Trends in hospitalization for abortion-related complications in Brazil, 1992-2009: why the decline in numbers and severity?

Brazil offers a unique opportunity to analyze trends in abortion-related morbidity over time with high-quality data. National data on facility-based treatment of abortion complications from 1992-2009 were analyzed. Large declines occurred in the number and rate of women treated for abortion complications: the national number of treated cases declined by 41% (from 282 000 in 1992 to 165000 in 2009), and the abortion treatment rate declined by 57% (from 7.1 to 3.1 per 1000 women) over the same period. The decline in this rate was more striking for more serious complications than for less serious ones (69% compared with 52%). Possible reasons for these overall declines include increasing use and greater availability of safer abortion methods, and greater ability to pay for such methods as well as a possible decline in incidence of unintended pregnancy and abortion through more widespread use of modern contraception.