Understanding Causal Routes and Sources of Unsafe Abortions: A Prospective Study amongst Abortion Clients in Selected Hospitals Medical Colleges of Madhya Pradesh-India

Unsafe abortion costs 12000 lives of women in India every year mostly due to lack of safe access of abortion services. Unfortunately, there is limited research that has looked holistically the causal routes and pathways of these unsafe abortions or aimed at reaching women who had faced post-abortion complications (PAC) as a consequence of unsafe abortion.

To address these gaps, an operation research has been launched in 10 selected secondary & tertiary hospitals to understand the incidence, types and severity of post-abortion complications, probable causes and routes of complications, type & profile of providers and uterine evacuations techniques which lead to complications, and consequences PAC in terms of hospitalization and cost to family.

With appropriate ethical clearance, the study has been carried out for five months (July-November 2008) in selected 10 hospitals. All women identified with post-abortion complications (PAC) by a trained medical provider were approached for a detail interview. A total of 381 women identified with PAC were successfully interviewed.

Data reveals a very high prevalence of post-abortion complication (29%). Complications include incomplete, missed & failed abortions with severe bleeding (67%) and perforation and injuries to organs (2%). 53% of women reported attempting abortion at home either through medications (84%) followed by homemade concoctions and local traditional methods (15%); 54% women admitted into hospital and 42% required blood/glucose transfusions. Average total cost of treating PACs comes out Rs. 721 ($18). Further controlled analysis will provide much room to understand the predominant cause of these complications.