title: Hospital admission following induced abortion in Eastern Highlands Province, Papua New Guinea--a descriptive study.
abstract: BACKGROUND
  In Papua New Guinea abortion is restricted under the Criminal Code Act. While safe abortions should available in certain situations, frequently they are not available to the majority of women. Sepsis from unsafe abortion is a leading cause of maternal mortality. Our findings form part of a wider, mixed methods study designed to identify complications requiring hospital treatment for post abortion care and to explore the circumstances surrounding unsafe abortion.
  
  
  METHODS
  Through a six month prospective study we identified all women presenting to the Eastern Highlands Provincial Hospital following spontaneous and induced abortions. We undertook semi-structured interviews with women and reviewed individual case notes, extracting demographic and clinical information.
  
  
  RESULTS
  Case notes were reviewed for 56% (67/119) of women presenting for post abortion care. At least 24% (28/119) of these admissions were due to induced abortion. Women presenting following induced abortions were significantly more likely to be younger, single, in education at the time of the abortion and report that the baby was unplanned and unwanted, compared to those reporting spontaneous abortion. Obtained illegally, misoprostol was the method most frequently used to end the pregnancy. Physical and mechanical means and traditional herbs were also widely reported.
  
  
  CONCLUSIONS
  In a country with a low contraceptive prevalence rate and high unmet need for family planning, all reproductive age women need access to contraceptive information and services to avoid, postpone or space pregnancies. In the absence of this, women are resorting to unsafe means to end an unwanted pregnancy, putting their lives at risk and putting an increased strain on an already struggling health system. Women in this setting need access to safe, effective means of abortion.
authors.affiliation: Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Alotau, Milne Bay Province, Papua New Guinea.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Vallely
authors.affiliation: Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea.
authors.forename: Primrose
authors.initials: P
authors.lastname: Homiehombo
authors.affiliation: Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea; International HIV Research Group, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Angela
authors.initials: A
authors.lastname: Kelly-Hanku
authors.affiliation: Division of Obstetrics and Gynaecology, Eastern Highlands Provincial Hospital, Goroka, Eastern Highlands Province, Papua New Guinea.
authors.forename: Antonia
authors.initials: A
authors.lastname: Kumbia
authors.affiliation: School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.
authors.forename: Glen D L
authors.initials: GD
authors.lastname: Mola
authors.affiliation: School of Social Sciences, Monash University, Victoria, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Whittaker
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects / Q000331:legislation & jurisprudence / Q000401:mortality*; D000029:Abortion, Legal; D000293:Adolescent; D000328:Adult; D003710:Demography; D005260:Female; D006301:Health Services Needs and Demand; D006760:Hospitalization; D006801:Humans; D008428:Maternal Mortality; D010219:Papua New Guinea; D011247:Pregnancy; D011275:Pregnancy, Unwanted