A Cross-Sectional Survey on Prevalence, Interventions, and Outcomes of Unsafe Abortions in GGH, Kadapa

Abstract

Objective: Unsafe abortions among the various age groups of women due to unintended pregnancy and socio- economic constraints have a deleterious effect on their reproductive and mental health. Hence, review and modification of safe abortion practices are crucial, owing to the rampant availability of over-the-counter MTP kits and D&C by unskilled professionals resulting in Maternal Mortality and Morbidity. This study provides an estimate of the outcomes of unsafe abortions. Methods: WHO [1] defines unsafe abortion as the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both. The present study is a cross-sectional descriptive analysis of outcomes of unsafe abortions at a tertiary care center, GGH Kadapa. The study data includes all the women admitted to the emergency obstetric unit and treated for unsafe abortions between January 2019 to June 2020. Age group of the selected population is between 15-45. The sample included 342 cases of recent induced abortions. The primary outcome of the study is to emphasise the burden, causes, setting and the morbidity of unsafe abortions. Results: Total number of deliveries that occurred between Jan 2019 to June 2020 is 13787 and the total number of induced abortions during this period was 342. Out of which, 211(61.7%) were unsafe abortions. Among them, 53 women (25.11%) presented with shock. 89 women (42.1%) needed blood transfusions. 8 (3.79%) women went into DIC. One woman had a uterine rupture, and underwent uterine rent repair. Four women had uterine perforation with associated bowel injury. Bowel repair was done in 1 case, and a colostomy was required in 3 cases. Emergency laparotomy was performed in these 5 cases. Conclusion: Unsafe abortions are one of the leading causes of maternal mortality and morbidity in a developing country like India. This is mainly attributed to socio-economic constraints, poor awareness of contraception, and cultural beliefs against sterilization forcing the pregnant women to indulge in unsafe abortion practices. Creating contraception awareness in reproductive age group, strict laws against unsafe abortion practices are to be implemented to reduce the maternal morbidity and mortality due to unsafe abortions.