Abstract

Each year, unsafe medical abortion costs the lives of thousands worldwide. Despite the legalization of abortion in Nepal in 2002, many still seek services from unauthorized sources. This has led to grave consequences including death. Our objective is to find out the prevalence of self-induced abortion by self-administration of abortive pills and related complications. It is a descriptive cross-sectional study carried out among abortion-related admissions in a tertiary care center from June 15 2018 to March 15, 2020. Ethical approval was taken from the institutional review committee (076/077/51). Data was collected using pre-designed proforma and analyzed in Statistical Package for the Social Sciences version 26. Point estimate at 95% Confidence Interval (CI) was calculated along with frequency and proportion for binary data. Out of 223 cases enrolled, 37 (16.6%) (9.6-23.6 at 95% Confidence Interval) were self-induced abortion cases by self-administration of abortion pills. The mean gestational age at the time of intake of pills was 7+6±3+1 week of gestation. The majority were diagnosed with incomplete abortion 14 (37.8%) followed by septic abortion 8 (21.6%). A surgical evacuation was performed in 25 (67.6%). Anemia was observed in 19 (51.3%) with severe anemia in 4 (10.8%). Blood transfusion was carried out in 14 (37.8%). Post abortive contraception was accepted by only 16 (42.3%). Medical abortion is safe if done under supervision but self-induced abortion by self-administration of abortion pills has a high complication rate. Therefore, further studies exploring a different dimension of the serious issue is the need of time.

Highlights

  • IntroductionDespite the legalization of abortion in Nepal in 2002, many still seek services from unauthorized sources

  • Each year, unsafe medical abortion costs the lives of thousands worldwide

  • Medical abortion is safe if done under supervision but self-induced abortion by selfadministration of abortion pills has high complications rate

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Summary

Introduction

Despite the legalization of abortion in Nepal in 2002, many still seek services from unauthorized sources. This has led to grave consequences including death. Medical abortion with mifepristone and misoprostol is safe for termination of pregnancy up to 63 days if practiced under medical supervision.[4] Despite clear guidelines, due to easy and illegal accessibility, many women self-administer these drugs. Some consider it as a method of birth spacing and depend on it without knowing its complications ranging from severe haemorrhage to death.[5]

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