Exploring the costs and economic consequences of unsafe abortion in Mexico City before legalisation.

An assessment of abortion outcomes and costs to the health care system in Mexico City was conducted in 2005 at a mix of public and private facilities prior to the legalisation of abortion. Data were obtained from hospital staff, administrative records and patients. Direct cost estimates included personnel, drugs, disposable supplies, and medical equipment for inducing abortion or treating incomplete abortions and other complications. Indirect patient costs for travel, childcare and lost wages were also estimated. The average cost per abortion with dilatation and curettage was 143 US dollars. For manual vacuum aspiration it was 111 US dollars in three public hospitals and 53 US dollars at a private clinic. The average cost of medical abortion with misoprostol alone was 79 US dollars. The average cost of treating severe abortion complications at the public hospitals ranged from 601 US dollars to over 2,100 US dollars. Increasing access to manual vacuum aspiration and early abortion with misoprostol could reduce government costs by 62%, with potential savings of up to 1.6 million US dollars per year. Reducing complications by improving access to safe services in outpatient settings would further reduce the costs of abortion care, with significant benefits both to Mexico's health care system and women seeking abortion. Additional research is needed to explore whether cost savings have been realised post-legalisation.