Résumé : Abortion is the second leading cause of maternal mortality in Colombia. The underregistration rate for maternal death is estimated at 50%, and that for abortion is probably higher still. Women in Colombia die from abortion because it is illegal and clandestine. Unwanted pregnancy is the major factor leading to abortion mortality. While unwanted pregnancy and abortion are difficult to avoid completely, abortion mortality has largely disappeared where abortion is legal. Abortion is not likely to be legalized in Colombia in the foreseeable future. Although abortion is a polarizing issue, in reality no one is in favor of abortion, even women resorting to it to terminate unwanted or inopportune pregnancies. Despite numerous studies and advances in the efficacy and availability of contraceptive methods, abortion continues to be very frequent. A study of abortion morbidity and mortality carried out in 15 hospitals by the Colombian Federation of Obstetrics and Gynecology found 4263 abortions and 21 resulting deaths, corresponding to a mortality rate of 493/100,000 abortions. 42% of the women admitted for abortion stated they wanted no more children, and 63% were not using a contraceptive method, but only 37% received family planning services in the hospitals. Just as abortion mortality is largely avoidable, the huge economic burden of treating abortion complications is also largely avoidable. Although knowledge of contraceptives is nearly universal, their correct and continuous use is much less well distributed. Obstetricians and gynecologists should reflect on their own attitudes toward abortion, and should contribute to finding a solution to the problem through concrete actions in their clinical practice, teaching, and influence over legislation.
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