Unsafe Abortions and Their Complications: Recent Experiences in a Rural Tertiary Care Facility

Abstract

Introduction The number of abortions when classified into facility based , medical abortions outside facilities and other type of abortions constituted a medium of 3375252, 14837497 and 807251 cases respectively, when adjusted for various parameters for India. The present study was conducted to include abortions outside medical facilities including methods of abortion, clinical complaints, complications and their management. Material and methods The hospital records for patients who underwent abortions were accessed for a four year period from 2016-2020. The number of patients undergoing supervised abortions and patients presenting with incomplete abortions or related complications were recorded. The presenting complaints for spontaneous abortions and abortions done outside medical health facility along with the therapeutic interventions for such unsafe abortions including complications were assessed. Results The total numbers of abortions were 4316, out of which hospital supervised termination of pregnancies constituted 59.8% where as abortions or related complications outside a medical facility were 40.2 %. The modes of abortion, presenting features and complications of abortions performed outside medical facilities (total number=1824) and the treatment were recorded. Out of these patients with spontaneous abortions were 36.8% whereas those presenting with complications constituted 63.2%. The commonest method for such abortions was use of abortions pills but other abortifacients and crude instrumentation were also recorded. The commonest clinical feature was discharge per vagina, with retained products of conception causing most complications. The main therapeutic procedure done was dilatation and curettage. Conclusion The rural population needs a robust health facility for abortion related care. The sale of abortion pills needs to be tightly regulated . Similarly, crude instrumentation which is a significant cause of morbidity, in unsupervised abortions can be eliminated by awareness and strengthening the health care system making it more approachable for women in rural population.