Abortion-related Maternal Mortality in the Russian Federation

Authors

  • Irina Alekseevna Zhirova,

    1. Irina Alekseevna Zhirova, Scientific Researchers, Scientific Research Centre for Obstetrics, Gynaecology, and Perinatology of the Russian Academy of Medical Sciences, Moscow.
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  • Olga Grigorievna Frolova,

    1. Olga Grigorievna Frolova is Professor and Head, Medicosocial Studies and Problem-analysis Department, Perinatology of the Russian Academy of Medical Sciences, Moscow.
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  • Tatiana Mikhailovna Astakhova,

    1. Tatiana Mikhailovna Astakhova are Scientific Researchers, Scientific Research Centre for Obstetrics, Gynaecology, and Perinatology of the Russian Academy of Medical Sciences, Moscow.
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  • Evert Ketting

    1. Evert Ketting is Coordinator of Sexual and Reproductive Health, Netherlands School of Public and Occupational Health, Amsterdam, The Netherlands. E-mail: e.ketting@tip.nl
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Abstract

This study examines characteristics and determinants of maternal mortality associated with induced and spontaneous abortion in the Russian Federation. In addition to national statistical data, the study uses the original medical files of 113 women, representing 74 percent of all women known to have died after undergoing an abortion in 1999. The number of abortions and abortion-related maternal deaths fell fairly steadily during the 1991–2000 decade to levels of 56 percent and 52 percent of the 1991 base, respectively. Regional and urban–rural variation is limited. Nine percent of abortion-related maternal mortality is due to spontaneous abortion; 24 percent is related to induced abortions performed inside and 67 percent to those performed outside a medical institution. In the latter group, older women, usually with a history of several pregnancies, are overrepresented. The high rate of abortion-related maternal mortality is due largely to the number of abortions performed at 13–21 weeks' and 22–27 weeks' gestation both inside and outside medical institutions. Improving access to safe second-trimester abortion, preventing delays during the abortion procedure, and adequate treatment of complications are key strategies for reducing abortion-related maternal mortality.

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