More Than 55% Pregnancies In Assam Unintended, States Study

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More Than 55% Pregnancies In Assam Unintended, States Study

Saumya Mishra | August 31, 2019 13:14 hrs

GUWAHATI: More than half of the pregnancies (55%) occurring in Assam in 2015 were unintended, as per a study conducted by Indian Institute for Population Sciences, Mumbai, Population Council, New Delhi, and the New York-based Guttmacher Institute on unintended pregnancy, abortion and post-abortion care in Assam.

Further, out of these unintended pregnancies, three-fourth (74%) of them ended in an abortion.

Experts claim that a major reason behind this is the unmet need of contraception. “One of the primary causes of so many unintended pregnancies is that the needs of contraception of people are not met,” Dr Tanma Saikia Das, a city-based gynaecologist told G Plus. 
   
She further added that lack of awareness is also an issue especially in the rural areas of the state. 

“The accredited social health activists (ASHAs) have now been taught to give contraception and spread awareness too, but it has not reached the consumers as such,” Dr Tanma mentioned.  
  
Experts also say that acceptability for contraception is also low in Assam. “Even when we conduct counselling after an abortion for a post-abortion contraceptive, it is usually seen that they are not willing to take it. At this stage, the husbands need to be counselled too, since it is a joint decision,” said another city-based doctor. 
    
The report also mentioned that close to 5,80,100 abortions are performed every year in Assam. This means that the state’s abortion rate was 66 terminations per 1,000 women of reproductive age.

Further, the 2015 report also states that these 5,80,100 abortions include those taking place in public as well as private health facilities and other settings. The study highlights the importance of access to and quality of safe abortion services in the state. The large majority of abortions (74%) took place in non-facility settings using medical methods of abortion, while 5% were performed outside of health facilities using other methods.

The report also brought to light that only 21% of abortions took place in health facilities in Assam in 2015. On the other hand, women preferred public health facilities for terminating their pregnancies. 

Throwing light about women opting for government health facilities for conducting abortions, Dr Tanma said that government health facilities are a popular choice among many as they provide abortion services for free.   

The study mentioned that an estimated 90% of the abortions occurring in health facilities in Assam are surgical, while around 10% are done using Medical Methods of Abortion.

The state’s abortion rate was found to be 66 terminations per 1,000 women in the reproductive age group.

The study further stated that among the six states in which the study was conducted, Assam is the only state which had better access to safe abortions in public facilities than private facilities.
Apart from this, some of the hurdles which were found in accessing facility-based abortions included lack of trained staff, social or religious concerns, paucity of equipment and supplies and lack of registration/authorisation to provide abortion. 
      
Further, the vast majority (94%) of health facility abortions took place in the first trimester of pregnancy and 65% occurred at less than 8 weeks’ gestation. Most were performed surgically using manual or electric vacuum aspiration (57%) or either dilatation and evacuation or dilatation and curettage (30%).

As per the report, although more than eight in 10 women of reproductive age in Assam live in rural areas, only 45% of facilities that provide any abortion-related services were located in rural areas. 

“All private facilities were located in urban areas, and only 18% of public hospitals that provide abortion-related services - the facilities best equipped to handle severe complications or later-term abortions - were located in rural areas,” it states. 

The 2015 report further mentions that pregnancy and abortion are closely linked to contraceptive use and other indicators of women’s status, including marriage, literacy and level of urbanization. These may also be associated with women’s and couples’ desire to control the timing of their births and to limit their fertility.

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