A replication of the Uruguayan model in the province of Buenos Aires, Argentina, as a public policy for reducing abortion-related maternal mortality

Abstract

Objective: To describe the application of the risk and harm reduction model at primary care level to decrease the mortality due to unsafe abortion in the Province of Buenos Aires, Argentina, and evaluate the results. Methods: The services offered at primary health units to women undergoing abortion are described—first, only risk reduction and later, legal termination of the pregnancy—including their evolution between 2010 and 2015. The changes in abortion-related maternal mortality are also evaluated. The χ<SUP>2</SUP> test was used to evaluate the differences in the percentage of abortion-related deaths out of the total number of maternal deaths. Results: Primary care services increased progressively, both for risk reduction and for legal termination of pregnancy, which was carried out successfully, including manual vacuum aspiration, by general physicians and midwives. The proportion of abortion-related maternal deaths with respect to total maternal deaths fell by two-thirds between 2010 and 2014 (P < 0.001). Conclusion: The Uruguayan risk reduction model was successfully applied in primary care in the Province of Buenos Aires.