Background: Birth spacing is defined as the time interval between two births. India has average birth spacing of 22 months, i.e. little less than two years, despite wide knowledge of contraception. Objective of present study was to investigate the knowledge, attitude, and practice regarding birth spacing and methods available for spacing in rural Haryana amongst sexually active married females of reproductive age.Methods: Cross sectional study of 500 sexually active, married females of reproductive age with at least one live issue and not meeting any exclusion criteria was carried at SGT medical college, Gurgaon during 3 months from August 2017.Results: Awareness of need for birth spacing was very high (82.6%) in females interviewed, with 70% of females being aware of birth spacing benefits as well as keen to opt for birth spacing but even higher count of females (92.6%) reporting requiring husband’s consent for birth spacing. Only 40% females were practising birth spacing with 14.6% of females reporting in-law’s opposition as reason for not practising birth spacing.Conclusions: Education is a major factor improving awareness of need as well as benefits of child spacing, with all college studied females being aware of both. Education also leads to improvement in keenness for practising child spacing as well as having lesser opposition to practise of child birthing. Females with only girl child/children were less keen to practise child spacing. Rural geographies still have health personnel as significant source imparting awareness of child spacing.

BACKGROUND Menstruation is unique phenomenon in girls. However, even in today's time in India, it is associated with many taboos and myths that affect many socio-cultural and economic aspects of life and is a hindrance in the overall development of a girl to women and becoming empowered. Besides the taboos, there are menstrual problems which a girl has to suffer. A woman's reproductive health is determined by her menstrual health. The prevalence of menstrual disorders is highest in the 20 to 24-year-old age group and decreases progressively thereafter. They affect not only the woman, but also family, social, and national economics as well. Even girls from good socioeconomic background and education are unable to dispel the taboos and are unable to discuss their menstrual issues and problems due to lack of menstrual education. Information on a woman's menstrual pattern will aid in clinical evaluation of gynaecological problems and will make womanhood easier for adolescent women and adults 1. However, studies on menstrual pattern, menstrual disorders, associated factors and taboos affecting the girls of medical students of university of rural North India are very few. We wanted to determine the menstrual pattern, menstrual disorders, information regarding menstruation and taboos associated with menstruation among female medical students of university of rural North India. METHODS A self-descriptive cross-sectional study was carried out among female medical students between the ages 17-22 years. A total of 235 questionnaires was administered to postmenarcheal Indian adolescent girls attending medical college in SGT University, Gurugram, and Haryana India. Participants were asked to respond to a semi-structured questionnaire on menstrual health awareness. The questionnaire included questions on age at menarche, menstrual cycle length and regularity, duration, and amount of flow, type and severity of pain related to menstruation, need for analgesia, and symptoms suggestive of premenstrual syndrome (PMS), and impact of menstrual pain on academic and social activities and taboos associated with menstruation. The main outcome measure was information regarding menarche, description of menstrual patterns, disorders and impact of the disorder on academic and social activities and taboos regarding menstruation.

ABSTRACT:In India medical abortion has become acceptable to the masses. As per the MTP Act 2003 medical abortion can be provided by certified providers at approved places or centres which have referral linkages even though the Centre is not approved for MTP. Despite this in India a large number of abortions are still illegal. People are resorting to abortion without any pre-abortion checkup or counseling which is contrary to the MTP Act. This study was carried out to determine the reasons for resorting to self-induced abortion, assess the associated complications and acceptance of contraception after abortion. 77.7% of women in this study included those who reported to hospital following self-administered abortion so did not have any checkup, investigation or counseling. 23% women got the prescriptions from RMP, 42.85% from chemists and 30% from friend even though 55% of them were not residing far from the hospital. Following self-administered abortion, women reported with pain abdomen, retained products, pelvic inflammatory disease and heavy bleeding requiring emergency suction evacuation. These women were not aware about the need for contraception and mistook self-induced abortion as a method for family planning. They resorted to self-induced abortions because they believed it to be safe, and presumed that a visit to the hospital is avoidable. 45% of these women had undergone abortions in the past without any side effect. It is feared that if self-induced medical abortions continues unheeded the health system will get overburdened with resultant complications besides losing an opportunity for contraceptive counseling. It is recommended that the private practitioners may be brought into the system besides ensuring that regulations regarding prescription of drugs and the MTP Act are followed. Besides this masses should be made aware of the legality of medical abortion by using handouts and posters.

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Emergency surgical management of patients who are COVID-19 positive is extremely challenging for the treating doctors as there is a need to keep the balance between delivering optimal medical care to the patient, preventing spread to others and protecting ourselves. COVID-19 manifestations in pregnant women are similar to non-pregnant patients. The patient may be asymptomatic or may present with symptoms like cough, cold, fever and shortness of breath. In obstetric emergencies like ruptured ectopic pregnancy, when a patient presents in casualty with history of amenorrhea, pain abdomen and features of shock, main priority for the clinician is to stabilize them and treat the underlying cause so as to save their life. We report the emergency management of a hemodynamically unstable ruptured ectopic pregnancy at 9 weeks of gestation in a COVID-19 positive patient. It was stressful for the treating doctors because of high infectivity of the disease, scarcity of resources during the pandemic and precarious condition of the patient.