KARACHI: Nearly 700,000 women in Pakistan last year went to health facilities for treatment of complications resulting from spontaneous or induced abortions using unsafe methods or with the assistance of an unskilled healthcare provider, according to a report launched at a programme on Friday.
The report titled “Post-Abortion Care in Pakistan: A National Study,” released by the Population Council was launched at a hotel. It points out gaps in the quality of post-abortion care following unsafe abortion procedures, societal stigmas and inequities in the healthcare system, the burden of post-abortion complications and the significant role of private and public sector hospitals in ensuring access to healthcare.
As an update to a study completed in 2002, this report provides recommendations for promoting safer post-abortion care, expanding access to high-quality and affordable family planning services and contraception, and building capacity among healthcare providers to help achieve these goals.
It said while safe procedures for post-abortion care were found to be more widely used in 2012 than they were in 2002, health facilities still relied on unnecessarily invasive procedures such as dilation and curettage (D&C).
Furthermore, many facilities did not have adequate equipment and supplies to provide quality care for complications and a majority of them were not equipped to provide round-the-clock services to manage severe complications.
Besides, the private sector played an important role in the provision of care, as more than 60pc of all cases were treated by private sector hospitals. The report said in Pakistan, 25pc of women liked to avoid or delay pregnancy, but were not using contraception, and therefore were at the risk for unintended pregnancy.
“As a result, many women resort to induced abortion to end unintended pregnancies. The current law in Pakistan permits abortion to save a woman’s life and provide necessary treatment,” said the report.
It said that due to legal restrictions and lack of clarity among women and healthcare providers in interpreting the law, women might be forced to seek abortion by untrained healthcare providers. “The resulting morbidity and mortality places a heavy burden on women, their families, communities and the national health system,” it said.
The study was funded by the UK Department for International Development (DFID) and the Australian Agency for International Development (AusAID) and was conducted by the Population Council in collaboration with the Guttmacher Institute and the National Committee for Maternal and Neonatal Health.
Dr Zeba A. Sathar, Country Director of Population Council, and report co-author presented the study findings, along with Dr Susheela Singh, vice president, Guttmacher Institute and report co-author, who participated via videoconference.
The report authors reached consensus on some key recommendations and called for improving quality of post-abortion care and expanding the use of safer, World Health Organisation-recommended treatment methods, such as manual vacuum aspiration and medication abortion.
Besides, to ensure that health facilities in the public and private sectors were equipped with technologies they needed to provide full range of post-abortion care.
The speakers called for reaching a national consensus on healthcare provider training and capacity-building and promoting continued advocacy and guaranteeing facilities that provided post-abortion care and prepared to offer a full range of contraceptive services onsite, or in their immediate vicinity, 24 hours a day and seven days a week.
Experts said the post-abortion care protocols that were in accordance with the latest scientific developments should be developed and distributed widely to service providers.
The participants were informed that the Population Council and the Guttmacher Institute collected data through two quantitative surveys and several qualitative methods, including surveys of 266 health facilities and 102 healthcare professionals; in-depth interviews of 44 women who had an induced abortion in the past six months; and 10 focus groups involving women with at least three children to gain an understanding of community norms regarding abortion and post-abortion care.