Safe Abortions: Are They a Reality Yet? A Case Series

Abstract

Objectives: Annually, 210 million women conceive globally and 3 in 10 resort to abortion with an estimated 45% unsafe abortions, majority being from the developing world. This case series highlights the issues of unintended pregnancies resulting from loopholes in family planning knowledge, accessibility, and provision and failure, leading to women seeking abortions from unauthorized providers and settings endangering their lives, along with increasing the financial, social, and psychological burden on women, their families, and on health systems. Materials and methods: Three case reports on unsafe abortion resulting into life-threatening complications, referred from peripheral centers are discussed. The data retrieved is a detailed discussion highlighting the reasons for unintended pregnancy, execution of unsafe abortion at periphery by untrained providers, its complications, and the management provided at our tertiary center in Jodhpur. Results: All the women were from rural areas, uneducated, and multiparous. None ever used any contraception. All had unwanted conceptions, and illegally procured medical termination of pregnancy (MTP) pills. One had rupture of the previous scar (from the previous two cesarean sections). The other two underwent dilatation and curettage at peripheral center by untrained staff, resulting in uterine and intestinal perforation. All underwent urgent laparotomies and admitted to intensive care unit for further management. One had bowel resection, anastomosis, and ileostomy. Two of the women required support from other medical specialties. All were discharged in healthy condition. Conclusion: A collective effort to strengthen family planning system, intensive training of health providers along with educating masses about the importance of contraception should be given utmost importance to save maternal mortality and morbidity due to unsafe abortions.