Unsafe abortions: The first contraception method used by married couples to limit family size in Pakistan

In Pakistan, 890,000 induced abortions happen every year, and an estimated 197,000 women are treated annually for complications stemming from induced abortions, like fistulas, bowel complications, hemorrhage, acute and chronic pelvic infections, septicemia, infertility and even death. But, because abortion is legally restricted and stigmatized by religion and society in Pakistan, it is extremely difficult to gather reliable data. Hence, induced abortion rates in Pakistan and the unsafe abortion-related morbidity and mortality are most probably underestimated.

Unlike most countries, the majority of Pakistani women seeking abortions are married and multi-parous. The main reasons these women opt for abortions are: (i)they have reached their ideal family size (ii)socioeconomic concerns and (iii) birth spacing. Due to the lack of safe abortion services and the legal restrictions on abortions, women desperate for pregnancy termination end up in the hands of untrained, traditional birth attendants (TBAs), who are the most common providers of induced abortions, particularly for rural women. Methods used to induce abortion are dilation and curettage (D&C), insertion of intra-uterine foreign bodies like knitting needles, coat hangers, bamboo sticks, vaginal and oral hormones and pills and vigorous abdominal massage.

Unsafe abortions in Pakistan greatly place the lives of women at risk and deserve the same kind of attention from public health officials, governmental agencies and medical professionals as other public health issues do. Pakistan needs to drastically improve its family planning services, conduct extensive research on reproductive health issues, legalize abortion and provide ready access to safe abortion services.