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UNSUCCESSFUL PRIOR ATTEMPTS TO TERMINATE PREGNANCY AMONG WOMEN SEEKING FIRST TRIMESTER ABORTION AT REGISTERED FACILITIES IN BIHAR AND JHARKHAND, INDIA

Published online by Cambridge University Press:  03 September 2012

RAJESH KUMAR
Affiliation:
Population Council, New Delhi, India
A. J. FRANCIS ZAVIER
Affiliation:
Population Council, New Delhi, India
SHVETA KALYANWALA
Affiliation:
Population Council, New Delhi, India
SHIREEN J. JEJEEBHOY
Affiliation:
Population Council, New Delhi, India

Summary

Many abortion seekers in India attempt to induce abortion on their own, by accessing oral medication/preparations from a chemist without a prescription or from an unauthorized provider, and present at registered facilities if these attempts fail. However, little is known about those whose efforts fail or the ways in which programmes and policies may address the needs of such women. This paper explores the experiences of women whose efforts failed, including their socio-demographic profile, the preparations they used, and the extent to which they experienced serious complications, delayed seeking care from an authorized provider, or delayed abortion until the second trimester of pregnancy. Data come from a larger study assessing the feasibility of the provision of medical abortion by non-physicians; a total of 3394 women who sought medical abortion from selected clinical settings in Bihar and Jharkhand between 2008 and 2010 constitute the sample. Prior to visiting the clinic, nearly a third of these women (31%) had made at least one unsuccessful attempt to terminate the unwanted pregnancy by using a range of oral medications/preparations available over-the-counter in medical shops. Logistic regression analysis suggests that educated women (OR 1.6–1.7), those from urban areas (OR 6.2) and those from Bihar (OR 1.6) were significantly more likely than women with no education, rural women and those from Jharkhand to have used such medication. Also notable is that the average gestational age of women who had made a previous attempt to terminate their pregnancy was almost identical to that of women who had not done so when they presented at the registered facility. These findings may inform policies and programmes that seek to identify and reduce the potential risks associated with unauthorized abortion-seeking practices, and highlight the need to fully inform women, chemists and providers about oral medications, what works and what does not, and how effective medication must be taken.

Type
Articles
Copyright
Copyright © Cambridge University Press 2012

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References

Asia Safe Abortion Partnership (n.d.) Country Profile – India. URL: http://www.asap-asia.org/country-profile-india.htm (accessed 6th July 2011).Google Scholar
Banerjee, S. K. & Clark, K. A. (2009) Exploring the Pathways of Unsafe Abortion: A Prospective Study of Abortion Clients in Selected Hospitals of Madhya Pradesh, India. Ipas, New Delhi.Google Scholar
Drugs Controller General, India (2006) Number of Permission and Date of Issue MF-7059/06.Google Scholar
Elul, B., Barge, S., Verma, S., Kumar, N., Bracken, H. & Sadhvani, H. (2004) Unwanted Pregnancy and Induced Abortion: Data from Men and Women in Rajasthan, India. Population Council, New Delhi.Google Scholar
Ganatra, B., Manning, V. & Pallipamulla, S. P. (2005) Availability of medical abortion pills and the role of chemists: a study from Bihar and Jharkhand, India. Reproductive Health Matters 13(26), 6574.CrossRefGoogle ScholarPubMed
Government of India (1971) The Medical Termination of Pregnancy Act (Act No. 34). Government of India, New Delhi.Google Scholar
Government of India (2003a) The Medical Termination of Pregnancy Rules (Amendment) 2003. Government of India, New Delhi.Google Scholar
Government of India (2003b) The Drugs and Cosmetics Act Rules. URL: http://cdsco.nic.in/html/copy%20of%201.%20d&cact121.pdf (accessed 13th January 2012).Google Scholar
IIPS & Macro International (2007) National Family Health Survey (NFHS-3), 2005–06: India. Volume I. International Institute for Population Sciences, Mumbai.Google Scholar
Jejeebhoy, S. J., Kalyanwala, S., Mundle, S., Tank, J., Zavier, A. J. F., Kumar, R., Acharya, R. & Jha, N. (2012) Feasibility of expanding the medication abortion provider base in India to include Ayurved physicians and nurses. International Perspectives on Sexual and Reproductive Health (forthcoming).CrossRefGoogle Scholar
Jejeebhoy, S. J., Kalyanwala, S., Zavier, A. J. F., Kumar, R. & Jha, N. (2010a) Experience seeking abortion among unmarried young women in Bihar and Jharkhand, India: delays and disadvantages. Reproductive Health Matters 18(35), 167168.CrossRefGoogle ScholarPubMed
Jejeebhoy, S. J., Zavier, A. J. F. & Kalyanwala, S. (2010b) Assessing Abortion-Related Experiences and Needs in Four Districts of Maharashtra and Rajasthan, 2006. Population Council, New Delhi.CrossRefGoogle Scholar
Ministry of Health and Family Welfare (2011) Family Welfare Statistics in India. Department of Family Welfare, MOHFW, New Delhi.Google Scholar
Mundle, S., Kalyanwla, S., Elul, B. & Ughade, S. (2008) Simplifying medical abortion: home administration of misoprostol. Journal of Obstetrics and Gynecology of India 58(5), 410416.Google Scholar
Office of the Registrar General and Census Commissioner (2011) Provisional Population Totals. Paper 1 of 2011 India Series 2011. Government of India, New Delhi.Google Scholar
Sujay, R. (2009) Premarital Sexual Behaviour among Unmarried College Students of Gujarat, India. Health and Population Innovation Fellowship Programme Working Paper No. 9. Population Council, New Delhi.CrossRefGoogle Scholar
World Health Organization (2003) Safe Abortion: Technical and Policy Guidance for Health Systems. World Health Organization, Geneva.Google Scholar
WHO-CCR in Human Reproduction (2003) RU 486: Use of RU 486 with Misoprostol for Early Abortion in India: Guidelines for Medical Officers. All India Institute of Medical Sciences, New Delhi.Google Scholar