KARACHI, Jan 14: Although abortion is legal in Pakistan and a consensus exists among Islamic scholars on its permissibility in certain conditions, a majority of medical professionals look upon it as an un-Islamic act and refuse treatment to women, compelling them to seek the help of untrained healthcare providers and risk their lives.
According to estimates, about 890,000 induced abortions are carried out every year in the country and the procedure — contrary to the general perception that it is sought by unmarried women — is wanted by married women, with four to five children, who consider abortion an ‘easier family planning tool’ rather than using contraceptives.
These were some of the points highlighted at a seminar, The politics of abortion, organised by the Society of Obstetricians and Gynecologists of Pakistan (SOGP) at the PMA House on Saturday.
Giving a presentation on abortion and maternal health in Pakistan, Dr Shershah Syed, a senior gynaecologist, said most victims of the ailing social mindset were poor women because the rich could pay huge amounts to get the procedure done by trained professionals.
“The politics of abortion is that to keep silent and not to create awareness of the subject,” he said.
Giving some statistics, he said 30,000 women died every year in Pakistan because of pregnancy-associated complications that put the maternal mortality rate to about 276 per 100,000 live births.
Complications of miscarriages/ abortions, he said, accounted for 10 to 12 per cent of maternal deaths while one out of six pregnancies was terminated by induced abortion through a risky method.
“Due to a lack of health services and access to modern family planning methods, a large number of abortion-related complications worsen the maternal health situation in our country. Besides, cases of abortion are mismanaged by untrained healthcare providers,” he said, adding that about 36.81pc of abortions were conducted by unskilled traditional birth attendants.
Reproductive and sexual health issues, including early marriages, unplanned pregnancies and sexually transmitted diseases, he said, increased the burden on women’s health.
Referring to a report in a foreign publication, he said about 75,000 women who tried to abort pregnancies by inserting different objects into their bodies died every year worldwide. Most of them, he said, belonged to South Asian and African countries.
Painting a picture of what’s happening in the United States, Dr Huma Farid, clinical fellow in obstetrics, gynaecology and reproductive biology, Brigham Women’s Hospital in Boston, Massachusetts, said the abortion issue had been politicised in America and it was no longer viewed as a health subject.
“The US is perceived as a liberal country, but what is happening there on the abortion issue could have dangerous repercussions in the coming years,” she said, while explaining that though abortion was legal in the US, a number of states under the strong influence of conservative Christians had started passing anti-abortion laws.
“The risk of death from a legal abortion performed by a licensed provider is 0.4 per 100,000 cases while the risk increases to 17pc in cases of illegal abortion,” she said.
The US, she said, had a high rate of unplanned pregnancies (49pc); of those unplanned pregnancies, 42pc ended in abortion; 19pc of abortions were among teenagers; 67pc of women who sought abortions were unmarried and almost half of American women had terminated at least one pregnancy.
She also traced the history of abortion and pointed out that in the early 1600s the procedure was legal. Two centuries later, the states started passing anti-abortion laws and by 1900 abortion was illegal in every state in the US.
“Since abortions were illegal, the procedure was performed in hiding (about 200,000 to 1.2 million cases annually) and in a highly unsafe environment and represented 18pc of maternal deaths in 1930,” she said.
The case, she said, finally went to the US Supreme Court, which ruled in 1973 that the right of personal privacy included the abortion decision.
Citing a survey, Dr Nighat Shah, representing the SOGP, said that 80pc of doctors wanted stricter laws on abortion instead of favouring relaxation of rules. She also stressed that abortion was purely a health issue and must not be confused with religion and culture.
Imtiaz Kamal, president of the Midwifery Association of Pakistan, said Pakistan laws permitted that abortion could be done to save a life and to carry out necessary treatment.
Islamic scholars, she said, permitted the procedure to be done within 120 days of pregnancy.
“Professional values are more important than personal beliefs. Healthcare providers must refer the patient seeking abortion to the right place if they are not willing to carry out the procedure,” she said.