Evidence map›Paper›PMID 31139465›Full record

ArticleBMJ global health2019

Unsafe abortion and abortion-related death among 1.8 million women in India.

Ryo Yokoe, Rachel Rowe, Saswati Sanyal Choudhury, Anjali Rani, Farzana Zahir, Manisha Nair

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed
13.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 83 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Ryo YokoeNuffield Department of Population Health, University of Oxford, Oxford, UK.
Rachel RoweNPEU, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Saswati Sanyal ChoudhuryDepartment of Obstetrics and Gynaecology, Guwahati Medical College and Hospital, Guwahati, India.
Anjali RaniDepartment of Obstetrics and Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Farzana ZahirDepartment of Obstetrics and Gynaecology, Assam Medical College, Dibrugarh, India.
Manisha NairNPEU, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0003-0660-5054
University of Oxford · GBAssam Medical College · INGauhati Medical College and Hospital · INInstitute of Medical Sciences · IN

Funding

Medical Research Council MR/P022030/1
6 · The paper itself

Abstract

introductionUnsafe abortion is a preventable cause of maternal mortality. While studies report high number of abortions in India, the population-level rates of unsafe abortion and their risk factors are not well understood. Our objective was to analyse the rates of and risk factors for unsafe abortion and abortion-related maternal death in India.

methodsWe conducted a secondary analysis of data from 1 876 462 pregnant women aged 15-58 years from nine states in the Indian Annual Health Survey (2010-2013). We calculated the rate of unsafe abortion and abortion-related mortality with 95% CI. Multivariable logistic regression models examined the associations of sociodemographic characteristics, health seeking behaviours and family planning with unsafe abortion and abortion-related mortality.

resultsThere were 89 447 abortions among 1 876 462 pregnant women in 2007-2011 (4.8%; 95% CI 4.8 to 4.9). Of these, 58 266 were classified as unsafe (67.1%; 95% CI 66.7 to 67.5). There were 253 abortion-related maternal deaths (0.3%; 95% CI 0.2 to 0.3). Factors associated with unsafe abortion: maternal age 20-24 years (adjusted OR (aOR): 1.13; 95% CI 1.09 to 1.18), illiteracy (aOR: 1.48; 95% CI 1.39 to 1.59), rural residence (aOR: 1.26; 95% CI 1.21 to 1.32), Muslim religion (aOR: 1.16; 95% CI 1.12 to 1.22), Schedule caste social group (aOR: 1.08; 95% CI 1.04 to 1.12), poorest asset quintile (aOR: 1.45; 95% CI 1.38 to 1.53), antenatal care (aOR: 0.69; 95% CI 0.67 to 0.72), no surviving children (aOR: 1.30; 95% CI 1.16 to 1.46), all surviving children being female (aOR: 1.12; 95% CI 1.07 to 1.17), use of family planning methods (aOR: 0.69; 95% CI 0.66 to 0.71). Factors associated with abortion-related deaths: maternal age 15-19 (aOR: 7.79; 95% CI 2.73 to 22.23), rural residence (aOR: 3.28; 95% CI 1.76 to 6.11), Schedule tribe social group (aOR: 4.06; 95% CI 1.39 to 11.87).

conclusionDespite abortion being legal, the high estimated prevalence of unsafe abortion demonstrates a major public health problem in India. Socioeconomic vulnerability and inadequate access to healthcare services combine to leave large numbers of women at risk of unsafe abortion and abortion-related death.

Indexed as

abortionIndiaratesrisk factorsunsafe

Identifiers

PMID31139465
PMCPMC6509605
OpenAlexW2943483842

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.