Abortion and fertility control in Pakistan: the role of misoprostol

Abstract

Misoprostol's availability, ease of use and effectiveness have increased the role of abortion in fertility control.

Abortion decision-making process trajectories and determinants in low- and middle-income countries: A mixed-methods systematic review and meta-analysis

“… Hospital; urban In-depth interview schedule High Chahal et al. (2017) 83 Pakistan Qualitative: ethnography 37 women Abortion seeking women; abortion providers Urban; Clinic Semi-structured interviews; topic guides; participant observation High Rominski et al. (2017) 84 Ghana Qualitative: in-depth interviews and focus group discussions 29 - in-depth interviews; 8 focus groups of community members Women receiving treatment for complications from a self-induced abortion or coming for an elective induced abortion; community members; consented Hospital for IDIs; community/markets for FGDs Topic guides for focus group discussions High MacFarlane et al.…”

“…Safety is understood by women to include not only medical safety (outcome) but also social safety (confidentiality, privacy, secrecy, and reputational safeguarding of the woman and/or her family), legal safety (protection from the law), and financial safety (protection from catastrophic expenditures). 6 , 9 , 12 , 28 , 32 , 35 , 36 , 37 , 38 , 40 , 41 , 44 , 45 , 47 , 48 , 51 , 53 , 54 , 56 , 58 , 59 , 60 , 61 , 62 , 63 , 75 , 78 , 79 , 81 , 83 , 84 , 85 , 98 The post-abortion phase …”

“…Depending on the outcome of the abortion procedure, the woman may develop complications which are managed at different referral points including the hospital and by skilled trained abortion providers such as gynaecologists. 6 , 26 , 27 , 32 , 33 , 36 , 38 , 40 , 44 , 45 , 47 , 49 , 55 , 60 , 61 , 62 , 74 , 81 , 82 , 83 , 84 Adolescents, women living with HIV, and commercial sex workers face additional barriers to access to post abortion care including requirements for consent from parents or partners, or stigma. 36 , 39 , 44 , 61 , 62 In only two of the included studies were women given post-abortion family planning.…”

“…Women and other actors considered cost as an important factor when choosing the method, place or provider for abortion services. 6 , 27 , 28 , 36 , 37 , 38 , 40 , 41 , 43 , 45 , 48 , 50 , 51 , 61 , 74 , 75 , 77 , 78 , 80 , 81 , 83 , 85 , 86 In terms of cost, women preferred medical abortion (misoprostol) over surgical abortion as it considered cheaper and more affordable. 28 , 40 , 48 , 51 , 77 , 83 , 86 For clandestine abortions obtained cheaply which resulted in complications, 27 , 37 , 40 , 43 , 50 , 83 post abortion care resulted in extra costs.…”

“… 6 , 27 , 28 , 36 , 37 , 38 , 40 , 41 , 43 , 45 , 48 , 50 , 51 , 61 , 74 , 75 , 77 , 78 , 80 , 81 , 83 , 85 , 86 In terms of cost, women preferred medical abortion (misoprostol) over surgical abortion as it considered cheaper and more affordable. 28 , 40 , 48 , 51 , 77 , 83 , 86 For clandestine abortions obtained cheaply which resulted in complications, 27 , 37 , 40 , 43 , 50 , 83 post abortion care resulted in extra costs. 6 , 78 , 86 Moreover, clandestine abortions resulting from advanced gestational age were more expensive than those at lower gestational age.…”