References

Characteristics of abortion seeking women: a study of Faisalabad City. 2016. http://www.jumdc.com/index.php/jumdc/article/view/197/171

Knowledge, attitude, and practices of mid-level providers regarding post abortion care in Sindh, Pakistan. 2017. https://ecommons.aku.edu/cgi/viewcontent.cgi?article=1047&context=jam

Channon MD. Son preference and family limitation in Pakistan: a parity-and contraceptive method–specific analysis. International Perspectives on Sexual and Reproductive Health.. 2017; 43:(3)99-110 https://doi.org/10.1363/43e4317

Faundes A, Comendant R, Dilbaz B, Jaldesa G, Leke R, Mukherjee B, de Gil MP, Tavara L Preventing unsafe abortion: achievements and challenges of a global FIGO initiative. Best Practice and Research Clinical Obstetrics and Gynaecology.. 2020; 1:(62)101-112 https://doi.org/10.1016/j.bpobgyn.2019.05.016

Ganatra B Global, regional, and subregional classification of abortions by safety. 2010–14: estimates from a Bayesian hierarchical model. The Lancet.. 2017; 2372-2381 https://doi.org/10.1016/S0140-6736(17)31794-4

Guttmacher Institute and Population Council. Postabortion care in Pakistan: in brief. 2013. https://www.guttmacher.org/sites/default/files/report_pdf/postabortioncarepakistan.pdf (accessed 14 May 2020)

Habib MA, Raynes-Greenow C, Nausheen S Prevalence and determinants of unintended pregnancies amongst women attending antenatal clinics in Pakistan. BMC Pregnancy and Childbirth.. 2017; 17 https://doi.org/10.1186/s12884-017-1339-z

Pakistan woman-centered post abortion care: reference manual-draft.Chapel Hill, NC: Ipas; 2020

Is Induced abortion used as one of the methods for birth spacing among married women in urban population of Lahore?. 2019. http://www.jsogp.net/index.php/jsogp/article/view/232/215 (accessed 10 May 2020)

National Institute of Population Studies. Pakistan demographic and health survey 2017–18. Pakistan demographic and health survey 2017–18. 2019. https://dhsprogram.com/pubs/pdf/FR354/FR354.pdf (accessed 10 May 2020)

Naveed Z, Shaikh BT, Nawaz MA. Induced abortions in Pakistan: expositions, destinations and repercussions. A qualitative descriptive study in Rawalpindi District. Journal of Biosocial Science.. 2016; 48:(5)631-646

Postabortion care in Pakistan: a national study. 2013. http://www.popcouncil.org/uploads/pdfs/2013RH_PakistanPAC.pdf (accessed 12 May 2020)

Sathar Z, Singh S, Rashida G, Shah Z, Niazi R. Induced abortions and unintended pregnancies in Pakistan. Studies in Family Planning.. 2014; 45:(4)471-491 https://doi.org/10.1111/j.1728-4465.2014.00004.x

Say L Global causes of maternal death: a WHO systematic analysis. The Lancet Global Health. 2014; e323-e333 https://doi.org/10.1016/S2214-109X(14)70227-X

Shah IH, Åhman E, Ortayli N. Access to safe abortion: progress and challenges since the 1994 International Conference on Population and Development (ICPD). Contraception.. 2014; 1:(6)S39-S48 https://doi.org/10.1080/17441692.2011.594072

Shellenberg KM, Moore AM, Bankole A, Juarez F, Omideyi AK, Palomino N, Sathar Z, Singh S, Tsui AO. Social stigma and disclosure about induced abortion: results from an exploratory study. Global Public Health.. 2011; 6:(1)S111-S125

Singh S, Maddow-Zimet I. Facility-based treatment for medical complications resulting from unsafe pregnancy termination in the developing world, 2012: a review of evidence from 26 countries. BJOG.. 2016; 123:(9)1489-1498 https://doi.org/10.1111/1471-0528.13552

Sultana R, Khuwaja AAJ, Ali SM. Induced abortion and Sub-sequent prevalence of contraceptive type. Journal of Liaquat University of Medical and Health Sciences.. 2019; 18:(2)104-108 https://doi.org/10.22442/jlumhs.191820610

Qayyum K, Rehan N. Sex-selective abortion in rural Pakistan. Journal of Advances in Medicine and Medical Research.. 2017; 22:(12)1-7 https://doi.org/10.9734/JAMMR/2017/33824

United Nations Population Fund. Sexual and reproductive health and rights: an essential element of universal health coverage. 2019. https://www.unfpa.org/sites/default/files/pub-pdf/SRHR_an_essential_element_of_UHC_SupplementAndUniversalAccess_27-online.pdf (accessed (13 May 2020))

World Bank. Sex ratio at birth (male births per female births) – Pakistan. 2019. https://data.worldbank.org/indicator/SP.POP.BRTH.MF?locations=PK (accessed 14 May 2020)

Safe abortion: technical and policy guidance for health systems evidence summaries and grade tables.: World Health Organization; 2012

World Health Organization. Preventing unsafe abortion. 2019. https://www.who.int/news-room/fact-sheets/detail/preventing-unsafe-abortion (accessed 13 May 2020)

Zafar H, Ameer H, Fiaz R Low socioeconomic status leading to unsafe abortion-related complications: a third-world country dilemma. Cureus.. 2018; 10:(10) https://doi.org/10.7759/cureus.3458

Zaidi S, Begum F, Tank J, Chaudhury P, Yasmin H, Dissanayake M. Achievements of the FIGO initiative for the prevention of unsafe abortion and its consequences in South-Southeast Asia. International Journal of Gynecology and Obstetrics. 2014; 126:S20-S30 https://doi.org/10.1016/j.ijgo.2014.03.015

Zakar R, Nasrullah M, Zakar MZ, Ali H. The association of intimate partner violence with unintended pregnancy and pregnancy loss in Pakistan. International Journal of Gynecology and Obstetrics. 2016; 133:(1)26-31 https://doi.org/10.1016/j.ijgo.2015.09.009

Induced abortions in Pakistan: an afflicting challenge needing addressal

02 February 2021
9 min read
Volume 29 · Issue 2

Abstract

Unintended pregnancies due to low prevalence of contraceptive use in Pakistan leads to a huge burden of induced abortions. These abortions are a major cause of concern, as a majority of these abortions are performed in an unhygienic environment by untrained providers, leading to maternal morbidities and mortalities. Some of the contributing factors of unsafe abortions are lack of availability of quality services, financial barriers, stigma associated with abortion and lack of awareness about abortion law. Therefore, there is an urgent need to invest on family planning and post-abortion care services through health system strengthening approach. The proposed comprehensive strategy for actions at the individual, facility, community and policy levels can address the issue of unsafe abortion in the country.

Unsafe abortion is one of the major causes of maternal mortality that accounts for approximately 4.7%–13.2% maternal deaths every year (Say et al, 2014). In developing countries, every year, nearly seven million women get admitted in hospitals for the treatment of complications related to unsafe abortion (Singh, 2016). Some of the complications that can occur as a result of unsafe abortion include haemorrhage, infection, uterine perforation, and injury to the genital tract and internal organs that can be life threatening to women (World Health Organization [WHO], 2019).

Induced abortions are a major cause of concern worldwide. According to the WHO, on average, 56 million induced abortions took place around the globe between 2010–2014; which formed 25% of all pregnancies (WHO, 2019). Induced abortions carry minimal risk, if performed as per the WHO recommended guidelines and methods for safe abortion. On the contrary, if they are performed by an untrained provider, who lacks the necessary skills, or are done in an environment that does not follow the minimal medical quality standards, they are considered as unsafe abortion (WHO, 2012). Ganatra and colleagues (2017) reported that 25 million unsafe abortions took place worldwide between 2010–2014; out of which almost 88% occurred in the developing countries. More than half of all the estimated unsafe abortions, globally, were performed in Asia, mostly in south and central Asia (Ganatra et al, 2017).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month