Induced Abortions and Unintended Pregnancies in Pakistan

Sathar, Zeba A.; Singh, Susheela; Rashida, Gul; Shah, Zakir; Niazi, Rehan M.

doi:10.1111/j.1728-4465.2014.00004.x

Cited by 69 publications

(78 citation statements)

References 21 publications

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“…At 47·0 abortions per 1000 women aged 15–49 years, the abortion rate in India is within the range of reported estimates of abortion incidence in three other south Asian countries (figure 3). 21,22,29 Additionally, our estimate of 3·4 million facility-based abortions in 2015 is nearly five times the number that was reported 4 to government sources in 2014–15 (701 415 abortions). The difference was expected because official data on abortion are known to be highly underreported.…”

Section: Discussionmentioning

confidence: 65%

The incidence of abortion and unintended pregnancy in India, 2015

Singh

Shekhar

Acharya

et al. 2018

The Lancet Global Health

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232

229

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Summary Background Reliable information on the incidence of induced abortion in India is lacking. Official statistics and national surveys provide incomplete coverage. Since the early 2000s, medication abortion has become increasingly available, improving the way women obtain abortions. The aim of this study was to estimate the national incidence of abortion and unintended pregnancy for 2015. Methods National abortion incidence was estimated through three separate components: abortions (medication and surgical) in facilities (including private sector, public sector, and non-governmental organisations [NGOs]); medication abortions outside facilities; and abortions outside of facilities and with methods other than medication abortion. Facility-based abortions were estimated from the 2015 Health Facilities Survey of 4001 public and private health facilities in six Indian states (Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu, and Uttar Pradesh) and from NGO clinic data. National medication abortion drug sales and distribution data were obtained from IMS Health and six principal NGOs (DKT International, Marie Stopes International, Population Services International, World Health Partners, Parivar Seva Santha, and Janani). We estimated the total number of abortions that are not medication abortions and are not obtained in a health facility setting through an indirect technique based on findings from community-based study findings in two states in 2009, with adjustments to account for the rapid increase in use of medication abortion since 2009. The total number of women of reproductive age and livebirth data were obtained from UN population data, and the proportion of births from unplanned pregnancies and data on contraceptive use and need were obtained from the 2015–16 National Family Health Survey-4. Findings We estimate that 15·6 million abortions (14·1 million–17·3 million) occurred in India in 2015. The abortion rate was 47·0 abortions (42·2–52·1) per 1000 women aged 15–49 years. 3·4 million abortions (22%) were obtained in health facilities, 11·5 million (73%) abortions were medication abortions done outside of health facilities, and 0·8 million (5%) abortions were done outside of health facilities using methods other than medication abortion. Overall, 12·7 million (81%) abortions were medication abortions, 2·2 million (14%) abortions were surgical, and 0·8 million (5%) abortions were done through other methods that were probably unsafe. We estimated 48·1 million pregnancies, a rate of 144·7 pregnancies per 1000 women aged 15–49 years, and a rate of 70·1 unintended pregnancies per 1000 women aged 15–49 years. Abortions accounted for one third of all pregnancies, and nearly half of pregnancies were unintended. Interpretation Health facilities can have a greater role in abortion service provision and provide quality care, including post-abortion contraception. Interventions are needed to expand access to abortion services through better equipping existing facilities, ensuring adequate and continuous suppl...

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Section: Discussionmentioning

confidence: 65%

The incidence of abortion and unintended pregnancy in India, 2015

Singh

Shekhar

Acharya

et al. 2018

The Lancet Global Health

Self Cite

232

229

View full text Add to dashboard Cite

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“…The overall abortion rate was 42 per 1,000 women aged 15–49, a rate comparable to the rates estimated using a similar methodology for two other South Asian countries—Pakistan, which had a rate of 50 per 1,000 women aged 15–49 in 2012, and Bangladesh, which had a rate of 37 per 1,000 women aged 15–44 in 2010. 24,25 …”

Section: Discussionmentioning

confidence: 99%

“…This is much lower than the rates in such South Asian countries as Pakistan and Bangladesh (93 and 74, respectively). 24,25 Nonetheless, about half of pregnancies in Nepal were unintended, and well over half of unintended pregnancies ended in an abortion.…”

Section: Discussionmentioning

confidence: 99%

Abortion Incidence and Unintended Pregnancy in Nepal

Puri¹,

Singh²,

Sundaram³

et al. 2016

International Perspectives on Sexual and Reproductive Health

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CONTEXT Although abortion has been legal under broad criteria in Nepal since 2002, a significant proportion of women continue to obtain illegal, unsafe abortions, and no national estimates exist of the incidence of safe and unsafe abortions. METHODS Data were collected in 2014 from a nationally representative sample of 386 facilities that provide legal abortions or postabortion care and a survey of 134 health professionals knowledgeable about abortion service provision. Facility caseloads and indirect estimation techniques were used to calculate the national and regional incidence of legal and illegal abortion. National and regional levels of abortion complications and unintended pregnancy were also estimated. RESULTS In 2014, women in Nepal had 323,100 abortions, of which 137,000 were legal, and 63,200 women were treated for abortion complications. The abortion rate was 42 per 1,000 women aged 15–49, and the abortion ratio was 56 per 100 live births. The abortion rate in the Central region (59 per 1,000) was substantially higher than the national average. Overall, 50% of pregnancies were unintended, and the unintended pregnancy rate was 68 per 1,000 women of reproductive age. CONCLUSIONS Despite legalization of abortion and expansion of services in Nepal, unsafe abortion is still common and exacts a heavy toll on women. Programs and policies to reduce rates of unintended pregnancy and unsafe abortion, increase access to high-quality contraceptive care and expand safe abortion services are warranted.

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“…A small body of literature has touched upon the possibility that couples may be opting for abortion to control their fertility 1 16 17. While misoprostol use is increasing, exactly how it fits within the new context of a smaller preferred family size,18 low contraceptive use19 and increasing prevalence of abortion1 is poorly documented. To address this gap in knowledge, this study sought to understand how the availability of misoprostol has impacted women's abortion-seeking behaviour in rural Punjab, Pakistan.…”

Section: Introductionmentioning

confidence: 99%