In this article, we describe the results of changes in abortion-related fatalities in CHL over four consecutive 3-year periods: 2005-07, 2008-10, 2011-13, and 2014-16. The outcome evaluated was the number of abortion-related deaths per 1000 women and the proportion of all maternal deaths caused by abortion. Analysis was based on retrospective evaluation of clinical records without identification of patients; thus, informed consent was not requested. This study was approved by the administration of CHL acting as the ethical review committee. No statistical analysis was done. The abortion-related fatality rate fell from 12.3 per 1000 abortions between 2005 and 2007, to 2.9 per 1000 in 2008–10, and 0.7 per 1000 in 2011–13 (Table 1). Abortion-related maternal deaths accounted for 25% of all maternal deaths in the first period, with this percentage decreasing to 10% in the second period and to 2% in the third period. After the changes in hospital administration, the abortion-related fatality rate increased to 10 per 1000 abortions and to 14% of all maternal deaths between 2014 and 2016. Our findings suggest that abortion-related mortality can be substantially reduced by interventions within the hospital aimed at improving the care of women with abortion-related complications, particularly by reducing delays in the provision of effective care. These findings also highlight the importance of constantly motivating hospital staff to ensure that this beneficial effect remains.
