ABORTION:BY NILISHA PRIYA MENDONCA@LEXCLIQ

ABORTION:

 

 

Abortion means when a pregnancy is ended and it doesn’t result in the birth of a child. It is also called ‘termination of pregnancy’.  Defining and accurately measuring abortion-related incidence is important for understanding the array of risk associated with unsafe abortion and for evaluating the impact of changes in abortion-related policy and practices. The drugs are commonly administered in the presence of clinicians, which is known as provider‐administered medical abortion. In self‐administered medical abortion, drugs are administered by the woman herself without the supervision of a healthcare provider during at least one stage of the drug protocol. Self‐administration of medical abortion has the potential to provide women with control over the abortion process. In settings where there is a shortage of healthcare providers, self‐administration may reduce the burden on the health system. However, it remains unclear whether self‐administration of medical abortion is effective and safe. It is important to understand whether women can safely and effectively terminate their own pregnancies when having access to accurate and adequate information, high‐quality drugs, and facility‐based care in case of complications.

Based on data collected between 1988 and 2014 from 28 countries, it is  estimated that at least 9% of abortion-related hospital admissions have a narrow escape event and approximately 1.5% ends in a death. Haemorrhage was the most common complication reported. There was strong evidence for between-study heterogeneity across most outcomes

The generality of abortion in Nepal is high. Education, religion, age, knowledge about legal abortion and safe places to undergo abortion were the major deciding factors associated with abortion. Young, poorest and uneducated women were more likely to undergo unsafe abortions.

Abortion in India is legal and can be performed until 24 weeks pregnancy after MTP act amendment 2021 comes in force by notification in periodical of India with notification of formation of MTP amendment 2021 rules and regulations. Until then, abortion law in India allows termination of pregnancy till 20 weeks. In exceptional cases, a court may allow a termination after 20 weeks. Abortion expense is covered 100% by the Government’s national health insurances Ayushmaan Bharath and Employees state insurance  with the package rate for surgical abortion being set at ₹15,500 (US$220) which includes consultation, therapy, hospitalization, medication, USG and any follow-up treatments. For medical abortion, the package rate is set at ₹1,500 (US$21) which includes consultation and USG.

The Medical Termination of Pregnancy (MTP) Act, 1971 provides the legal framework for making CAC services available in India. Termination of pregnancy is permitted for a broad range of conditions up to 20 weeks of gestation as detailed below:

  • If continuation of pregnancy is a risk to the life of a pregnant woman or could cause grave injury to her physical or mental health;
  • When pregnancy is caused due to rape (presumed to cause grave injury to the mental health of the woman)
  • When pregnancy is caused due to failure of contraceptives used by a married woman or her husband (presumed to constitute grave injury to mental health of the woman)
  • When there is substantial risk that the child, if born or dead would be seriously handicapped due to physical or mental abnormalities;

Miscarriage leave is legalized:

India was the first country to legalize miscarriage leave. The Maternity Benefit Act 1961 states that in case of miscarriage, a woman will be entitled to paid leave for six weeks immediately following the day of her miscarriage. Women are required to submit proof for miscarriage and willful termination of pregnancy (abortion) is excluded.

In addition, if women are suffering from illness which arises out of miscarriage on production are also entitled to paid leave of upto one month on submission of relevant medical proofs.

 

In December 2017, a 13-year-old rape survivor’s father approached the Bombay High Court seeking permission for the termination of 26-week foetus. The girl was repeatedly raped by her cousin. Considering the

  • report of the medical board which claimed that there was greater risk to the pregnant girl’s life if continued., The Court held that the girl was physically incapable to deliver a child, and granted permission for termination.

 

In the absence of any supervision from medical personnel, research is needed to know that how best it is to inform and support women who choose to self‐administer, including when to seek clinical care.

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