Medical abortion: is it a blessing or curse for the developing nations?

Abstract

Objectives: Medical abortion is definitely a safer and a better option but in developing countries, its widespread misuse has led to partial or septic abortion thereby increasing maternal mortality and morbidity. The study was carried out to analyze the use and misuse of abortion pill and to analyze the factors responsible for avoiding the government facilities. Methods: The study included all female patients who visited the rural health centre of our institute with pre-tested questionnaire, designed in a manner to obtain the qualitative information regarding their attitude towards the abortion services, use of medical methods of abortion and the current contraceptive practices among them. At the end of study, the data was compiled systematically and was subjected to statistical analysis with simple non parametric tests and the value of P<0.05 was considered significant. Results: Only 49.62% of the patients had complete abortion while rest was reported with incomplete (41.54%), septic (6.54%) or failed abortion (1.15%) or ectopic pregnancy (1.15%). Local dais (36.55%) and pharmacists (29.61) were the main channels of procurement of pills used for medical abortion. Non-availability of medical methods (65.38%) and compulsion for the accompanied contraception (35%) were the most commonly cited reasons for avoiding government sector facilities. Conclusions: The low level of awareness, education and misuse of medical methods of abortion are responsible for converting a safe abortion into an unsafe practice. We suggest for an urgent need for strict legislations by the government to regulate the supply of drugs used for medical abortion.

A Study of Complications following Self-administration with Medical Abortion Pills

“…Similarly Ojha et al 15 reported the incidence of infection after self administration of MA as 3.5%. In another study conducted by Bajwa et al, 16 the incidence of sepsis was 6.54% following medical abortion which was similar to our study. In a systematic review covering 46,421 women, the frequency of infection after medical abortion done in ideal condition was less than 1%.…”

Over-the-counter MTP Pills and Its Impact on Women’s Health

“…Federation of Obstetrics and Gynecological Societies of India (FOGSI) recommends close monitoring of distribution of these drugs and that the medical profession and pharmaceutical industry should exercise due diligence in the promotion and usage of drugs that are used for medical abortion [9]. Despite this, it has been perceived by the society that medical abortions are extremely safe option even in the hands of untrained personnel, leading to overthe-counter dispensing and possible increase in unsupervised terminations and life-threatening complications [10]. Being a tertiary care center, we come across many cases of self-medication with abortion pills leading to many complications causing maternal mortality and morbidity.…”

Self-Medication of Abortifacient Agent and Its Impact on Women’s Health- An Experience in a Government Medical College of West Bengal

“…Those 2 patients received multiple blood product transfusions and also were on critical care support. (1) Bajwa et al (9) Sarojini et al (11)…”

“…[8] Despite this, it has been perceived by the society that medical abortions are extremely safe even in hands of untrained personnel, leading to overthe-counter dispensing and possible increase in unsupervised terminations of pregnancy and life-threatening complications. [9] In the present study, we want to highlight the consequences of self-medication of these abortifacient agents. The term self-medication is applied when patient, her husband, her friend or her relative has bought the abortifacient agents (for the patient) over-the-counter without medical guidance/ supervision/ prescription.…”