Background and Aims: In spite abortion has been legalized in India over three decades, unsafe abortion continues to be a significant contributor of maternal mortality and morbidity. The aim of the present study is to assess the magnitude of septic abortion in a tertiary care hospital over a period of three years with a special emphasis on maternal mortality and morbidity and various surgical complications. Settings and Design: Retrospective study of patients who were admitted with unsafe abortions over a three year period from 2005 to 2008 in a tertiary teaching Hospital of Rural India. Materials and Methods: Hospital records of the patients who were admitted with unsafe abortion in three years (2005-2008) were reviewed to evaluate the demographic and clinical profile in relation to age, parity, marital status, indication of abortion , the methods of abortion ,qualification of abortion provider complications and maternal mortality. Results: Unsafe abortion constitutes 11.6% ( n=132) of total abortion cases admitted over 3 years. Majority of women (70.45%) were in their thirties, married (89%).Sixty percent wanted abortion for birth spacing. Abortion methods included various primitive methods (30%) but majority by dilatation and evacuation. About 60% of abortionists were unqualified. Majority of women admitted with serious complications like peritonitis (70%), visceral injuries (60%), hemorrhagic and septic shock, renal failure (17.4%), and life threatening conditions like DIC, hepatic failure and encephalopathy. A total of 231 women died of unsafe abortion making it 12.55% of total maternal mortality in our institution. Out of 73 women requiring laparotomy, 22% were done within 24 hours of admission and majority (49%) were performed beyond 24-48 hours. Interestingly no women died when early aggressive surgery was done. Conclusion: The present study confirms that unsafe abortion is a great neglected health care problem leading to a considerable loss of maternal lives. Education and accessibility of contra caption, readily available, quality abortion services by trained abortion providers remain the key to limit mortality and morbidity arising from unsafe abortion
