Unsafe abortion and its challenges

While becoming a mother is a dream that most women harbour, not knowing the right things could lead to disaster. Read more about the difficulties that women could face...

Most women feel complete when they become mothers, but do they always have a smooth nine-month journey during pregnancy? No. In many cases, the pregnancy can go so horribly wrong that abortion becomes the only option instead of giving birth.

In many cases, women are unable to complete their pregnancies despite conceiving. There can be two reasons for this; miscarriage or abortion. In both the situations, D&C or ‘Dilation and Curettage’ is required. D&C is a procedure which involves cleaning of endometrium, the inner lining of the uterus.

The D&C procedure should always be done by medical experts who have specialised knowledge and tools for this. Doing it without the help of medical advice and experts could lead to fatal consequences. The tools used in this procedure are sharp, and the inner parts of the uterus are sensitive, and untrained hands can cause serious internal injuries. Yet, several women in rural as well as urban areas do not go to hospitals out of public shame, and instead, go to small clinics. In many of these centres, D&C procedures are carried out by untrained people. As a result, the women pay the price by suffering pain and physical distress throughout their life.

When is D&C procedure required?

The D&C procedure becomes vital to clean the interior part of the uterus after abortion, to remove a growing tumour inside the uterus, to get rid of the remains of the placenta in the uterus after the delivery or to take out a cancer-free polyp from the uterine cervix or uterus. Sometimes, hysteroscopy is also carried out with D&C operations. 

When can D&C procedure be dangerous?

Dr Kuldeep Kaur, Gynecologist says, “It is risky to get the D&C procedure by untrained hands because it could pierce the uterus”. Sometimes, the injury heals, but in most of the cases, it doesn’t happen, and the patient has to undergo the D&C procedure again. This poses grave risk, especially to those women who have become pregnant recently or have had menopause.

Injury to the uterine cervix could cause intense bleeding and both medicinal treatment and stitching become necessary to heal it. However, risks remain high.

Unsafe D&C can also cause ‘Asherman’s syndrome’, which generally happens when women undergo the procedure either after delivery or miscarriage. In such conditions, the patient can suffer from excessive pain during menstruation or absence of menstrual periods. The future risk of miscarriage or infertility also grows. 

Lack of awareness

According to a report by the United Nations Population Fund’s flagship State of World Population 2022, the rate of unsafe abortion in India is as high as 67 percent and as many as eight women die every day. It also said that the risk of unsafe abortion is the highest among girls/women aged between 15 and 19.

A report of the fifth round of India’s National Family Health Survey has said that 43 in 1,000 girls/women between 15 and 19 become mothers at a young age, which puts their lives in danger. Many of such girls/women undergo D&C procedure without the help of a healthcare expert because of social embarrassment, and this leaves them with lifelong challenges. 

When D&C adds more to women’s plight

Nineteen-year-old Avantika (name changed) said she got married at the age of 18 and had a miscarriage because of frailty. She underwent D&C surgery, but her problems increased after that. She suffered from excessive pain during periods forcing her to take medicine and sometimes even injection. She also faced problem in conceiving again. When she consulted the doctor about her condition, she learned that wrong D&C procedure had caused an injury in her uterus. Treatment started and Avantika had to undergo the D&C procedure again. Her condition is better now but she could have avoided the pain and suffering had the first D&C procedure been done properly.

Lalita Devi (name changed), who lives in a village, told that when her daughter-in-law got pregnant the first time, they were forced hire a local ‘dai’ (midwife) for the delivery due to financial hardships. But after her delivery, her daughter-in-law started having frequent intense pain. They went for a medical check-up in the city, and it was diagnosed that her uterus had developed an infection due to unhygienic delivery procedure. They had little knowledge that such problems could occur for not seeing an expert earlier.

Dr Kalpana Apte, the secretary general of the Family Planning Association of India said, “it is very important to get girls married at the right age because they become physically prepared and mentally sound about things related to motherhood and health. This can minimise the risks of maternal mortality and control population growth. Nearly 10 per cent women prefer not to get pregnant but they either lack knowledge about condoms and other contraceptives or do not know how to use them. Almost 21 per cent of the cases of pregnancy are unplanned”.

‘Pratigya Campaign’ is here to help

Every woman has a right to safe abortion. An organisation called ‘Pratigya Campaign’ works towards educating each woman about safe abortion. You just have to put your pin code on its website and get your identification verified to get information about the nearest providers of safe abortion. You can avail this facility without revealing your identity. Only those medical experts who are recognised under the Medical Termination of Pregnancy (MTP) Act, 1971, are involved in this campaign.

A society moves forward towards betterment when sex education is encouraged in schools and kids are made aware. The D&C procedure might look harmless, but a wrong surgery can lead to serious consequences. Pregnancy at premature age and undergoing abortion because of social fear are recipes for serious future ailments. Also, bearing children at a very young age can also affect a woman’s health in the long run. Women should strongly assert their rights. For this, every family should focus on educating their daughters so that they become aware about their health and take strong decisions for their own well-being. 

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