Region | Annual Number of Maternal Deaths | Maternal Mortality Ratio 1 | Lifetime Risk of Maternal Death One in: |
|---|---|---|---|
| WORLD | 585,000 | 430 | 60 |
| DEVELOPED COUNTRIES2 | 4,000 | 27 | 1,800 |
| DEVELOPING COUNTRIES | 582,000 | 480 | 48 |
| AFRICA | 235,000 | 870 | 16 |
| Eastern Africa | 97,000 | 1,060 | 12 |
| Middle Africa | 31,000 | 950 | 14 |
| Northern Africa | 16,000 | 340 | 55 |
| Southern Africa | 3,600 | 260 | 75 |
| Western Africa | 87,000 | 1,020 | 12 |
| ASIA2 | 323,000 | 390 | 65 |
| Eastern Asia | 24,000 | 95 | 410 |
| South-central Asia | 227,000 | 560 | 35 |
| South-eastern Asia | 56,000 | 440 | 55 |
| Western Asia | 16,000 | 320 | 55 |
| EUROPE | 3,200 | 36 | 1,400 |
| Eastern Europe | 2,500 | 62 | 730 |
| LATIN AMERICA & THE CARIBBEAN | 23,000 | 190 | 130 |
| Central America | 4,700 | 140 | 170 |
| South America | 15,000 | 200 | 140 |
| NORTH AMERICA | 500 | 11 | 3,700 |
| OCEANIA2 | 1,400 | 680 | 26 |
Region | Annual Number of Unsafe Abortions (in Millions) | Annual Number of Deaths from Unsafe Abortions | Risk of Death from Unsafe Abortion |
|---|---|---|---|
| World Total | 20.00 | 70,000 | |
| Developed countries | 2.34 | 600 | |
| Europe | .26 | 100 | |
| Developing countries | 17.62 | 69,000 | |
| Africa | 3.74 | 23,000 | |
| Asia | 9.24 | 40,000 | |
| Latin America | 4.62 | 6,000 |
| Staff May Include: | Emergency Postabortion Care Provided: | Facilities Needed: | Equipment and Supplies Needed: | Family Planning Services Offered: | |||
|---|---|---|---|---|---|---|---|
| Those given basic health training, including: * Traditional birth attendants * Traditional healers * Community residents |
* Recognition of abortion complications and spontaneous
abortion * Timely referral to formal health care system * Health education on unsafe abortion * Family planning information, education, and supplies |
Usually none at this level. Good communication with primary health facility is essential. | If available: * Health education materials (client brochures, leaflets) health facility * Counseling materials (cue cards, brochures, flipchart) |
* Counseling and education * Condoms * Spermicides * Oral contraceptives * Referral and follow-up for these and other methods | |||
| * Nurses * Auxiliary health workers including: Auxiliary nurse-midwives Health assistants Aides At some primary-level facilities staff may include: * Trained midwives * General practitioners * Medical residents |
All community level activities plus: * Simple physical and pelvic examination, especially taking vital signs and determining uterine size * Diagnosis of stages of abortion * Resuscitation and preparation for treatment or transfer, including: Management of airway and respiration Control of bleeding Pain control Hematocrit/hemoglobin test Referral When trained staff and appropriate equipment are available, activities can include: * Initiation of antibiotic therapy, intravenous fluid replace ment, and oxytocics * Pain control including paracervical block, simple analgesia, and sedation |
* Outpatient treatment room or area * Side laboratory * Family planning clinic If antibiotics, or pain control * Separate room or private corner of treatment room |
Those listed for the community level plus: * Examination couch/table, * Gloves, protective clothing, * Vaginal specula * Soap/disinfectants * Emergency resucitation kit * Essential drugs * Side laboratory equipment * Transport vehicle or standing arrangements for transport uterine evacuation is offered: * Broad-spectrum antibiotics * Uterine evacuation (first trimester) * Uterine evacuation kitsMVA or sharp cutterage * Means of sterilizing equipment * Local anesthesia * Sedatives * Analgesics * Needles and syringes |
All community-level services plus: * Injectables, * IUDs * Norplantฎ implants, where available * Referral for voluntary sterilization * Follow-up | |||
| All those listed for the primary level plus: * Trained midwives * Medical residents * General practitioners * Physicians with training in obstetrics/gynecology |
All primary level activities plus: * Uterine evacuation for first and second trimester * Treatment of most complications including surgical treatment of sepsis * Blood replacement, including cross-matching (testing the compatibility of the donor and patient blood types) and transfusion * Local and general anesthesia * Laparotomy and indicated surgery for uterine perforations and associated injuries * Diagnosis of pregnancy * Diagnosis and referral of severe complications such as septicemia, peritonitis, or renal failure |
* Treatment room in outpatient area, emergency
ward, gynecology ward * Recovery area * Laboratory * Surgical room |
All those listed above plus: * Sufficient uterine evacuation kits for caseload * Laboratory equipment and reagents for microscopy, culture and basic hematology * Blood or blood substitutes * Blood collection, transfusion, and storage equipment * Anesthesia, local and general * Standard laparatomy set * Pregnancy tests * Ambulance |
All those listed above plus: * Voluntary sterilization | |||
| All those listed for the primary and first referral
levels plus: * Specialists in obstetrics, gynecology, and other relevant fields |
All activities listed above plus: * Uterine evacuation for all abortions * Treatment of bleeding/clotting disorders * Treatment of severe complications such as septicemia, septic shock, renal failure, bowel injury, tetanus, gas gangrene, including: Diagnostic X-ray Ultrasonography Laparoscopy Laparotomy including hysterectomy |
All those listed above plus: * 24-hour access to surgical room * More complete laboratory * Intensive care unit * Shielded X-ray room * Blood bank |
All those listed above plus: * Intensive care equipment * X-ray equipment * Sonograghy equipment * Laparoscope |
All those listed above | |||