to hospital for these types of services were under the age of 20. Another study in this country shows that approximately 17% of women under 20 who had abortions went to the hospital for complications linked to the interruption of their pregnancies, whether spontaneous or induced (Paiewonsky, 1994).

Likewise, a study indicates that the Peruvian Maternal and Prenatal Institute cared for 424 women under the age of 19 for abortion-related causes. The research shows that pregnant adolescents wait far longer before requesting medical assistance, which puts them at more of a risk of suffering serious complications (Almeyda Castro, 2001). According to health statistics from facilities that treat women with abortion complications in Peru, 14% of those admitted for such care in 2000 were adolescents (Ferrando, 2002). Gutiérrez and Ferrando (2004) estimate that of the 352,000 abortions that occurred in the year 2000 in that country, 33,475 were in women under the age of 20.

In Mexico, in 2001, abortion constituted the fifth most frequent cause of hospital discharges among women ages 10 to 14 in the medical units of the Health Secretariat, accounting for 4% of all hospital discharges. In the following age group, women aged 15 to 19, abortion was the second-place cause of hospital discharges that same year (8%) (Velasco Murillo and Navarrete Hernandez, 2003).

Likewise, a third of the 300 women admitted to the Mexico City Women’s Hospital for abortion complications were under 20, according to a study conducted between August 1990 and January 1991. Of all these admissions, 44% were linked to induced abortions (Elú, 1999).

Misago and Fonseca (1999) note that in a clinic in northeastern Brazil, 22.6% of the 2,084 women admitted for abortion complications between October 1992 and September 1993 were under 20. In a hospital in Santana-Bahia, 55.2% of approximately 300 adolescents hospitalized for abortion complications between October 1995 and December 1997, had complications related to induced abortions. In 30.2% of the cases, the type of abortion could not be determined, but the authors assume that they were provoked (Souza et al., 2001).

Weller also referred to a study conducted in the Argentinean city of Rosario that consisted of the review of 1,220 clinical histories of patients admitted to the gynecology service of a public hospital between March 1990 and March 1994. Of the total number of women considered in the research, 115 of them (17.4% of the cases) were teenagers aged 14 to 20, admitted for complications stemming from incomplete abortions (Weller, 2000).

The question of abortions due to rape is also documented in very many different ways in some countries, but it is often only dealt with from a legal perspective. In a study on the issue, Lara et al. (2003) analyzed the 1,651 files of women treated for sexual assault between 1991 and 2001 in a Mexican hospital. Of these, 231 became pregnant as a result of rape and 66% of those were aged between 10 and 19 (7% were aged 10 to 12, 28% were aged 13 to 15 and 31% were aged 16 to 19). Only 22% of these cases eventually underwent an abortion, gestational age (not over 12 weeks) being a crucial factor and the most important barrier to allowing this procedure to be undertaken. These limitations (gestational age and the bureaucratic paperwork required for its authorization) largely explain why many women continue with an involuntary pregnancy, as in the case of Paulina, the young woman whom the Mexican authorities prevented from having an abortion after she became pregnant as a result of a rape that took place in the year 2000.

All this evidence of the complications of abortion shows the high risks to which adolescents are exposed when they wish to interrupt an unwanted pregnancy. It also shows the urgent need to facilitate access to abortion among young women so that they can interrupt their pregnancies in the best possible conditions.

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