Open Journal of Obstetrics and Gynecology, 2013, 3, 732-738 OJOG Published Online December 2013 (
Profile of abortion in Chile, with extremely restrictive law
Ramiro Molina-Cartes1*, Temístocles Molina2, Ximena Carrasco3, Pamela Eguiguren4
1School of Public Health, Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Chile, Santiago, Chile
2Centre for Reproductive Medicine and the Integral Development of the Adolescent Faculty of Medicine, University of Chile, Santi-
ago, Chile
3Chilean Ministry of Health, Santiago, Chile
4School of Public Health Faculty of Medicine, University of Chile, Santiago Chile
Email: *
Received 10 November 2013; revised 8 December 2013; accepted 16 December 2013
Copyright © 2013 Ramiro Molina-Cartes et al. This is an open access article distributed under the Creative Commons Attribution
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Chile, together with El Salvador, Malta and Nicara-
gua has the most restrictive abortion laws. In these
countries there is very little information on preg-
nancies that end in abortions. An analysis is made of
official information regarding hospital discharges for
abortion in Chile between 2001 and 2010, classified
according to age and according to the WHO ICD 10.
The Chilean Ministry of Health’s Statistics Office
(DEIS) collected the data. In 334,485 hospital dis-
charges for abortion, Ectopic Abortion (O00), the Hy-
datidiform Mole (O01) and Other Abnormal Pro-
ducts of Conception (O02) corresponded to 37.2% of
hospital discharges. Spontaneous Abortion (O03)
reached 15% and Non Specified Abortion (O06) rea-
ched 35.5% and most probably included compli-
cations of induced abortions. 77% of hospital dis-
charges corresponded to women between 20 and 34
years of age. Adolescents correspond to 11% of hos-
pital discharges. In the annual average of 33,500
hospital discharges, Other Abnormal Products of
Conception (O02), Other Abortions (O05), and Non
Specified Abortions (O05) contribute to 72.7% of
hospital discharges. This is explained by incomplete
diagnoses, by means of the omission of induced abor-
tion as this would mean jail for the woman and legal
red-tape for the health personnel involved. Maternal
mortality has not fallen. Abortion Mortality and Fa-
tality rates do not change. There is a discrepancy
between the law and hospital discharge diagnoses for
abortion. The antiabortion law remains unheeded
and obeys an ideological bias that brings damage and
abuse to Chilean women. The aim of this study is to
gain better information from a country that does not
allow abortion under any circumstance, and its use-
fulness to countries in similar situations, together with
its negative consequences on woman’s health and ri-
Keywords: Abortion Di scharges, Abortion Law,
Unlawful Abortion
Chile together with El Salvador, Malta and Nicaragua
has the most restrictive abortion laws [1-4]. Therapeutic
abortion or an in terrupted pregnancy is no t allowed even
in cases of risk of death or serious complications of pre-
gnancy on maternal health. There is no information avai-
lable, on the total female population, on what hap- pens
in these countries as with pregnancies that are terminated
by abortion, as it is very difficult to explore clandestine
abortion and the info rmation available is biased [5].
The World Health Organization defines abortion as the
interruption of pregnancy with adequate procedures prior
to fetal viability. This definition makes no mention of the
fact that the fetus is alive or dead [6]. Fro m a legal point
of view, it has been interpreted as the interruption of the
natural pregnancy process which produces the death of
the fetus or product of conception. But there is no ex-
plicit explanation of this issue in Chilean legislation,
only medico-legal or forensic interpretations [7]. Each
country has definitions that vary in time and reforms in
the legislation make it difficult to compare. From the
point of view of obstetrics and gynecology, there is a
variety of criteria for classifying abortion, but the one
which is most frequently used is the WHO International
Classification of Diseases (ICD 10) which permits an
analysis according to age, gender, occurrence, prevalence,
*Corresponding a uthor.
R. Molina-Cartes et al. / Open Journal of Obstetrics and Gynecology 3 (2013) 732-738 733
evolution in time and comparison among countries.
Abortion appears in Chapter XV, heading O and has 9
categories (00 - 08) and 9 sub-categories [8].
Since 1931, therapeutic abortion in Chile has been
contained in article 119 of the Health Code. Its text was
repealed in 1989, towards the end of the dictatorship, and
currently reads as follows: “No action may be taken
which has the objective of provoking an abortion” [1].
The aim of this study is to provide the best official in-
formation available on abortion in Chile, to analyze its
scope, limitations and to make it available to help other
countries in similar situations, together with its eventual
consequences on Women’s Health.
Official information has been obtained from hospital
discharges for abortion cases in all the establishments in
the country between 2001 and 2010, classified according
to WHO ICD 10 and according to age. The records of
discharge causes of hospitalized patients cover the whole
country. The Ministry of Health’s Department of Statis-
tics (DEIS) collects this information through a special
software application developed and placed at the disposal
of all public and private establishments. The source is th e
National Hospital Discharge Statistics (IIEH), which is
compulsory in the country. Diagnoses are recorded by
physicians upon th e patien t’s discharge from hospital and
kept in the corresponding medical record [9]. These re-
cords are processed by specialized personnel in each
hospital, and are validated by the Statistics Departments
of each region. The DEIS finally validates, analyses,
consolidates and publish es the information. In th e case of
this study, the DEIS provided a special analysis of the
data base of hospital discharges for abortion in Chile,
classified into five year age groups between 2001 and
The information analyzed is ex pressed in simple tables.
Simple percentages and rates have been used with in-
formation on women of fertile age, live infants born pro-
vided by DEIS and INE (National Statistics Institute)
[9,10]. The linear correlation coefficient uses the Pearson
and Lee model.
Table 1 shows total annual discharges and WHO ICD 10
composition according to causes, remains stable over the
decade. In a total of 334,485 discharges in 10 years, the
highest proportion is 10.5% (2002), and the lowest 9.5%
(2010), a difference that is not statistically significant.
Discharges for ectopic pregnancies (O00) remain steady
with variations of less than 2%. Hydatidiform Mole (O01 )
reached a maximum of 12.8% and a minimum of 8.5.
Other abnormal products of conception (O02) also
maintain similar proportions, v arying from 10.8 to 8.9%,
and corresponding to 37.2% of total discharges.
This group includes the interruption of embryonic de-
velopment, Non hydatidiform Mole, retained abortion
and other specified and unsp ecified abnor mal products of
conception. These are open categories that not always
have histopathological studies to back them. Sponta-
neous abortion (O03) reaches 15%, which could be over-
Medical Abortion (O04), which includes legal abortion
and therapeutic abortion are not recorded, as established
by the current legislation. Non Specified Abortion (O06)
is the second most frequent, with 34.7%. For the ho spital
discharge statistical staff, this category is invoked when
reports contain insufficient information and therefore
cannot be given a more specific classification. This ca-
tegory might possibly include complications caused by
hemorrhages in illegal voluntary abortions. The last two
categories Failure of Induced Abortion (O07) and Com-
plications caused by Abortion, Ectopic Pregnancy and
Hydatidiform Mole reach very low percentages.
Table 2 shows the age distribution of the total abor-
tions recorded in the 10-year records.
41% of discharges correspond to women between 25
and 34 years of age, and 77% to women between 20 and
34 years of age. Adolescents corresponded to 11% of
total hospital discharges.
Ectopic pregnancy increases with age until the age of
34. Mola pregnancies reach 1.7% in adolescents. The
same proportions are maintained in the following five-
year periods. Other abnormal products of conception
increase progressively till the age of 34 and remain stea-
dy until age 39. Spontaneous abortion has a greater fre-
quency than expected between ages 20 to 39. Other
Abortions corresponds to 60% in the 20 to 34 year olds.
Non Specified Abortion accumulates high rates of dis-
charge at all ages. The last two rubrics (O07 and O08)
show no great variations with age.
Table 3 shows abortion risks according to age and
causes. Adolescents have been divided into two groups:
under 14 years of age and 15 to 19 years of age, in order
to compare the information on these two groups, of
which there is very little. The risk of ectopic pregnancy
increases progressively with age, coming to 27.3 per
1000 for women of over 40; nevertheless the risk is
greater in the 10 to 14 year old age group than in 15 to
19 year olds. The rest shows the classical J curves de-
scribed as fertility risks according to age. The criteria of
this cause coding do not differ in the analysis of abortion
risk per 1000 li ve birt hs and by age groups.
The last column gives indication of interruption of
abnormal pregnancies for reasons of health. described in
all textbooks, as is the case ofectopic pregnancies, molar
Copyright © 2013 SciRes. OPEN ACCESS
R. Molina-Cartes et al. / Open Journal of Obstetrics and Gynecology 3 (2013) 732-738
Copyright © 2013 SciRes.
Table 1. Hospital discharges for abortion cases. Chile 2001-2010, by year and WHO ICD.
ICD O00 O01 O02 O03 O05 O06 O07 O08 Total
Year N % N % N % N %N %N %N% N % N (*) %
2001 3460 9.8 226 8.511065 8.9 6364 12.5314 11.51266710.94011.3 249 13.9 34.385 10.3
2002 3694 10.4 280 10.5 11752 9.4 5527 10.9282 10.41317511.3339.3 225 12.5 34.96810.5
2003 3490 9.9 341 12.8 11702 9.4 5272 10.4252 9.31216210.55716.1 221 12.3 33.497 10.0
2004 3265 9.2 262 9.912399 10.0 48009.4309 11.31234210.64312.2 225 12.5 33.64510.1
2005 3370 9.5 262 9.912231 9.8 49349.7310 11.41181310.27019.8 194 10.8 33.1849.9
2006 3573 10.1 235 8.812818 10.3 46989.2234 8.6113889.86217.6 137 7.6 33.1459.9
2007 3371 9.5 234 8.812542 10.1 48049.5235 8.6111699.64312.2 134 7.5 32.5329.7
2008 3543 10.0 260 9.813396 10.8 47809.4222 8.1110989.62 0.6 123 6.8 33.42410.0
2009 3927 11.1 303 11.413925 11.2 48279.5242 8.9104229.03 0.8 123 6.8 33.77210.1
2010 3702 10.5 255 9.612697 10.2 48189.5324 11.99971 8.60 0.0 166 9.2 31.9339.5
Total 35395 2658 124527 50824 2724 116207 353 1797 334485
Mean 3540 100 266 10012453 100 5082 100272 1001162110035100 180 100 33449100
%ICD 10.6 0.8 37.1 15.2 0.8 34.7 0.1 0.5 100.0
O00: Ectopic pregnancy; O01: Hydatidiforme Mole; O02: Other abnormal products of conception; O03: Spontaneous abortion; O04: Medical Abortion; O05:
Other Abortion; O06:Unspecified abortion; O07:Failed Attempted abortion; O08: Complications following abortion and ectopic pregnancy and molar preg-
nancy; (*) Total female population in fertile age (10 - 49 years old: 4, 820, 387 in 2001 and 5, 206, 810 in 2010, increasing 7,42%). Latin America and Carib-
bean population esti mates and pr oj ections 1 950 2050. 2004, Demographic Bulletin United Nation/C EPAL/ECLAC, Bulletin 73, [ 62 ].
Table 2. Abortion risk by age and ICD10 of WHO. Chile 2001-2010. Ratios by 1000 New Born.
ICD O00 O01 O02 O03 O05 O06 O07 O08 Total
Age n % n %n % n % n %n %n % n % n %
5 - 9 -- -- -- -- -- 1 0.0-- -- 1 0.0
10 - 14 57 0.2 40 1.5410 0.3 328 0.623 0.8721 0.68 2.3 9 0.5 1596 0.5
15 - 19 1685 4.8 432 16.310500 8.4 6632 13.0 410 15.11584013.66117.3 226 12.6 3578610,7
20 - 24 5139 14.5 486 18.318735 15.0 1022120.1 580 21.32307719.98624.4 354 19.7 5867817.5
25 - 29 8828 24.9 509 19.124757 19.9 1001019.7 531 19.52237219.37320.7 408 22.7 6748820,2
30 - 34 9943 28.1 425 16.027728 22.3 9320 18.3 491 18.02113318.27320.7 377 21.0 6949020.8
35 - 39 7404 20.9 329 12.426209 21.0 8522 16.8 438 16.11967616.9349.6 276 15.4 6288818.8
40 - 44 2091 5.9 235 8.814363 11.5 506010.02248.21171310. 1174.8 114 6.3 3381710.1
45 - 54 248 0.7 202 7.61825 1.5 731 1.427 1.01674 1.41 0.3 33 1.8 4841 1.4
Total 35395 100. 2658 100.124527 100 508241002724100116207100353100 1797 100 334485100
O00: Ectopic pregnancy; O01: Hydatidiforme Mole; O02: Other abnormal products of conception; O03: Spontaneous abortion; O04: Medical Abortion; O05:
Other Abortion; O06: Unspecified abortion; O07:Failed Attempted abortion; O08: Complications following abortion and ectopic pregnancy and molar preg-
Table 3. Abortion risk by age and ICD10 of WHO. Chile 2001-2010. Ratios by 1000 New Born.
Abortion hospital discharges by group of age and Ratios
ICD 10 10 - 14 Ratios 15 - 19 Ratios 20 - 39 Ratios 40 - 54RatiosTotal Ratios % of A bortions for
medical reasons
O00 57 5.7 1.685 4.5 31.314 16.2 2.339 27.335.395 14.7
O01 40 4.0 432 1.2 1.749 0.9 437 5.1 2.658 1.1
O02 410 40.7 10.500 28.3 97.429 50.3 16.188188.7124.527 51.8
67.6 %
O03 328 32.5 6.632 17.9 38.073 19.7 5.791 67.550.824 21.2
O05 23 2.3 410 1.1 2.040 1.1 251 2.9 2.724 1.1
O06 721 71.5 15.840 42.7 86.258 44.6 13.387156.0116.206 48.4
O07 8 0.8 61 0.2 266 0.1 18 0.20353 0.1
O08 9 0.9 226 0.6 1.415 0.7 147 1.7 1.797 0.7 0.9%
Total 1.597 158.3 35.786 96.5 258.544 133.6 38.558449.4334.484 139.3 68.5%
Total NB 10.085 370.772 1.935.243 85.798 2.401.898
O00: Ectopic pregnancy; O01: Hydatidiforme Mole; O02: Other abnormal products of conception; O03: Spontaneous abortion; O04: Medical Abortion; O05:
Other Abortion; O06: Unspecified abortion; O07: Failed Attempted abortion; O08: Complications following abortion and ectopic pregnancy and molar preg-
R. Molina-Cartes et al. / Open Journal of Obstetrics and Gynecology 3 (2013) 732-738 735
pregnancy and abnormal products of conception, which
include undeveloped pregnancies, non hydatidiform
moles, and other embryonic development abnormalities
[11]. It adds failed abortion attempts and complications
caused by ectopic pregnancies, moles, and other abnor-
malities of conception, which gives 68.5% of total hos-
pital discharges.
An important proportion of abortions classified as hav-
ing no specific cause could correspond to hemorrhagic
complications of voluntary pharmacologically induced
Table 4 shows the abortion rate recorded in hospital
discharges is high between the ages of 25 and 34. Lower
rates are seen in women under19 years of age. This in-
formation depends on the age distribution of the Chilean
population, with high rates in girls of under 19 years of
age. It is indispensible to compare reasons for abortions
with live births, as this is the best way of measuring pre-
gnancy risk, when ending in abortion.
Table 5 gives the impact of abortion on maternal death
and in abortion fatality.
Maternal death rate per 100,000 LB over the 10 year
period reaches 2.4 and does not express a trend, varying
from 1.2 in 2009 to 3.0 in 2005 and 2006.
Overall maternal death is 19.9 over the 10 year period,
varying from 12.8 in 2003 to 20.8 in 2005, and has a not
significant tendency to increase owing to Direct or Indi-
rect Maternal Death.
Abortion fatality rate over the 10 year period is 15.5
deaths per every 100,000 hospital disch arges for abortion,
fluctuating from 8.9 in 2009 to 21.1 in 2005 and 2006.
There is no definite trend in its development, but there
are enormous variations from year to year.
With an average of 33,500 annual hospital discharges for
abortion,the most frequent causes are: Other Abnormal
Products of Conception (O02) Other Abortions (O05)
and Non Specified Abor tio ns (O06) , which co rr esp ond to
72.7%. This leads us to suspect that this classification
category has been overnumbered owing to incomplete
diagnosis records on patients’ discharge, where voluntary
self induced abortions, or abortions caused by third par-
ties, are omitted because in these cases the mother risks a
jail sentence in addition to involving judicial red- tape for
the health authorities. This is validated by a recent report
of a qualitative research carried out by Universidad
Diego Portales [12].
It is interesting to note that this classificatio n does not
show an important proportion of infectious or septic
complications, which should be located in category
(O08). This only reaches 0.5% and has tended to fall sin-
ce 2001. This coincides with national data regarding the
reduction of maternity ward beds destined to the treat-
ment of septic complications of abortion [13].
The use of Misoprostol was introduced in Latin
America 1984 for extremely specific medical use [14].
This prostaglandin is sold legally and illegally through-
out the region and its emergence and use is associated to
the fall in septic abortions throughout the Region [15].
Chile is no exception, and in spite of the fact that the
drug is only available on a public and private institu-
tional basis, the public can easily buy it through the
internet and its sale also occurs in an informal parallel
market which is unsafe, abusive, and even criminal be-
cause on many occasions false medications are given at
very high prices that do not correspond the real market
value of the product.
It is also interesting to see that although the market is
easy to intervene, this has not occurred. The only expla-
nation might be that the disappearance of this drug could
result in the massive reappearance of abortion by means
of abortions performed by non-qualified gynecologists,
with the consequences known to us all [16]. Nevertheless,
in order to ensure th at there is no psychological pressure
when obtaining data, the Chilean Ministry of Health has
issued precise Guidelines to medical professionals on the
use of Misoprostol in patients who request emergency
treatment, or who are about to have an abortion, or have
suffered the consequences of abortion [17].
Hospital discharges according to age show a profile
similar to that described in various very old studies on
abortion in Chile [18]. The larger proportion of hospital
discharges for abortion in the categories, Other abnormal
products of conception (O02) between the ages of 30 to
34 years and the items Other Abortions (O05) and Un-
specified Abortions, with higher rates between the ages
of 20 and 24, years leads us to suspect the existence of
incomplete diagnoses at hospital discharge in the ages
with a higher frequency of abortion. This confirms the
Table 4. Abortion rates by age. Chile 2001-2010 by 10,000 Fe-
male population.
Age Female
At year 2005(*)
Mean of
in ten years(**)
Rates per
10,000 fem a le
10 - 14731,237 160 2.2
15 - 19719,637 3579 49.7
20 - 24651,942 5868 90.0
25 - 29580,621 6749 116.2
30 - 34618,176 6949 112.4
35 - 39620,390 6289 101.4
40 - 44634,370 3382 53.3
45 - 54987,607 474 4.8
Total 5,543,980 33,448 60.3
(*)National Chilean Population. Information from Chilean National Institute
Statitics. One case of abortion: 5 - 9 years old was not included. (**) Annual
mean Hospital abortion discharges (Total abortion in 10 years/10).
Copyright © 2013 SciRes. OPEN ACCESS
R. Molina-Cartes et al. / Open Journal of Obstetrics and Gynecology 3 (2013) 732-738
Tabl e 5. Maternal Mortality Rates by 100,000 NB and Fatality Abortion Rates. by 100,000 abortionhospital discharges. Chile 2001-
Year Rates (*) O00-O08a O10-O95b O96-O97c O98-O99d Total
(**) N0Ab. Dischargesand
Fatality Rates ***
2001 N0 4 29 1 11 45 246,116 34,385
MmR 1.6 16.7 18.3 11.6
2002 N0 7 27 0 9 43 238,981 34,968
MmR 2.9 15.1 18.0 20.0
2003 N0 5 18 0 7 30 234,486 33,497
MmR 2.1 10.7 12.8 14.9
2004 N0 4 22 0 16 42 230,352 33,645
MmR 1.7 16.5 18.2 11.9
2005 N0 7 21 3 17 48 230,831 33,184
MmR 3.0 17.8 20.8 21.1
2006 N0 7 22 0 18 47 231,383 33,145
MmR 3.0 17.3 20.3 21.1
2007 N0 4 26 2 12 44 240,569 32,532
MmR 1.7 16.6 18.3 12.3
2008 N0 5 25 0 11 41 246,581 33,424
MmR 2.0 14.6 16.6 15.0
2009 N0 3 28 0 19 50 252,240 33,772
MmR 1.2 18.6 19.8 8.9
2010 N0 6 23 1 16 46 250,643 31,933
MmR 2.4 16.0 18.4 18.8
C.Ce 0.68 0.38 0.90 0.16 0.46 0.90
N0 60 264 10 148 482 2,195,182 334.485
To tal
10ys. MmR 2.4 17.5 19.9 15.5
*Maternal Mortality Rate (MmR) per 100,000 NB (Report from Health Ministry). **Total Number of New Born per year (Report from Health Ministry).
***Fatality Rate: Abortion death per 100,000 hospitalized abortion cases per year. aAbortion maternal Rates, bDirect maternal Rates cLate maternal Rates dIndi-
rect Maternal Rates; eLinear Pearson Correlation Cofficient (n/s).
fact that in situations of extreme penalization of volun-
tary abortion, these figures are increased artificially. The
same happens with spontaneous abortion at all ages be-
tween 20 and 34, which reaches proportions that are
much higher than the expected 10 to 15% [19].
In the item Risk per Live Births, age distribution
shows the classical evolution of fertility risk according to
age [20]. Nevertheless the highest rates are seen in the
categories other Abnormal Products of Conception and
Non-specified Abortions, which reaffirm the doubt re-
garding an over-dimensioning of these categories that
cover up non septic complications of voluntary pharma-
ceutically induced abortions
Molar pregnancy reaches its highest levels at both ex-
tremes of reproductive life, as has been seen in other
publications, and reaffirms the fact that very early or late
pregnancies tend to present genetic malformations in
humans [20,21]
With regard to the expression of abortion risk for
Women of Fertile Age, abortions accumulate in the in-
termediate reproductive age (25 - 39 years). When abor-
tion is expressed according to Live Birth risk and ac-
cording to age, the two highest rates appear in the cate-
gories, Other Abnormal Products of Conception (O02)
and Unspecified Abortions (O06). This profile is ex-
plained as a consequence of the Chilean legislation that
covers up real d i ag n o se s, a s has been expl ai n ed above.
Another extremely important fact is the high fre-
quency of medical recommendations on the part of the
specialty of Obstetrics and Gynecology for the interrupt-
tion of pregnancy owing to Ectopic Pregnancy, Molar
Pregnancy and almost the totality of the category Other
Abnormal Products of Conception [11]. To these head-
ings it is necessary to add failed abortion attempts, which
is a specialized medical action and the complications
mentioned in the first three items of the ICD 10. All this
comes to 68% of hospital discharges. It is impossible to
give an exact estimate of how many abortions have been
caused by reasons of health, and which have been in-
cluded in the categories Other Abortion and Non-Speci-
fied Abortions. It is expected that in this profile 7 of
every 10 hospital discharges correspond to interrupted
pregnancies owing to reasons of health, which places
Chilean law in a situation of contradiction, and makes it
Copyright © 2013 SciRes. OPEN ACCESS
R. Molina-Cartes et al. / Open Journal of Obstetrics and Gynecology 3 (2013) 732-738 737
inapplicable, generating more risks than benefits and
reveals the misinterpretation of a public policy based on
laws that do not adjust to th e reality of the normal evolu-
tion of human fertility and its consequences on maternal,
fetal and perinatal morbidity
Chile has maintained one of the lowest maternal mor-
tality rates in the Latin American Region, but this decade
shows no great variations that indicate a falling trend.
This occurs with Direct, Indirect and Total Maternal
Mortality. It will possibly be necessary to implement
additional measures in the areas of promotion and early
detection of obstetric pathologies like hypertension, es-
pecially among youngsters of under 20 years of age in-
order to change this rising trend. There is no change is
specific abortion mortality.
The Abortion Fatality Rate per abortion varies amply
with a tendency to remain as it is, which reflects th e lack
of impact of undesired pregnancy prevention measures or
the non-application of a strategy aimed specifically at
women with high Predictive Risks which had been suc-
cessfully applied in the country [22]. For Chile, with
extremely restrictive anti-abortion laws, it is impossible
to gain more in-depth knowledge of what is really hap-
pening in the community. Furthermore, this restrictive
law has no impact on the reduction of Matern al Mo rtality
or on Abortion Fatality Rates.
Following the logic of a projection, this unchanged
mortality should take into account the near-disappear-
ance of septic complications which have been described
as one of the great causes of maternal death by abortion.
The CELADE (Latin American Centre for Demography)
projection for Chile, based on an old study [23] calcu-
lated that for every woman hospitalized for abortion
complications, there were 2 or 3 women in the commu-
nity who aborted without complications, or who did not
go to hospital, or whose complication was treated on an
outpatient basis. Guttmacher has presented another series
of projections for the countries of the Region [24], in
which Chile has 3 women with illegal abortions who do
not go to hospital for every hospi tal di scharge for abortion.
This current profile of hospitaldischarges for abortion
considers that the following categories should be taken
as voluntary abortions: Other abortions (O05), Non-
specified abortions (O06), Failed abortion attempt (O07)
with an annual average of 11,800 abortions to which it
would be necessary to add 50% of hospital discharges for
Other abnormal products of conception (O02): 6300
and 10% of hospital discharges for spontaneous abor-
tions, which totals 18,200 hospital discharges per annum
for induced abortion. With the introduction of Misopros-
tol, this figure should be multiplied by 6, because it is
estimated that for every hospital discharge for abortion,
at least 6 women will have interrupted their pregnancy
by means of abortion, without requiring hospital care.
This gives us an estimated tot al of 109,200 induced ab or-
tions per annum in the country. This figure could vary
between 72,800 and 145,600.
The situation in Chile is characterized by a profile of
Maternal and Perinatal Health with fewer risks than other
developing countries, but with a tendency for an in-
crease of Direct and Indirect Maternity Risks, and a sta-
bilization in abortion deaths expressed as maternal mor-
tality and abortion fatality. The current legal framework
of extreme penalization and restriction of abortion have
not given the expected results in the welfare of the popu-
lation; it violates the fundamental human rights of wo-
men and exposes them to violence, abuse, discrimination,
damage to their physical and mental integrity. Other
studies show that in countries where abortion is legal,
abortion rates fell as a consequence of the implementa-
tion of services which, together with providing the pos-
sibility of a safe abortion, give proper counseling ser-
vices and offer access to methods for preventing new
unwanted abortions [25].
In Chile, it has been shown that good quality contra-
ception, including good quality service, and an ample
availability of contraceptive methods prescribed by phy-
sicians and midwives, significantly prevent unwanted
pregnancies in women with high predictive abortion risk
[22]. These sim pl e measures ha ve not been applied .
The profile of hospital discharges for abortion in Chile
shows a serious discrepancy between the abortion law
and the daily practice of medicine in Health Services of
the Public and Private Health Systems. Health professio-
nals and workers are exposed daily to ethical conflicts,
and tensions are created that contribute to hiding and giv-
ing misinformation on the grave problem of abortion and
its consequences, seriously affecting reliable epidemiclo-
gical information leading to making decisions on t his issue.
This reality, which applies to various countries in the
region, has received an international recommendation to
“Consider the possibility of amending the laws regula-
tions, strategies, and public policies on the voluntary
interruption of pregnancy in order to protect the lives and
health of women and adolescents, improving their qual-
ity of life and reducing the number of abortions” [26].
This study once again reaffirms the urgency with which
our country must obey this recommendation.
[1] Código de Derecho Sanitario Chileno. (1967) Artículo
No. 119, 1989.
[2] Ley sobre el aborto Republica de El Salvador. (2012)
Copyright © 2013 SciRes. OPEN ACCESS
R. Molina-Cartes et al. / Open Journal of Obstetrics and Gynecology 3 (2013) 732-738
Copyright © 2013 SciRes.
[3] Busuttil, C. (2005) Plans for abortion law to be entren-
ched in Constitution, Times of Malta.
[4] Supreme Court of Nicaragua. (2008) Challenge to Abor-
tion Law in Nicaragua/Amici.
[5] World Health Organization, Guttmacher Institute. (2012)
Facts of induced abortion worldwide. Brief Fact Sheet.
[6] WHO. (1978) Induced abortion. Technical Report 623,
[7] Carlos Künsemüller L. (2013) Delito de Aborto. Apuntes
de derecho penal facultad de derecho. Universidad de
Chile Departamento de Ciencias Penales.
[8] WHO. (1994) International classification of diseases.
Revision 10.
[9] Departamento de Estadísticas (DEIS). (2013) Ministerio
de Salud de Chile.
[10] Instituto Nacional de Estadísticas de Chile (INE). (2013).
[11] Beckmann, C., Ling, F.W., Herbert, W.N.P., Laube , D.W.
Smith, R.P, Casanova, R., Chuang, A. Goepfert, A.R.
Hueppchen, N.A. and Weiss, P.M. (2014) Ectopic Preg-
nancy and Molar Pregnancy. In: Horvath, K. andWilliams,
L. Eds., Obstetrics and Gynecology (7th Edition),
179-185; 394-395. Lippincott Williams & Wilkins, 351
West Camden Street Baltimore MD 21201, USA, Printed
in China.
[12] Casas, L. and Vivaldi, L. (2013) La pelización del aborto
como una violación a los derechos humanos de las mu-
jeres. Informe Anual sobre Derechos Humanos en Chile,
2013. Universidad Diego Portales. Ediciones UDP.
[13] Molina, R.C. (2013) Aspectos bioéticos del aborto en
Chile. 2nd Edition, Revista Chilean Obstetricia y Gine-
cologia, 78, 259-261.
[14] WHO. (2012) Safe abortion: Technical and policy gui-
dance for health systems. 2nd Edition. Geneve.
[15] (2013) Aborto en Latinoamérica. Información de aborto
en Latinoamérica. El misoprostol es un método seguro
para abortar en la clandes ti nidad.
[16] Donoso, E. (200) ¿Unsafe Abortion in Chile? Revista
Chilena de Obstetricia y Ginecología, 73, 359-361.
[17] Ministerio de Salud. (2009) Ordinario A 15. 1675. Ex-
tracción de confesiones sobres conductas abortivas de pa-
cientes mujeres.
[18] Ramiro Molina C. (1995) Aborto Inducido. In: Sánchez,
G.A.P. (2nd Edition), Ed., Mediterráneo Santiago. Chile.
[19] Silva, S. (2011) Aborto 2011. In: Obstetricia. Editores
Pérez Sánchez, Enrique Donoso. Cuarta Edición. Edito-
rial Mediterráneo, Santiago.
[20] Committee on Maternal Nutrition/Food and Nutrition
Board (1970) Biosocial and psycogical determinants of
pregnancy outcome (16-20). Maternal nutrition and the
course of pregnancy. National Academy Science. Washing-
ton DC.
[21] Gamer, E.L., Goldstein, D.P., Felmate, C.M. and Ber-
kowitz, R.S. (2007) Gestational trophoblastic disease.
Clinical Obstetrics and Gynecology, 50, 112-122.
[22] Molina, R., Pereda, C., Cumsille, F., Martinez Oliva, L.,
Miranda, E. and Molina, T. (1999). Prevention of pre-
gnancy in high risk women: Community intervention in
chile. Chapter 2 (57-77). In: Mundigo, A. and Indriso, C.,
Eds., Abortion in the Developing World, WHO, Vistaar
Publication, London.
[23] Barbara Santee (1975). A prospective abortion study in
Santiago, Chile. Scientific Publication. No 206. Pan Ame-
rican Health Organization.
[24] Rossier C. (2003) Estimating induced abortion rates: A
review. Studies in Family Planning, 34, 87-102.
[25] Sedgh, G., Singh, S., Shah, I.H., Ahman, E., Henshaw,
S.K. and Bankole, A. (2012) Induced abortion: Incidence
and trends worldwide from 1995 to 2008. Lancet, 379,
[26] CEPAL. (2013) Consenso de Montevideo. Primera reu-
nión de la conferencia regional sobre población y desar-
rollo de América Latina y el caribe. Page 14/42.