Deaths from Complications of Unsafe Abortion: Misclassified Second Trimester Deaths

Causas externas e mortalidade materna: proposta de classificacao

“…12,20,23 In this study, two suicide cases of suicide involving Carbamate due to unwanted pregnancy were identifi ed. From the information available, it is not possible to conclude whether the aim was to interrupt the pregnancy or to actually commit suicide.…”

“…If domestic violence was behind the death of a pregnant woman or one who had recently given birth, such deaths should be investigated and classifi ed as maternal deaths from indirect obstetric causes. 5,9,14,23 Although the relationship between suicide and pregnancy is a controversial topic in the literature, some authors have shown the existence of an association at the same time as they question its exclusion from the construction of maternal death indicators. 20,23 In some suicide cases, the pregnancy does not appear; in others, they represent unsuccessful attempts to abort a pregnancy which could not be legally terminated.…”

“…5,9,14,23 Although the relationship between suicide and pregnancy is a controversial topic in the literature, some authors have shown the existence of an association at the same time as they question its exclusion from the construction of maternal death indicators. 20,23 In some suicide cases, the pregnancy does not appear; in others, they represent unsuccessful attempts to abort a pregnancy which could not be legally terminated. 1 Alves & Antunes 2 proposed adding a category to chapter XV, "Complication in pregnancy, birth and postpartum" of the 10 th edition of the International Classifi cation of Diseases (ICD-10), 18 code (O93) to admit, after investigation, deaths from external causes as deaths related to pregnancy or obstetrically indirect maternal death.…”

A Critical Appraisal of Laws on Second Trimester Abortion

“…A study in 2001 in two sites in two states of Mexico, for example, with about 1.5 milllion inhabitants, found no officially registered second trimester abortion-related deaths. However, verbal autopsy and review of clinical records and death certificates found, among the 32 registered maternal deaths, four misclassified deaths that were actually second trimester abortionrelated deaths, 5 that were probably purposely covered up to avoid investigation and prosecution.…”

Second trimester abortion laws globally: actuality, trends and recommendations

“…4,5 They are also responsible for a disproportionate number of abortion-related maternal deaths, even though in some cases they may be misclassified as due to other causes. 6,7 *Reflecting medical practice in the latter half of the 20th century, most of the world's countries that have liberalised their abortion laws based those laws on when in pregnancy certain abortion methods were used, i.e. in the first trimester (up to 13 weeks), or the second trimester (through 28 weeks).…”