Abortion in Bangladesh

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Abortion is illegal in Bangladesh under most situations, but menstrual regulation is often used as a substitute. Bangladesh is still governed by the penal code from 1860, where induced abortion is illegal unless the woman is in danger. [1] [2]

Contents

Historically, abortion has been prevalent, especially during the years following the Bangladesh Liberation War. For example, in 1972, the law allowed for abortion for those women who has been raped during the war. [2] In 1976, the Bangladesh National Population Policy unsuccessfully attempted to legalize abortion in the first trimester. [3]

Since 1979, menstrual regulation has been the favored alternative to induced abortion, and it is legally permitted because pregnancy cannot be established. [3] [2] In 2012, the Drug Administration for Bangladesh legalised the combination of mifepristone and misoprostol for medical abortion. [4]

Menstrual regulation

Part of the family planning program in Bangladesh since 1979, menstrual regulation is a procedure that uses manual vacuum aspiration to make it impossible to be pregnant after missing a period. [1] It is simple and can be done with inexpensive equipment. The procedure also is performed without the use of anaesthesia. [5]

A study about menstrual regulation in 2013 studied 651 consenting women from 10 different facilities in Bangladesh, who were seeking menstrual regulation and were about 63 days or less late of their menstrual cycle. They were given about 200 mg of mifepristone, followed later by 800 mg of misoprostol. The researchers found that 93% of the women had evacuated the uterus without the use of the surgical intervention, and 92% of the women were satisfied with the pills and the rest of the treatment. [6]

Although menstrual regulation centers are centralized and free of charge, many women still lack access due to socioeconomic barriers and social stigma. [6] Centers charge additional fees if the pregnancy is beyond 10 weeks, and many women are unaware of menstrual regulation or face male opposition to the procedure. As a result, some women turn to illegal abortions. [7]

Abortion

An abortion can be legally performed by a physician in a hospital, if it is necessary to save the life of the mother. A person who performs an abortion under any other circumstances, including a woman who self-aborts, can be punished by a fine and imprisonment. [2]

Menstrual regulation allows a woman to terminate within 10 weeks of her last period, but unsafe methods to terminate pregnancy are widespread. In response, a hotline was created for women to get information about fertility control, including menstrual regulation. [8]

According to an article by the Guttmacher Institute, which studied the rural sub-district of Matlab, illegal abortion is becoming increasingly prevalent despite the availability of safer methods of fertility control. [9]

A study by Mizanur Rahman and Julie DaVanzo showed that between 2000 and 2008, a woman was more likely to die from the complications of unsafe abortion than from childbirth itself, and that death rates from childbirth were similar of the death rates for the complications of menstrual regulation. [10]

Another study in Matlab found that between 1982 and 1998, abortion about 35 times more prevalent among unmarried adolescent girls than among married adolescent girls, and it was much higher among who were less than 18 years of age and those who passed or had more than primary education. [11]

Statistics

As of 2014, the national rate that women participate in menstrual regulation as a post-contraceptive way to control their fertility was 10 per 1,000 women aged 15–49. The national rate for induced abortion was 29 per 1,000 women in the same age interval. [1] The United Nations estimated that in 2000, the abortion rate was 4.0 abortions per 1,000 women aged 15–44. [12]

Only 42% of facilities that were expected to provide menstrual regulation services actually did so. Of the Union Health and Family Welfare Centres, which are especially relied upon in rural areas, half provided these services. [1] According to Guttmacher, about 27% of women (about 105,000) are turned away annually. In addition, in 2014, about 50% of married Bangladeshi women had not heard of menstrual regulation. [1]

In 2014, it was estimated that between 523,808 and 769,269 abortions occurred per year in Bangladesh. [4]

Related Research Articles

Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of all pregnancies. When deliberate steps are taken to end a pregnancy, it is called an induced abortion, or less frequently "induced miscarriage". The unmodified word abortion generally refers to an induced abortion. The reasons why women have abortions are diverse and vary across the world. Reasons include maternal health, an inability to afford a child, domestic violence, lack of support, feeling they are too young, wishing to complete education or advance a career, and not being able or willing to raise a child conceived as a result of rape or incest.

Dilationand curettage (D&C) refers to the dilation of the cervix and surgical removal of part of the lining of the uterus or contents of the uterus by scraping and scooping (curettage). It is a gynecologic procedure used for diagnostic and therapeutic purposes, and is the most commonly used method for first-trimester miscarriage or abortion.

<span class="mw-page-title-main">Mifepristone</span> Medication

Mifepristone, also known as RU-486, is a medication typically used in combination with misoprostol to bring about a medical abortion during pregnancy and manage early miscarriage. This combination is 97% effective during the first 63 days of pregnancy. It is also effective in the second trimester of pregnancy. It is taken by mouth.

<span class="mw-page-title-main">Abortifacient</span> Chemical substances that interrupt pregnancy after implantation

An abortifacient is a substance that induces abortion. This is a nonspecific term which may refer to any number of substances or medications, ranging from herbs to prescription medications.

<span class="mw-page-title-main">Misoprostol</span> Medication to induce abortion and treat ulcers

Misoprostol is a synthetic prostaglandin medication used to prevent and treat stomach and duodenal ulcers, induce labor, cause an abortion, and treat postpartum bleeding due to poor contraction of the uterus. It is taken by mouth when used to prevent gastric ulcers in people taking nonsteroidal anti-inflammatory drugs (NSAID). For abortions it is used by itself or in conjunction with mifepristone or methotrexate. By itself, effectiveness for abortion is between 66% and 90%. For labor induction or abortion, it is taken by mouth, dissolved in the mouth, or placed in the vagina. For postpartum bleeding it may also be used rectally.

<span class="mw-page-title-main">Self-induced abortion</span> Abortion performed by a pregnant person themselves outside the recognized medical system

A self-induced abortion is an abortion performed by the pregnant woman herself, or with the help of other, non-medical assistance. Although the term includes abortions induced outside of a clinical setting with legal, sometimes over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, potentially more dangerous methods. Such practices may present a threat to the health of women.

<span class="mw-page-title-main">Unsafe abortion</span> Termination of a pregnancy by using unsafe methods

An unsafe abortion is the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both. An unsafe abortion is a life-threatening procedure. It includes self-induced abortions, abortions in unhygienic conditions, and abortions performed by a medical practitioner who does not provide appropriate post-abortion attention. About 25 million unsafe abortions occur a year, of which most occur in the developing world.

Menstrual extraction (ME) is a type of manual vacuum aspiration technique developed by feminist activists Lorraine Rothman and Carol Downer to pass the entire menses at once. The non-medicalized technique has been used in small feminist self-help groups since 1971 and has a social role of allowing access to early abortion without needing medical assistance or legal approval. ME usage declined after 1973, when Roe v. Wade legalized abortion in the United States. There has been renewed interest in the technique, in the 1990s and more recently in the 2010s, due to increased restrictions on abortion. In some countries where abortion is illegal, such as Bangladesh, the terms "menstrual regulation" or "menstrual extraction" are used as euphemisms for early pregnancy terminations.

<span class="mw-page-title-main">Abortion in South Africa</span> Overview of the legality and prevalence of abortions in South Africa

Abortion in South Africa is legal by request when the pregnancy is under 13 weeks. It is also legal to terminate a pregnancy between week 13 and week 20 under the following conditions: the continued pregnancy would significantly affect the pregnant person's social or economic circumstances, the continued pregnancy poses a risk of injury to the pregnant person's physical or mental health, there is a substantial risk that the foetus would suffer from a severe physical or mental abnormality, or the pregnancy resulted from rape or incest. If the pregnancy is more than 20 weeks, a termination is legal if the foetus' life is in danger, or there is a likelihood of serious birth defects.

Abortion in India has been legal under various circumstances with the introduction of the Medical Termination of Pregnancy (MTP) Act, 1971. The Medical Termination of Pregnancy Regulations, 2003 were issued under the Act to enable women to access safe and legal abortion services.

<span class="mw-page-title-main">Women on Web</span> Canadian online abortion help service

Women on Web (WoW) is a Canadian non-profit organization that aims to increase access to safe abortion known for its online abortion service accessible in multiple countries. The organization was founded by Dr. Rebecca Gomperts, a Dutch physician, in 2005.

Abortion in Venezuela is currently illegal except in some specific cases outlined in the Venezuelan Constitution, and the country has one of Latin America's most restrictive laws.

In Trinidad and Tobago, abortion is illegal save for few exceptions. The respective laws are in place since 1925.

Abortion in Cuba is legal and available upon request, which is rare in Latin America because of widespread Catholic influence.

A medical abortion, also known as medication abortion, occurs when drugs (medication) are used to bring about an abortion. Medical abortions are an alternative to surgical abortions such as vacuum aspiration or dilation and curettage. Medical abortions are more common than surgical abortions in most places, including Europe, India, China, and the United States.

Abortion in Uganda is illegal unless performed by a licensed medical doctor in a situation where the woman's life is deemed to be at risk.

Abortion is a controversial topic in Nigeria. Abortion in Nigeria is governed by two laws that differ depending on geographical location. Northern Nigeria is governed by The Penal Code and Southern Nigeria is governed by The Criminal Code. The only legal way to have an abortion in Nigeria is if having the child is going to put the mother's life in danger. However, sex-selective abortion has long had acceptance in Nigeria.

<span class="mw-page-title-main">Abortion in Kenya</span> Termination of pregnancy in Kenya

Abortion in Kenya is prohibited with the exception of certain circumstances including danger to the life and health of the expectant mother, and rape. Unsafe abortions are a major cause of deaths and health complications for women in Kenya.

In 2005, the Ethiopian Parliament liberalised the abortion law to grant safe abortions to women in specific circumstances.

Abortion is illegal in Tanzania except to preserve the life of the mother. Under the Tanzanian penal code, health practitioners who perform illegal abortions may receive sentences of up to 14 years in prison, while those who procure abortions for themselves may be sentenced to up to seven years in prison.

References

  1. 1 2 3 4 5 "Fact Sheet: Menstrual Regulation and Induced Abortion in Bangladesh". Guttmacher Institute. September 2012. Retrieved 14 March 2017.
  2. 1 2 3 4 "Bangladesh". Abortion Policies: A Global Review (DOC). United Nations Population Division. 2002. Retrieved 14 March 2017.
  3. 1 2 "Country Profile – Bangladesh". Asia Safe Abortion Partnership. Archived from the original on 11 November 2016. Retrieved 14 March 2017.
  4. 1 2 Zaidi, Shahida; Begum, Ferdousi; Tank, Jaydeep; Chaudhury, Pushpa; Yasmin, Haleema; Dissanayake, Mangala (2014). "Achievements of the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences in South-Southeast Asia". International Journal of Gynecology & Obstetrics. 126: S20–S23. doi: 10.1016/j.ijgo.2014.03.015 . PMID   24743025.
  5. ↑ Laufe, Leonard E. (October 1977). "The Menstrual Regulation Procedure". Studies in Family Planning. 8 (10): 253–256. doi:10.2307/1966015. JSTOR   1966015. PMID   929663.
  6. 1 2 Alam, Anadil; Bracken, Hillary; Johnson, Heidi Bart; Raghavan, Sheila; Islam, Noushin; Winikoff, Beverly; Reichenbach, Laura (June 2013). "Acceptability and Feasibility of Mifepristone-Misoprostol For Menstrual Regulation in Bangladesh". International Perspectives on Sexual and Reproductive Health. 39 (2): 79–87. doi: 10.1363/3907913 . JSTOR   41959959. PMID   23895884.
  7. ↑ Islam, Mohammad Amirul; Padmadas, Sabu S.; Kabir, Mohammad (6–10 November 2004). Evaluation of reported induced abortion in Bangladesh: Evidence from the recent DHS. 132nd Annual Meeting of the American Public Health Association.
  8. ↑ "Safe Abortion Hotline Launched for Menstrual Regulation in Bangladesh" (Press release). International Campaign for Women's Right to Safe Abortion. 23 October 2013. Archived from the original on 2014-10-24. Retrieved 2014-10-24.
  9. ↑ "In Bangladesh, Unsafe Abortion is Common Despite Availability of Safer Pregnancy Termination Procedure" (Press release). Guttmacher Institute. 22 September 2014. Retrieved 14 March 2017.
  10. ↑ DaVanzo, Julie; Rahman, Mizanur (September 2014). "Pregnancy Termination in Matlab, Bangladesh: Trends And Correlates of Use of Safer and Less-Safe Method s". International Perspectives on Sexual and Reproductive Health. 40 (3): 119–126. doi: 10.1363/4011914 . PMID   25271647.
  11. ↑ Ahmed, M. Kapil; van Ginneken, Jeroen; Razzaque, Abdur (February 2005). "Factors associated with adolescent abortion in a rural area of Bangladesh". Tropical Medicine and International Health. 10 (2): 198–205. doi:10.1111/j.1365-3156.2004.01362.x. PMID   15679564. S2CID   10742624.
  12. ↑ "World Abortion Policies 2013". United Nations. 2013. Retrieved 14 March 2017.
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