Reviewer ’s report  
 
Title: Trends in Comprehensive Abortion Care (CAC) and Characteristics of Women Receiving  
abortion care in Tertiary Hospital in Nepal.  
 
Version: 3 Date: 10 Jan 2018  
 
Reviewer: Sam Rowlands  
 
Reviewer's report:  
 
This is a retrospective case note review of abortion care at a single hospital in Nepal over a ten -
year period. There are some problems with this paper and I cannot recommend publication in its 
present form.  
 
The grammar needs attention - in particular the definite and indefinite article are missing 
throughout.  
 
Readers would benefit from some explanation of the ethnic groups in Table 1.  
 
The author refers to the prevalence of abortion complications - this should be incidence.  
 
The references are somewhat dated  and there are several transcription errors.  
 
All five Figures need legends - I would question the need for Figure 1.  
 
Developing countries are often referred to as low -resource countries these days.  
 
According to Ganatra et al in the Lancet 2017, 24.3 millio n abortions in low resource countries 
are unsafe (reference 1 is dated).  
 
Nepalese references 2 - 4 are all 5 - 10 years old.  
 
The author has missed the systematic review of mid -level providers by Sjostrom et al in BJOG in 
2017.  
 
Two key WHO documents are not  cited: Clinical practice handbook for safe abortion 2014 and 
Health worker roles in providing safe abortion care and post -abortion contraception 2015.  
 
The internationally accepted abbreviation for an intrauterine device is IUD.  
 
Although nurses and doctors  in the study perform treatments at different gestations, I think some 
attempt should be made to determine the significance of the difference in complication rates.  
 
Modern guidelines do not recommend the routine use of the uterotonic methylergonovine.  
 
Are the methods appropriate and well described ? 
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify wh at aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
 
 
 
 
 
 
 
Declaration  of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose fin ancially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you  hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript ? 
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
 
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is ye s to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any atta chments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal