Political battleground: Women needing abortions are typically over 30, married

Many couples are using this method instead of proper family planning.

KARACHI:

Harrowing tales of self-induced abortions by desperate women were shared by experts at the Society of Obstetricians and Gynaecologists Pakistan (SOGP) seminar at the Pakistan Medical Association (PMA) on Saturday.

“We know of desperate women who have straightened and shoved iron clothes hangers, sharpened sticks and even knitting needles up their vagina with the intention to abort pregnancy,” said  renowned gynaecologist and executive member of SOGP, Dr Shershah Syed.

Three women die every hour due to pregnancy-related complications — this includes abortions as well as mismanagement of the women after a natural miscarriage. One in six women induce abortion through unsafe methods, including those mentioned above.

But this is not a legal issue. In fact it has “...more to do with the social stigma and cultural barriers attached to abortion,” Syed said. In 1999, a group of religious scholars from all sects formed a consensus on the issue and declared abortion permissible with 120 days of conceiving. Yet each year, hundreds of women die “lonely and bleeding”.

The causes behind these avoidable deaths are as depressing as the state of these women’s health. Medical curriculum in colleges and universities easily side-step teaching on abortion. There is a lack of training for midwives. Opinionated and judgemental doctors add to the list of culprits, resulting in the deaths of at least 30,000 women every year, experts said.

“If a woman you refuse to help, dies of abortion-related complications, who do you think is responsible for her death?” asked veteran Imtiaz Kamal, who is a trailblazer for midwifery in the country. “Training for safe methods of abortion is at present beyond the spectrum of regular learning in obstetrics.” Mostly senior midwives were trained in the hope that the information would trickle down to others so that they could at least point women in need in the right direction. “Please do not bring your personal opinions into your profession. If you do not want to, or can’t help her, at least refer her to someone who can.”

Many hospitals and medical professionals turn women away because they believe they are unmarried and since they have ‘wronged’ they should not be helped in any way. Consultant gynaecologist Dr Azra Ahsan dispelled such notions. “The typical woman seeking an abortion is 30 years or older, married and the mother of three or four children.” Many women use abortion as a technique for family planning as it is a one-time procedure instead of a daily routine.

In the same vein, the secretary general for SOGP, Dr Nighat Shah, shared an experience she had with a woman early in her career as a post-graduate. A woman in her mid- to late 40s came to Shah for an abortion for an unplanned pregnancy. She had several children one of whom was due to marry in two days. Unwilling to go against her principles, Shah turned the woman away. Her supervising doctor at the time, Dr Shershah Syed, said she had just written that woman’s death certificate. He told her, “The woman was left with no choice but to seek unprofessional help or probably use unsafe methods.” Shah rushed out to call her back. “Our job is not to judge or decide matters in other women’s private lives,” she said. “Our job is to save lives, even if it is one woman at a time.”

Syed urged the government to refocus its priorities on the dire state of women and child health for which even small steps can propel huge positive changes. “The government is willing to spend millions on robotic machines which have a one-time cost of $5,000 for treatment but ignore simple measures such as training midwives and creating awareness on family planning,” Syed added.

Dr Huma Farid, a clinical fellow at Brigham and Women’s Hospital in Boston, shared her experiences of the “not-so-liberal country on the issue of abortion”. “Half the pregnancies in the US are unplanned,” she said. “About 42 per cent end in abortion of which 89 per cent are within the first 12 weeks.” But over the course of a century, the country has struggled with conservative and liberal, religious and political opinions and perspectives on the controversial topic. “There are still some conservative hospitals which will turn a patient away if she is seeking an abortion or even if she is suffering from abortion-related complications, even if her life is at stake.” At least 27 states are regulated by three or more laws on abortion.

Published in The Express Tribune, January 15^th, 2012.