Morbidity from unsafe termination of pregnancy in South Africa

The Termination of Pregnancy (TOP) Act in South Africa (SA) allows women to request TOP for social reasons. A retrospective record review was done on all (85) women who were admitted with complications arising from TOP over a 1-year period in 2008, at the Charlottee Maxeke Johannesburg Academic (CMJA) Hospital, SA. The demography, methods and place of TOP, presenting complications and final management was discussed. Morbidity such as severe blood loss (39%), sepsis (26%), multiple organ dysfunctions (4%) and organ injuries (5%) were observed. A correct guideline for TOP was followed in only 33% of women. Self-induced TOP remained common practice. There is a need for accelerated training among healthcare workers providing TOP in SA to prevent this costly and preventable maternal morbidity.