We are fully aware that the
abortion deaths are totally needless deaths and RCH services have
not improved much despite the RCHprogramme and National Population
Policy in our country.
Concerns about drugs : many of
the women’s groups are raising concerns regarding the potential
of misuse of pharmaceutical products. We have seen how pharmaceutical
products have been used in the past, and we really need to be very
careful. Abortion services should be available in a controlled manner
so that postmarketing surveillance can be done. This is a very important
component during the initial phases of introduction.
Cost of medical abortion pill may be a limiting factor for clients
below poverty line and these women may be more in need. Many ayurvedic
pills are sold as abortion pills, which is to be curbed.
Client needs : As a client,
safe abortion services are needed. Prevention of a needless abortion-related
death is of prime importance. The clients should not suffer from
the complications of abortion and its resultant morbidity and mortality.
This should be provided as a part of the RCH services and be an
important component of essential healthcare services. We also need
to take care of pre existing anaemia and need for blood transfusion.
All women should be provided with iron, calcium and folic acid.
Female foeticide :Large numbers
of women are choosing sex determination and female foeticide, which
needs to be stopped at all costs, infliction of unwanted pregnancy
has to be challenged. Contraception for
couple :Both male and female should share contraceptive
responsibility, and men should not shirk the responsibility of using
condom, saying, now you have an ‘Abortion Pill’. Knowledge
of emergency contraception is a must to prevent future mishaps.
Problems with medical abortion :
Approximately 8% of women suffer from incomplete abortion. Adequate
arrangements need to be made available to look after the complications
of medical abortion.
Accessibility : Safe abortion
services should be easily accessible. Unbiased information should
be provided in patient’s language i.e. side-effects, contraindications,
complications etc. Demystification of information is essential and
appropriate counseling is very important. Absolute functional information,
e.g. where to go in case of problem needs to be provided.
Confidentiality (purchasing condoms, oral pills) and privacy should
be well assured. Knowledge of emergency contraception should be
given.
We do not want trivialization of abortion to the extent that the
side-effects are ignored. Prevention of unwanted pregnancy is a
much better option by using contraception (regular/emergency). Responsible
male sexual behaviour should be encouraged. Unwanted pregnancies,
abortions, HIV and AIDS can be prevented by timely action.
Everything should be done in a gender-sensitive manner. Periodic,
client based evaluations to assess women’s experiences, and
complications, quality of care received, and access to services
will provide important information for improving clinic and outreach
services. |
