Abortion — a taboo: ‘Every sixth pregnancy in the country is aborted’

ISLAMABAD/KARACHI: A senior nurse at the gyneacology ward of Pims said that once an unmarried girl came to her seeking guidance on getting an abortion.

The girl, who was 21 years of age, told the nurse that while travelling in a train when she was raped and as a result she got pregnant.
“However she was refused. In the government hospitals illegal abortions are strictly prohibited,” said the nurse.

Talking to The Express Tribune, Dr Anis Kausar, Joint Executive Director Polyclinic Hospital said in Islamabad and Rawalpindi there are many clinics that are being run where illegal abortions are being done after charging high sums of money.

“They charge Rs50,000 to 60,000 for one abortion,” said Dr Kausar. Robina Sikendar a lady health worker, said the professionals are also assisted by midwives in their clinics. “There are some midwives who are doing this business in their homes as no one can get inside to check what is happening there,” she said.

At least 890,000 abortions take place in Pakistan which means that every sixth pregnancy is terminated in abortion.

These figures were revealed by the Pakistan Demographic Health Survey (PDHS), which is the only national study on abortion-related incidents, said Dr Azra Ahsan, a gynaecologist and technical consultant at National Committee for Maternal and Neonatal Health (NCMNH). She was speaking at a discussion arranged by the NCMNH on Wednesday.

The speakers felt that legislators refrain from discussing sensitive issues, such as abortion, in the parliament and that is why no steps have been taken to overcome unsafe abortions.

MPA Nasreen Kethran, who was representing Pakistan Muslim League-Quaid from Balochistan, said that there was a wide communication gap when it came to discussing abortion, firstly, because it is considered controversial and forbidden by religion, and secondly, because maternal health issues are not really taken seriously.

According to Kethran, the fear - of creating awareness on abortion - worsened when three people of the Family Health Planning office were gunned down in Bakra Piri, Quetta, by unidentified men. The police said that the murders were caused by personal enmity but people working in the health sector said that the killings were committed by a group of extremists who were against family planning.

Such incidents do not make a constructive environment to speak on such issues, she said.

Even after approvals from doctors and ulemas, implementation of family planning programmes is a difficult process due to extremist elements within our society. “Even the slightest hint can spark off protests. People are out to kill you for saying something supposedly unconventional.” Kethran felt that the situation was dismal in the country, particularly in the health sector.

During her presentation, Dr Ahsan said that abortion was not illegal but it was restricted in the country for sure. “With the dearth of family planning policies, women are unfortunately using abortion as a method for family planning,” she said.

Dr Ahsan admitted that the law was also confusing. “The law was amended in the early 90s and it said that an abortion could be performed when it is affecting the life of a mother and other necessary treatments. The term “necessary treatment” is very vague and can mean anything. So the need is to make it more specific and clear.”

Midwifery Association of Pakistan president Imtiaz Kamal pointed out that, “We were the first ones in the world to present a family plan and policy in the country in 1953.”

Indonesia and other Asian countries came to learn about the policy from us and now they are implementing everything that we planned and we are still in the same place as before.”

The speakers noted that most of the abortions performed at home resulted in the death of the woman. Kamal believed that the absence of laws, regulating medicines, nursing and midwifery, are the main reasons for this. “A midwife would know her limit only when it is defined by the law. There is no law or regulation so they continue to do what according to them is their duty,” he added.

The doctors in the discussion panel expressed some confusion over the concept of abortion as a crime and whether or not it was forbidden in religion. “We need to agree on one point when it comes to abortion and maternal health issues,” said Dr Yousuf Bizenjo, the provincial programme coordinator at NCMNH. “Otherwise the nation would move about in circles without getting to the root cause,” said Dr Bizenjo.

Several panellists urged that abortion and maternal health issues need to be discussed in the media, to which Kamal said, “It would take us a minute to say something about abortion on national television and a million years to calm down the hysteria it would create.”

Published in The Express Tribune, February 11^th, 2011.