244179 Unsafe abortions: The first contraception method used by married couples to limit family size in Pakistan

Monday, October 31, 2011

Amna Rizvi, Masters Candidate, Public Health , School of Medicine, Public Health, University of Pennsylvania, Philadelphia, PA
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.

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs

Learning Objectives:
By the end of the session, the participants will be able to: 1. Describe abortion-related morbidity and mortality in Pakistan. 2. Identify reasons why married couples seek unsafe abortions to limit family size. 3. List methods of unsafe abortions used in Pakistan. 4. Identify solutions to unsafe abortion-related morbidity and mortality in Pakistan

Keywords: Abortion, Contraception

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Prior to enrolling in the Master's of Public Health program at the University of Pennsylvania, I was a Health Reporter in Pakistan. I have produced and written numerous stories on women's health issues, particularly stories related to family planning, domestic violence and abortion. I have also worked as a Communications Specialist for Maternal and Neonatal health organizations in Pakistan and the United States.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.