Report: Abortion Incidence and Severity of Related Complications in Sierra Leone

Abstract

Maternal mortality remains a major public health concern in Sierra Leone. Although the maternal mortality ratio declined from 1,360 deaths per 100,000 live births in 2016, then the world's highest, to 717 per 100,000 live births in 2019, the rate remains well above the Sustainable Development Goal target and above regional averages. A 2011 study estimated that unsafe abortion accounts for roughly 10 percent of maternal deaths in the country, with a substantial share of women treated for post-abortion complications presenting with moderate or severe outcomes, at significant cost to the public health system. Sierra Leone's abortion law remains restrictive, permitting the procedure only to save a woman's life, prompting many women to resort to unsafe methods and to delay seeking care for fear of prosecution. The country also has high rates of teenage pregnancy and unmet need for modern contraception. Drawing on a nationally representative study, this report estimates the national and regional incidence of induced abortion and the severity of associated complications in Sierra Leone, providing the country's first such nationally representative evidence. The findings are intended to inform the Safe Motherhood and Reproductive Health Bill and related clinical guidelines under development.