Abortion is one of the basic reproductive rights of a woman. Unsafe abortion is the root cause of many sexual and reproductive health problems in India. Although it can be prevented but still it is the most common issue that occurs be it legal or illegal. 98 % of unsafe abortions happen in developing nations. In spite of all progress in medical science, women still die due to unsafe abortions and millions suffer from illness as its consequence. The main reason for it is either the person is not trained to perform or it is done in a substandard way compromising sterilization or both. Complication of unsafe abortion causes severe morbidities like infection, hemorrhage, injury to internal organs due to perforation and incomplete abortion leading to sepsis, anemia, secondary infertility, prolonged bleeding and operation of internal organs by opening of abdomen (laparotomy).
Dr. Sonia Malik said, “The rate of unsafe abortions in our country has increased tremendously in the recent time. Girls who conceive at a young age have little knowledge on safe abortion and post-abortion care; opt for abortion from any easily accessible clinic or doctor. This leads to blockage of fallopian tubes, which carry the egg from the ovaries to the uterus which further leads to infertility in the future. Rural India is especially reeling under the burden of unsafe abortion and also do not have resource to take High end infertility treatment like IVF. Measures to educate these women should be our priority! ”
In India, abortion on request is legal up to 20 weeks. After 12 weeks proper consultation from gynecologists is required along with a valid reason. There are many socio economic barriers for provision of proper facilities to conduct an abortion. Second problem in India is lax law. Although a clear cut law for Medical Termination of Pregnancy (MTP) exists but nobody follows it. Any chemist or nurse or dai openly perform abortions in an illegal manner that is punishable by the court of law.
Dr. Ragini Agrawal said, “Unsafe abortion is completely preventable because abortion is legal in India. But due to social stigma, women fear to get a legal abortion done and fall prey to illegal practitioners. In rural areas, there are many myths and misconceptions related to abortion. Also, aborting the first child may cause infertility in future or fertilization in the fallopian tube itself or abnormal pregnancy. Surgical abortion involves insertion of foreign objects in the vagina which has very high risk of infection. In many cases of unsafe abortion the intestine too can be ruptured and hemorrhagic bleeding can also occur. The only solution for this is education women on these health issues.
World Health Organization (WHO) defines unsafe abortion as a procedure for terminating an unintended pregnancy either by individuals without the necessary skills or in an environment that does not conform to minimum medical standards, or both.
It is very difficult to access exact data of illegal abortions as most of the abortions carried out at unregistered places are not reported. A big chunk of these females are young girls who are sexually assaulted or had consensual sex with boyfriends but due to fear of society they do not go to proper places. It is very common in our society and one or more women die from an unsafe illegal abortion especially the underprivileged strata.
1. Unsafe abortions are a preventable. It poses huge burden of maternal morbidity and mortality on society.
2. Although it is difficult to give exact data but more than 15 million unsafe abortions are done world wide and 97 % in developing countries.
3. Around one million die and many millions suffer due to its consequences.
4. Although legalization of abortion on request is a big step towards its solution, still we have to go many miles for preventing it.
5. It is necessary to provide proper knowledge of contraception to society. Pregnancy too is not preventable in all the cases as No contraceptive gives 100% protection.
6. Main consequences of unsafe abortion other than death are hemorrhage, infection, sepsis, anemia, injury, secondary infertility and poisoning from things used for induced abortion like putting chemicals inside vagina. Unsafe abortion could also increase risk of ectopic pregnancy, premature delivery in subsequent pregnancies
7. Only solution of its prevention is legalized, easily accessible abortion. Health education is the biggest tool to make women aware about this.
8. It is a huge burden on economy of poor countries to deal with consequences of unsafe abortions
Health education, awareness for methods of contraception, strict laws for quacks for disobeying MTP law and female feticide at the community level are few measures that can reduce this preventable menace.
Thanks & best regards
adhey S. Gaud
c-40, 2nd floor
south ext ii new delhi