The magnitude of abortion complications in Kenya

BJOG. 2005 Sep;112(9):1229-35. doi: 10.1111/j.1471-0528.2004.00503.x.


Objective: To estimate and describe the magnitude of abortion complications presenting at public hospitals in Kenya.

Design: Cross-sectional descriptive study.

Setting: Hospital-based. Population Records of all women presenting prior to 22 weeks of gestation with abortion-related complications at selected hospitals during a three-week study period. All public tertiary and provincial hospitals were included; stratified random sampling was employed to select a subset of 54 district hospitals nationwide.

Methods: Data collectors identified 809 patients with abortion complications on all hospital wards and completed a standardised questionnaire for each by extracting information from the patient's hospital record.

Main outcome measures: Incidence, aetiology, morbidity and mortality of abortion complications.

Results: Most women (80%) presented with incomplete abortion. Approximately 34% of the women had reached the second trimester of pregnancy. Adolescents (14-19 years old) accounted for approximately 16% of the study sample. Manual vacuum aspiration was used to manage 80% of first trimester cases. The projected annual number of women with abortion complications admitted to public hospitals in Kenya is 20,893. The case fatality rate was estimated to be 0.87% (95% CI 0.71-1.02%), so an estimated 182 (95% CI 148-213) of these women die annually. The annual incidence of incomplete abortion and other abortion-related complications per 1000 women aged 15 to 49 years is projected to be 3.03.

Conclusions: The high rate of abortion-related morbidity and mortality documented in the study highlights the critical need to address the issue of unsafe abortion in Kenya.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Induced / adverse effects*
  • Adolescent
  • Adult
  • Cervix Uteri / injuries
  • Contraception / statistics & numerical data
  • Cross-Sectional Studies
  • Female
  • Humans
  • Incidence
  • Kenya / epidemiology
  • Middle Aged
  • Pregnancy
  • Pregnancy Trimester, First
  • Pregnancy Trimester, Second
  • Reproductive History
  • Vacuum Extraction, Obstetrical / statistics & numerical data
  • Vagina / injuries