Unsafe abortion after legalisation in Nepal: a cross‐sectional study of women presenting to hospitals

Abstract

Objective To investigate abortion practices of Nepali women requiring postabortion care.Design Cross-sectional study.Setting Four tertiary-care hospitals in urban and rural Nepal.Sample A total of 527 women presenting with complications from induced abortion in 2010.Methods Women completed questionnaires on their awareness of the legal status of abortion and their abortion-seeking experiences. The method of induction and whether the abortion was obtained from an uncertified source was documented. Multivariable logistic regression was used to identify associated factors.Main outcome measures Induction method; uncertified abortion source.Results In all, 234 (44%) women were aware that abortion was legal in Nepal. Medically induced abortion was used by 359 (68%) women and, of these, 343 (89%) took unsafe, ineffective or unknown substances. Compared with women undergoing surgical abortion, women who had medical abortion were more likely to have obtained information from pharmacists (161/359, 45% versus 11/168, 7%, adjusted odds ratio [aOR] 8.1, 95% confidence interval 4.1-16.0) and to have informed no one about the abortion (28/359, 8% versus 3/168, 2%, aOR 5.5, 95% CI 1.1-26.9). Overall, 291 (81%) medical abortions and 50 (30%) surgical abortions were obtained from uncertified sources; these women were less likely to know that abortion was legal (122/341, 36% versus 112/186, 60%, aOR 0.4, 95% CI 0.2-0.7) and more likely to choose a method because it was available nearby (209/341, 61% versus 62/186, 33%, aOR 2.5, 95% CI 1.5-4.3), compared with women accessing certified sources.Conclusions Among women presenting to hospitals in Nepal with complications following induced abortion of pregnancy, the majority had undergone medically induced abortions using unknown substances acquired from uncertified sources. Women using medications and those accessing uncertified providers were less aware that abortion is now legal in Nepal. These findings highlight the need for continued improvements in the provision and awareness of abortion services in Nepal.

Mother’s Experiences with Cut380a Postpartum Intrauterine Contraceptive Device in Enugu, Southeast, Nigeria

“…It is a safe, cheap, long-acting, reversible, and non-hormonal contraceptive method that is highly effective for prevention of unwanted pregnancies and the abortion-related complications [1][2][3][4][5]. PPIUD can promote the health of mothers and children by preventing financial, psychological, obstetric, and other health complications associated with short-interval pregnancies [2].…”

Unmet Need for Family Planning in Nepal during the First Two Years Postpartum

“…This suggests there are missed opportunities to provide information and counselling on family planning methods and services to postpartum women. Studies conducted in Nepal have shown that unintended pregnancies, due to low use of contraception and reliance on less effective family planning methods (traditional methods), have caused repeated abortions and abortion-related complications [9, 10]. Therefore, to consolidate and extend the achievements made in maternal and child health, increased access to quality family planning services and strengthened postpartum counselling will be instrumental.…”

A systematic review of the research evidence on cross-country features of illegal abortions

“…Face to face interview 36-41,44 and application of a self-administered questionnaire 31-33,35,43 in queries about illegal abortion were the most common reported data collection method respectively. The study’s findings have also revealed that married 25-27,31,33,35,38,39,41,43 and unemployed women 25-27,29,35,37,38,40,43,44 of 26-30 years old age group 35-38,41,42 with 1-2 children 9,13,16,19,25,31,34,35,37,41,43 and low socioeconomic backgrounds 7,13,16,17,21,27,38,39,40,42 were the most typical illegal abortion seekers in the included studies. The observed partial inconsistency in the attributes of the abortees in the quoted studies; however, may reflect inherent cultural differences regarding pre-marital sexual relationship, out of wedding pregnancies or aberrant methodologies used.…”