5.6% of maternal deaths in Pakistan attributed to abortion-related complications

Updated 12 Mar 2015

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One maternal death occurs every 30-40 minutes in the country and there was the lifetime risk that one in 170 women would die of maternal causes.  — AFP/file
One maternal death occurs every 30-40 minutes in the country and there was the lifetime risk that one in 170 women would die of maternal causes. — AFP/file

KARACHI: At least 5.6 per cent of maternal deaths — out of nearly 16,000 women of pregnancy and childbirth-related complications every year — are attributed to abortion related complications in Pakistan, experts said on Wednesday.

This was stated at the ‘Lunch for cause: unsafe abortions — a grave public health issue and its burden on the health systems’ hosted by Ipas, an international non-governmental organisation whose mission is to reduce maternal deaths and disabilities from unsafe abortion and to increase women’s ability to exercise their sexual and reproductive rights, at a local hotel.

The experts said one maternal death occurred every 30-40 minutes in the country and there was the lifetime risk that one in 170 women would die of maternal causes.

Dr Ghulam Shabbir Awan, country manager of Ipas, said the country had significantly high maternal mortality ratio (MMR). The national MMR was 276 while it was much higher in the rural areas and the entire Balochistan province.

“Nearly one in four births in Pakistan is unplanned and 25pc of women have an unmet need for family planning,” he said.

He said the contraceptive prevalence rate was 35pc with current use of modern methods (condoms, intrauterine contraceptive devices, injectable, pills, implants and female sterilisation) was at just 26pc.

Dr Awan said nationally about one in seven pregnancies was terminated by abortion and an estimated 2.2 million induced abortions took place each year in Pakistan — an annual abortion rate of 50 per 1,000 women.

He said most women who had induced abortions were 30 years or older, residents of rural areas, uneducated, poor and had five or more children.

The experts said 696,000 women were treated annually in public health facilities and private teaching hospitals for complications resulting from unsafe abortions.

“Women are dying wherever they go for unsafe abortions. The tragedy is that death and disability from unsafe abortion is entirely preventable and what is needed is to promote responsive health policies and practices,” said Dr Awan.

Dr Sadiah Ahsan Pal, consultant obstetrician and gynaecologist, said one in every four births in the country was unplanned and 25pc of married women had an unmet need of family planning, which was reflected in a mammoth 900,000 abortions every year and the number of such abortions was on the rise.

“Married women are involved in most of abortions, who choose it as a method of family planning instead of proper family planning tools,” she said.

She said around 700,000 abortion-related complications were reported in a year. Besides, it required huge money that the families, majority of whom belonging to lower or lower middle classes had to spend.

She said contraceptive prevalence rate in Pakistan stood at 35 per cent for the last decade, which was dismally low compared to other Muslim countries, which put to question the faith-based arguments against such devices.

According to her, Iran had a rate of 73pc, Turkey 73pc, Morocco 63pc, Indonesia 61pc, Egypt 60pc and Bangladesh 61pc.

Dr Azra Ahsan, also consultant obstetrician and gynaecologist, said the law relating to abortion was quite clear by the end of 1998 in which abortion was clearly permissible. But in 1999, along with several other laws, it had too been amended and in such a confounded manner that it became extremely difficult for anyone to derive anything clear from it.

“Earlier it did not stop from abortion to save the life of women, but now it merely says to take necessary treatment to save women’s life.”

The experts and participants were of the opinion that abortion was taken as a right of women up to 120 days of conception.

Experts, however, said it was difficult to underscore a cut-off date for abortion.

They said medical abortion methods, instead of the existing surgical ones, through the use of Mifepristone Misoprostol doses were less painful, safe and modern, which were being introduced in Sindh and Punjab.

Published in Dawn, March 12th, 2015

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