Unsafe abortion costs in Mexico City

Until 2007, when first trimester abortion was legalised in Mexico City, abortion was restricted in Mexico. Even in cases when abortion was legal, few states established effective care systems. Women often found illegal abortion services more accessible.

To inform policy decisions on abortion services, researchers documented the economic costs to the health system of caring for women who undergo unsafe abortion. They compared the costs of treating abortion complications (as a substitute for costs of unsafe abortion) with the costs of performing safe abortions (in legal public or illegal private settings) in Mexico City.

Costs were estimated for three hospitals providing post-abortion care and some legal abortions, and one private clinic providing safe but illegal abortion services. Direct costs included personnel, drugs, medical supplies and equipment. Indirect costs included patient travel, child care and lost wages.

Using surveys with hospital staff and patients, as well as a review of facility records, researchers estimated the total cost per woman treated with manual vacuum aspiration (MVA), dilation and curettage (D&C) or medical abortion (MA) using misoprostol.

• At the public hospitals, the average cost per woman of MVA was US$111 and the average cost of D&C was US$143, whilst at the private clinic, the average cost of MVA was US$53 and the average cost of MA was US$79. Operating costs at the private clinic were significantly lower than at the public hospitals.
• The average cost of treating abortion complications at the public hospitals ranged from US$601 to over US$2,100 depending on severity.
• Increasing access to MVA and MA services for early abortion reduces Mexico City government costs by 62 percent, with a potential saving of up to US$1.6 million per year.

Using MVA can reduce the costs of post-abortion care which would benefit Mexico's health system and women who have an unplanned pregnancy. Improving access to safe abortion methods at smaller public and private facilities is likely to result in significant cost savings to the health system, by lowering the incidence of complications and moving services out of hospitals into less costly outpatient settings.

Carol Levin
PATH, 1455 NW Leary Way, Seattle, WA 98107, USA
clevin@path.org

Daniel Grossman
Ibis Reproductive Health, 17 Dunster Street, Suite 201, Cambridge, MA 02138, USA
dgrossman@ibisreproductivehealth.org

Sandra G. Garcia
Population Council, Escondida 110, Col. Villa Coyoac‡n, Deleg. Coyoac‡n, C.P. 04000, México, D.F.
sgarcia@popcouncil.org.mx

See also

'Estimating Costs of Post-Abortion Services at Dr. Aurelio Valdivieso General Hospital, Oaxaca, Mexico', by Carlos Brambila, Ana Langer, Cecilia Garc’a-Barrios and Angela Heimburger, in Post-Abortion Care: Lessons From Operations Research, New York: Population Council, edited by Dale Huntington and Nancy J. Piet-Pelon, 1999

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