Trends in Techniques of Abortion in Iran from 1994 to 2014

Abortion is desperately selected by some females who cannot continue their unintended pregnancies in all societies, some will suffer complications and some will die. Annual number of induced abortion has increased in the developing countries but the maternal death related to unsafe abortion has declined in the world since 2003. Medical abortion has contributes to this decline. In Iran, abortion rate of one per four female is estimated. The current study evaluated the technique of induced abortion among mothers with parity score of 0 - 1 (0.49), who attempted abortion; approximately 65 females performed induced abortion medically by misoprostol in 50.7%, surgically by curettage in 28% and manual vacuum aspiration (MVA) or vacuum curettage in 18% of the cases at the gestational age of six weeks. Since previously mentioned technique of abortion was surgical; the unsafe and clandestine abortions with 1.35% maternal death in the 1990s later changed to medical abortion by dinoprostone (prostaglandin E2) in the 2000s and now medical abortion is replaced by misoprostol (prostaglandin E1) in the 2010s. Complete abortion occurred in approximately 60% of the misoprostol cases. The parity score and gestational age in abortion cases have declined. Failure of withdrawal method of contraception (57%) and unmet need to modern effective contraception are contributing factors in these abortions. The trends in abortion are replaced by medical abortion with less morbidity at earlier stages of pregnancy. Traditional contraception and lack of effective contraceptive facilities and accessibilities are likely to increase unintended pregnancies and consequently abortions as well.