Download - Postabortion care
Taking a glance at abortion situation
High unmet need
↑Unwanted pregnancy
↑Unsafe abortion
17.7% (2007)
CPR in 2007: 41%
66/1,000 (2007)
MMR in 2007: 316/100,000LB
1, 2 (FRHS – 2007)
11% of pregnancies in married adolescent (15-19) end in abortion1
25% of hospital admission due to abortion – unsafe2
Country’s legal and sociocultural context
Law: abortion is illegal except when necessary to save women’s life
Population policy: Pronatalist
Religious based belief: abortion as killing a human being
Social factor: pregnancy of an unmarried woman as taboo
How women end their pregnancies?(Pummeling, Sticks and Kathy Pan)
TBAs- 44%
Bamboo sticks
Bicycle spoke
Cotton buds
Bird feather quill
Twig from tree
Fertility and pregnancy loss, Dr. Cynthia Maung and Suzanne Belton
Self-30%
Thway Say
“Hot” medicine
Where and who did abortion?
TBAs’ home
Private clinic
Home
% interviewed youth indicated1
78%
40%
36%
1 Family and Youth survey, 2004 country report, Department of population
Unsafe abortion
Incomplete abortionBleedingInfection
What are the consequences of abortion?
Bleeding
Infection
Trauma
Hospitalization
Mortality
↑Cost
Unsterilized and unskilled acts ensue in incomplete and septic abortion:
How to manage the consequences and prevention of such an event?
Consequences: B I T Emergency treatment
Management
Unwanted pregnancy Family planning
Barriers and concerns Counseling
Post
Abortion
Care
Where PAC services are available?
Emergency treatment
Services available
in some hospitals
Difficult to reach the facility
Consequences of abortion
Maternal deaths due to abortion related condition:
15 – 24% in rural area (2005 NCSMM)
Maternal deaths due to abortion related condition:
60% in hospital setting (hospital based data1)
1 Integration of PAC: roles of TMO and midwives in Myanmar, Thein Thein Htay et al, 2003
If emergency treatment services are available in primary level, which will be the most suitable?
D & C
MVA
Misoprostol
Severe Complication EfficacyEase of use
2 – 4%
1 – 2%
Physician
Trained Health worker
>95%
>95%
RareTrained Health worker
>90%
How does Misoprostol work?
Bleeding after delivery
Bleeding after abortion
Use of the drug
Cheap, easy to store, transport and use