Article Text

Download PDFPDF
Barriers to safe abortion access: uterine rupture as complication of unsafe abortion in a Ugandan girl
  1. Rose McKeon Olson1,
  2. Solomon Kamurari2
  1. 1School of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
  2. 2Uganda-UK Health Alliance (UUKHA), Department of Health Innovation and Investment, Kampala, Uganda
  1. Correspondence to Rose McKeon Olson, olso6360{at}


A 15-year-old girl at 18 weeks gestation by the last menstrual period presented to a rural Ugandan healthcare facility for termination of her pregnancy as a result of rape by her uncle. Skilled healthcare workers at the facility refused to provide the abortion due to fear of legal repercussions. The patient subsequently obtained an unsafe abortion by vaginal insertion of local herbs and sharp objects. She developed profuse vaginal bleeding and haemorrhagic shock. She was found to have uterine rupture and emergent hysterectomy was performed. Young and poor women are at high risk of unplanned pregnancy and subsequent mortality during pregnancy and childbirth. Unsafe abortion is a leading and entirely preventable cause of maternal mortality worldwide. Multiple barriers restrict access to safe abortions including social and moral stigma, gender-based power imbalances, inadequate contraceptive use and sexual education, high cost and poor availability, and restrictive abortion laws.

  • global health
  • abortion
  • pregnancy
  • reproductive medicine
View Full Text

Statistics from


  • Contributors The patient initially presented to SK, who understood the importance of this case report and assisted in writing the case presentation. RO developed the concept, performed the literature review and was the main writer.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.