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Safe abortion steps elude rural women

Ranchi, May 18: A recent survey carried out in the Arki block in Ranchi district revealed that only three of 25 women opted for a safe abortion.

Lack of human resources, negligible number of NGOs, ignorance of scientific methods and heavy reliance on quacks and ojhas have increased unsafe abortions in the state.

Few trained doctors coupled with low awareness among women have made the situation worse. Moreover, there exists a social stigma and secrecy surrounding abortion in the state.

The MMP (maternal mortality programme) — death per 100,000 live births — in the state is 371 while the national average is 301. The number of induced abortions in Jharkhand is 146,000 per year while the number of safe abortions per year is 97,000.

Even though abortion up to 20 weeks of gestation is legal, safe but legal abortion services are not easily available to poor, rural women.

“Unsafe abortion endangers 4 million women in India every year, damaging the health and fertility of thousands and causing an estimated 15,000 preventable deaths,” said Usha Rani, a city-based gynaecologist.

While Vanoj Manin, country head of IPAS, an international NGO protecting women’s health and advancing women’s reproductive rights, said two-thirds (67 per cent) of induced abortions are carried out in unsafe conditions.

The IPAS programme, which was established in India in 2001, has helped establish safe abortion practices in Maharashtra, Madhya Pradesh, Bihar and Uttarakhand.

“The proportion of maternal deaths due to unsafe abortions is gradually on the decrease. It has come down from 12 per cent in 2001 to 8 per cent in 2006,” Manin said.

IPAS works with the state government in rural areas. “People in rural areas are superstitious. But the state government is training doctors to handle abortion cases,” he added. “Besides, limited primary health centres exist and women come here only after developing complications,” said Manin.

In fact, senior gynaecologist Rani, who is also a member of the National Association of Gynaecologists, said: “Members should show their commitment in increasing the number of doctors, promoting expanded use of appropriate technologies and increasing awareness among women.”

The survey carried out in Chandankiari block (Bokaro) revealed rural practitioners often used ayurvedic and allopathic methods for abortion. Besides, wrong pills were also prescribed, Rani pointed out.

Some of the rural practitioners are trained by qualified doctors of Chas and Bokaro. Besides, several medical agents who refer cases earn around Rs 200-300 every day while medical practitioners charge Rs 800 for the abortion. Traditional midwives, however, refer to herbal practitioners and rely on drugs and herbal medicines.

“There are no abortion services in government health centres in Bokaro. The study also revealed four death cases due to abortion. Only two women had opted for medical care while two women used oral contraceptive pills. Only one man used protection,” added Manin.

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