Bleeding hemorrhage: how widespread use of abortion pills is becoming a health hazard in Kashmir

Srinagar: Panic gripped Rehana (name changed) when she conceived for the third time. The over 40-year-old took an abortion pill and landed in hospital with abnormal vaginal bleeding.

“She came to us with the complaint of extended periods. We asked her to take a Gravindex test, which is an agglutination inhibition test performed on a urine sample to detect pregnancy. It came positive. Ultrasound also showed evidence of incomplete abortion and retained products of conception,” said the doctor treating her.

Similarly, another 40-year-old woman decided to abort her second baby because her husband was unwilling to take on the financial responsibilities.

“She too had taken a pill on her own, which resulted in an incomplete abortion,” added the doctor.

Unsafe abortions and over-the-counter pills

Dr Rumisa Mir, a doctor at the Char-Sharif sub-district hospital, said an abortion performed without a doctor’s advice is dangerous.

There is a risk in each case.

“Unsafe abortion is the third leading cause of maternal mortality. Every month, we receive at least 10 married women in OPD with complications developed due to unsafe abortion.

Doctors have said that the easy availability of abortion pills is one of the reasons, which leads to incomplete abortions or excessive bleeding.

“Usually the first pill is given to terminate the pregnancy and after 24 to 72 hours another set of pills is given to trigger the bleeding. Many tests are done before giving these pills. We check hemoglobin levels, rule out other medical conditions, and watch for side effects,”

Dr Rumisa

“Usually the first pill is given to terminate the pregnancy and after 24 to 72 hours another set of pills is given to trigger the bleeding. Many tests are done before giving these pills. We check hemoglobin levels, rule out other medical conditions and monitor side effects,” Dr Rumisa said.

She said that due to the ease of access to abortion pills, women take them without any supervision. “Many come to us with heavy bleeding and there is a risk of bleeding, which could become fatal,” she said.

The doctor said that we also cannot deny the fact that abortions are also performed illegally. “Such practices must be curbed in the valley. A woman must take a medical termination test and first cite a valid reason for the abortion,” she said.

She stressed that couples should visit family planning clinics. “Married couples can be educated about the options of having safer sex rather than unnecessarily opting for abortion. The health expert can give them a basket of choices for contraceptives and accordingly the partners can decide and delay the pregnancy,” Dr. Rumisa said.

All about abortion and the Medical Termination of Pregnancy Act 2021

Abortion is a procedure to end a pregnancy. Pregnancy is terminated either by taking medication or by surgery. It is also sometimes known as a termination of pregnancy.

Medical termination of pregnancy is a procedure for termination of pregnancy using medication. In the early stages of pregnancy (7-9 weeks), it can be terminated with the help of medication, otherwise the surgical process is necessary.

“MTP is performed by professionals and experienced gynecologists because even if the procedure is minor, the risk involved is high. It is important to consult a gynecologist because there can be many complications regarding abortion and before proceeding, one should check all the risks associated with medical termination of pregnancy,” said Dr Nausheen Khan, gynecologist at the Lal Ded Hospital.

She said under new rules in the Medical Termination of Pregnancy Act 2021, seven specific categories are eligible for termination of pregnancy up to 24 weeks.

“They include survivors of sexual assault, rape or incest; minors; change in marital status during the current pregnancy (widowhood and divorce); women with physical disabilities; mentally ill women; fetal malformation which presents a substantial risk of incompatibility with life or if the child is born, it may suffer from serious physical or mental abnormalities; and pregnant women in humanitarian settings or disaster or emergency situations,” said Dr Khan.

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