OBJECTIVES: To investigate the use of manual vacuum aspiration in postabortion care in Malawi between 2008–2012.
METHODS: A retrospective cross-sectional study was done at the referral hospital Queen Elisabeth Central Hospital, and the
two district hospitals of Chiradzulu and Mangochi. The data were collected simultaneously at the three sites from Feb-March
2013. All records available for women admitted to the gynaecological ward from 2008-2012 were reviewed. Women who
had undergone surgical uterine evacuation after incomplete abortion were included and the use of manual vacuum
aspiration versus sharp curettage was analysed.
RESULTS: Altogether, 5121 women were included. One third (34.2%) of first trimester abortions were treated with manual
vacuum aspiration, while all others were treated with sharp curettage. There were significant differences between the
hospitals and between years. Overall there was an increase in the use of manual vacuum aspiration from 2008 (19.7%) to
2009 (31.0%), with a rapid decline after 2010 (28.5%) ending at only 4.9% in 2012. Conversely there was an increase in use of
sharp curettage in all hospitals from 2010 to 2012.
CONCLUSION: Use of manual vacuum aspiration as part of the postabortion care in Malawi is rather low, and decreased from
2010 to 2012, while the use of sharp curettage became more frequent. This is in contrast with current international