Evidence Brief: Abortion Incidence and Severity of Complications in Sierra Leone

Abstract

This evidence brief examines the incidence and severity of complications associated with abortion in Sierra Leone, where the procedure remains legally restricted to cases involving danger to a woman's life, rape, incest, or serious risk to physical or mental health. Despite legislative and policy reforms aimed at improving maternal health outcomes, Sierra Leone continues to report a high maternal mortality ratio, suggesting that unsafe abortion remains a persistent threat to women and girls of reproductive age. Drawing on a nationwide study jointly conducted by the Ministry of Health and Sanitation, Statistics Sierra Leone, the African Population and Health Research Center, and the Guttmacher Institute, the brief summarizes estimates of induced abortion incidence, the profile of women seeking abortion-related care at health facilities, and the nature and severity of complications they present with, alongside the quality of care received. The findings point to a substantial burden of unsafe abortion nationally and regionally. The brief concludes that stronger legal protections, expanded access to post-abortion care, and continued investment in reproductive health services are needed to reduce abortion-related morbidity and mortality and to support ongoing legislative reform efforts in the country.