KARACHI, June 28: An estimated 980,000 unsafe abortions are carried out in Pakistan every year, which translates to one terminated pregnancy in every six. While society refuses to discuss the medical aspects of the issue, focussing erroneously on morality and religion, the fact is that 90 per cent of these cases involve married women with three or more children. Every year, 250,000 Pakistani women suffer post-abortion complications at the hands of unskilled, purported “healthcare providers,” and 3,000 of these women die.
The issue is not just one of human rights but also economic reality, since large families impose severe economic constraints but unsafe abortions cause expensive recurrent medical complications. On the flip side of the vicious cycle, Pakistan’s social conditions are such that the majority of men oppose the use of contraceptives but agree to abortion.
These grim facts were highlighted at the second consultative meeting to discuss women’s reproductive health and give details of a post-abortion care project being launched in Karachi. Organised by the National Committee for Maternal and Neonatal Health in collaboration with the US-based NGO Ipas and the Packard Foundation, speakers emphasised the need to sensitise doctors and promote debate amongst civil society.
Furthermore the legalities of the matter, such as who is authorised to carry out a safe abortion and under what conditions, must be identified and publicised. Participants at the meeting pointed out that the general public, policy makers and even the majority of healthcare providers are ignorant of the fact that following an amendment of the Pakistan Penal Code in 1990, abortion is allowed in the early stages of pregnancy not just to save the mother’s life, but also to provide “necessary treatment.”
Speakers pointed out that unsafe abortion is a major healthcare issue in most developing countries since its causes include poverty, gender inequality and a poor human rights’ record. Globally, approximately 20 million unsafe abortions are carried out every year of which nearly 97 per cent are in developing countries and half of these are in South-East Asia. It is further estimated that 13 per cent of all maternal deaths are caused by post-abortion complications.
Women take the decision to terminate a pregnancy in order to limit family sizes or for financial reasons. When doctors, who fear legal repercussions or demand exorbitant fees, refuse to help them, such women resort to untrained staff at unregistered clinics and as a result, often suffer complications such as sepsis, haemorrhage, uterine perforations and visceral injuries. Long-term effects can include infertility, disability and pelvic inflammatory diseases.Senior country adviser of the Packard Foundation, Dr Yasmeen Sabeeh Qazi, quoted a Population Council report as saying that the majority of men oppose the use of contraceptives but agree to abortion, which she termed unfortunate, given that Pakistan is signatory to many international conventions on women’s reproductive rights.
Dr Kaiser Bengali pointed out that prolonged illness resulting from unsafe abortions pushes a family under the poverty line, and meanwhile deprives the state of money that could usefully be allocated elsewhere since poverty reduces purchasing power and has a significantly negative impact on the GDP.
Meanwhile, pregnancies among unmarried women are also reported. According to Dr Sher Shah Syed, one such patient comes to the attention of Orangi’s Qatar General Hospital every week. Of the cases that he has personally dealt with, there was a recurring incidence of rape and incest.
