Haemorrhage to bleeding: How rampant 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 40-plus woman took an abortion pill and landed at the hospital with abnormal vaginal bleeding.

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

Similarly, another 40-year-old female decided to abort her second baby as her husband was not ready to take up the financial responsibilities.

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

Unsafe abortions and over the counter pills

Dr. Rumisa Mir, Medical officer at Sub-district hospital Char-Sharif said an abortion done without the guidance of a doctor is unsafe.

There is risk involved in every case.

“Unsafe abortion is the third leading cause of maternal mortality. Every month we receive at least 10 married females at the OPDs with the complications developed due to unsafe abortion.”

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

“Usually the first pill is given to disrupt the pregnancy and after 24 to 72 hours another set of pills is given to start the bleeding. Lots of tests are done before giving these pills. We check haemoglobin levels, have to rule out other medical disorders, and monitor side effects,” Dr. Rumisa said.

She said that because of the easy availability of abortion pills, women take them without any supervision. “Many come to us with heavy bleeding and there’s a chance of haemorrhage, which could turn fatal,” she said.

The doctor said we cannot also deny the fact abortions are also done illegally. “Such practices need to be curbed in the valley. A female has to go for a Medical Termination of Pregnancy test and cite a proper reason for the abortion first,” she said.

She emphasized that the couples should visit family planning clinics. “The married couples can get awareness on the options on having safer sex rather than unnecessarily opting for abortion. The health expert can give them a basket of choice 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. The pregnancy is ended either by taking medicines or having a surgical procedure. It’s also sometimes known as a termination of pregnancy.

Medical Termination of Pregnancy is a procedure of terminating pregnancy using medicines. In the early stages of pregnancy (7-9 weeks), it can be terminated with the help of medicine, otherwise, the surgical process is needed.

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

She said under the new rules of 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 or rape or incest; minors; change of marital status during the ongoing pregnancy (widowhood and divorce); women with physical disabilities; mentally ill women; fetal malformation that has a substantial risk of being incompatible with life or if the child is born, he/ she may suffer from serious physical or mental abnormalities; and women with pregnancy in humanitarian settings or disaster or emergency situations,” Dr. Khan said.