In Bangladesh, early-gestation pregnancy terminations, known as menstrual regulations (MR), provided at public health facilities are legal, while illegal, less safe abortions are available from village practitioners. Previous studies show that abortion has increased with the fertility decline in Bangladesh and the increase in abortion is associated with the increased desire to limit and space births. However, abortion has either stabilized or declined in the Matlab MCH-FP area where family planning services are more available and of a higher quality than in the “comparison area” where only the standard government family planning services are available. Longitudinal data was used from the Matlab Demographic Surveillance System to compare abortion behavior in the MCH-FP area with that in the comparison area. The percentage of pregnancy terminations by MR increased over time in both areas so that by 1994-98, the majority of pregnancy terminations were by a safer, legal method. The increase in this percentage was greater in the MCH-FP area, and the percentage of pregnancy terminations that are unsafe is now significantly lower in the MCH-FP area than in the comparison area. MR is practiced relatively more by those with higher education and those with greater household space (a proxy for income). We conclude that legal abortion is still an “access” issue: those who are not aware of MR services or those who cannot afford MR services are at a greater risk of unsafe abortions which causes a huge toll on morbidity and mortality.
Learning Objectives: At the conclusion of the session, the participants will be able to: 1) identify which programmatic and socio-economic factors affect the choice of safe abortion; and 2) discuss the policy implications that will help reduce abortion, especially unsafe abortion.
Keywords: Abortion, Access
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.