Post-abortion care in Pakistan: A national study

Abstract

The Population Council confronts critical health and development issues-from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs, and technologies that improve lives.

Induced Abortions and Unintended Pregnancies in Pakistan

“…The increased recourse to this reproductive strategy may be partly explained by wider access to improved abortion care services, such as misoprostol and manual vacuum aspiration (MVA) (Sathar et al 2013). Compared with 2002, a much higher proportion of HPS respondents reported misoprostol and MVA as methods of abortion in 2012, and misoprostol was perceived by HPS respondents as one of the two most commonly used abortion methods, with dilation and curettage (D&C) being second (Sathar et al 2013).…”

“…Compared with 2002, a much higher proportion of HPS respondents reported misoprostol and MVA as methods of abortion in 2012, and misoprostol was perceived by HPS respondents as one of the two most commonly used abortion methods, with dilation and curettage (D&C) being second (Sathar et al 2013). The large increase in the absolute number of abortions and postabortion complications documented by this study may in part reflect increased use of misoprostol.…”

“…This has allowed the private sector (which provides better quality of care) to step in and become the leading source of outpatient consultations and maternal and child health services, despite their high cost (World Bank 2010; Afzal and Yusuf 2013). This trend toward the private sector is also reflected in the provision of postabortion care, where an estimated 62 percent of women were treated by private-sector providers in 2012 (Sathar et al 2013). Increasing urbanization is also likely linked to increased access to private health care services in general, including providers of abortion services.…”

Abortion and fertility control in Pakistan: the role of misoprostol

“…While these services offer women a greater degree of confidentiality and some protection from punitive measures,3 they are typically administered by poorly trained providers lacking the appropriate equipment and medical training needed to safely perform the procedure 6 7. Risks of acute and long-term complications such as damage to reproductive organs and secondary infertility are elevated in such unsafe settings 8.…”

“…It was not, however, until 2012, after misoprostol was put on the 16th World Health Organization Model List of Essential Medicines, that Pakistan permitted its availability in the country for prevention and treatment of postpartum haemorrhage and management of incomplete abortion 14. In 2014, clinical protocols for use of the drug were endorsed by all provincial health departments and the drug's use was included in Pakistan's nursing, community midwifery and community health worker training curriculum 3 7 15…”