title: Unsafe abortion in rural Tanzania - the use of traditional medicine from a patient and a provider perspective.
abstract: BACKGROUND
  The circumstances under which women obtain unsafe abortion vary and depend on the traditional methods known and the type of providers present. In rural Tanzania women often resort to traditional providers who use plant species as abortion remedies. Little is known about how these plants are used and their potential effect.
  
  
  METHODS
  Data were obtained among women admitted with incomplete abortion at Kagera Regional Hospital during the period January - June, 2006. The women underwent an empathetic interview to determine if they had experienced an unsafe abortion prior to their admission. In all 125/187 women revealed having had an unsafe abortion. The women identified as having had an unsafe abortion underwent a questionnaire interview where information about abortion provider and abortion method used was obtained through open-ended questions. To get more detailed information about the traditional methods used to induce abortion, in-depths interviews and focus group discussions were performed among traditional providers and nurses. Finally, the plant specimen's effectiveness as abortion remedies was assessed through pharmacological analyses.
  
  
  RESULTS
  Among women admitted with incomplete abortions, 67% had had an unsafe abortion. Almost half of the women who had experienced an unsafe abortion had resorted to traditional providers and plant species were in these cases often used as abortion remedies. In all 21 plant species were identified as potential abortion remedies and analysed, 16 of the species were found to have a uterine contractive effect; they significantly increased the force of contraction, increased the frequency of contractions or did both.
  
  
  CONCLUSIONS
  Unsafe abortion is common in rural Tanzania where many women use plant species to terminate an unwanted pregnancy. The plants have a remarkable strong uterine contractive effect. To further understand the consequences of unsafe abortion there is a need for further analyses of the plants' potential toxicity and mutagenicity.
authors.affiliation: Department of Obstetrics and Gynaecology, Odense University Hospital, 5000, Odense C, Denmark. vrasch@health.sdu.dk.
authors.forename: Vibeke
authors.initials: V
authors.lastname: Rasch
authors.affiliation: Department of International Health, Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 3D Blegdamsvej, 2200, Copenhagen N, Denmark. pernillehartvigsen@yahoo.dk.
authors.forename: Pernille H
authors.initials: PH
authors.lastname: Sørensen
authors.affiliation: The Medical Faculty, University of Southern Denmark, 5000, Odense C, Denmark. annawang1989@gmail.com.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Wang
authors.affiliation: Department of Botany, University of Dar es Salaam, Dar es Salaam, P.O. Box 35060, Tanzania. ismailfar8@gmail.com.
authors.forename: Flora
authors.initials: F
authors.lastname: Tibazarwa
authors.affiliation: Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, 2 Universitetsparken, 2100, Copenhagen O, Denmark. ankj@sund.ku.dk.
authors.forename: Anna K
authors.initials: AK
authors.lastname: Jäger
mesh_terms: D000019:Abortifacient Agents / Q000494:pharmacology; D000028:Abortion, Induced / Q000009:adverse effects / Q000379:methods*; D000818:Animals; D001291:Attitude of Health Personnel; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D016488:Medicine, African Traditional / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D009119:Muscle Contraction / Q000187:drug effects; D010936:Plant Extracts / Q000494:pharmacology; D010946:Plants, Medicinal; D011247:Pregnancy; D051381:Rats; D012424:Rural Population; D011795:Surveys and Questionnaires; D013636:Tanzania; D014599:Uterus / Q000187:drug effects
chemical_list: D000019:Abortifacient Agents; D010936:Plant Extracts