A Safe Guide to Abortions

“Why is abortion abnormal, but police brutality, hate crime, suicide abetment just the way of life? I choose not to bring a life into this world, that I am not ready to care for. I am protecting my unborn by keeping it away from this patriarchal world.”

Anonymous

What is ABORTION?

Abortion refers to the termination of pregnancy by the removal or expulsion of an embryo or fetus. It is also referred to as termination of pregnancy.

Why is it Important to Have a Safe and Informed Abortion?

Each year 6.4 million fetuses are aborted, 3.4 million of which are unsafely performed using unsanitary methods. Each day, approximately 13 women die as a result and thousands more suffer severe reproductive health issues. 

Unsafe Abortions are the 3rd most leading cause of mortality amongst women. 

Further, a huge chunk of our population are unaware of the legality of abortions and opt for unsanitary alternatives. 

Not every General Practitioner, Gynaecologist, nor Obstetrician is legally allowed to carry out abortions nor prescribe medications.

Safe abortions don’t limit to just the procedure. Abortions have a huge impact on a woman’s body and frequent check-us are vital. Carrying out proper treatment is the only way to avoid other medical conditions. 

Reasons for Abortion:

There are multiple reasons why women might want to abort. A few reasons include:

  • When the parent(s) is financially unprepared
  • Unplanned/Accidental
  • Bad/Abusive Partner
  • Conception by Rape, Incest, or any other sexual assault 
  • Teen/Early Pregnancy
  • Health Issues
  • Dependent and/or Unprepared
  • Addiction
  • No longer want kids
  • Delaying Parenthood
  • Unwilling to be a parent
  • Not ready to have a kid
  • Pregnancy interfering with Education, Work, Promotion.
  • Any other unique reason a woman wants to terminate her pregnancy.

When is a Pregnancy Unsafe?

There are many situations where medical complications harm or might harm the mother and baby. Some situations might end in abortion because of unsafe pregnancies.

It is important to routinely have check-ups, take prenatal vitamins and other prescribed medications, and avoid taking any stress or straining yourself physically.

A few warning signs and complications of unsafe pregnancy: 

(NOTE: these warning signs don’t always lead to abortion, but please contact your doctor immediately)

  • Heavy bleeding and abdominal pain
  • Severe Nausea
    • Nausea is common in pregnancy, many women have morning sickness. 
    • Uncontrollable vomiting and not eating and drinking properly can make you dehydrated and harm you and the baby
  • Significant Decline in Baby’s activity
  • Contractions early in the 3rd trimester
  • When your water breaks early
  • Gestational Diabetes
  • Macrosomia
    • The baby is much larger than normal
    • When the mother’s blood had too much glucose, the pancreas of the fetus converts the extra glucose into fat
  • Flu-Like symptoms
  • Amniotic Fluid Complications
    • Too much or too little amniotic fluid in the sac
    • Difficulty in breathing 
    • Prenatal diabetes
  • Ectopic Pregnancy
    • The development of the fetus outside of the uterus. 
  • Placental Complications
    • Placental Abruption – detached placenta from the uterine wall
    • Placental Previa – the condition in which the placenta is attached too close to the cervix. 
  • Preeclampsia or Eclampsia
    • Pregnancy-induced high blood pressure
    • Can lead to seizures, coma, and death

Who is Allowed to get an Abortion in India?

Medical Termination of Pregnancy (MTP) Act legalized the termination of pregnancy (still not using the word abortion) with several conditions up to 20 weeks (from the first day of the last menstrual period). The conditions are:

  • “When continuation of pregnancy is a risk to the life of a pregnant woman or could cause grave injury to her physical or mental health;
  • When there is substantial risk that the child, if born or dead would be seriously handicapped due to physical or mental abnormalities;
  • When pregnancy is caused due to rape (presumed to cause grave injury to the mental health of the woman);
  • When pregnancy is caused due to failure of contraceptives used by a married woman or her husband (presumed to constitute grave injury to mental health of the woman).”

The Indian Abortion Laws are not liberal and do not permit women to terminate a pregnancy because they are not ready or unprepared. More information on the legal details of abortion in India can be found here.

Who is allowed to Perform an Abortion in India?

The MTP Act also specifies who is legally allowed to terminated a pregnancy, a practitioner who 

  • “has a recognized medical qualification under the Indian Medical Council Act, 
  • whose name is entered in the State Medical Register, and 
  • who has experience or training in gynecology and obstetrics.”

Not every Gynaecologist and/or Obstetrician is legally allowed to perform abortions. Be sure to check their license and get a safe and secure abortion if and when needed.

Consent for Abortion?

In India, an adult woman does not need consent from her husband, father nor the father of her unborn child until 20 weeks of gestation. Minors, however, require a legal adult’s consent. 

Once the pregnancy crosses 20 weeks, a woman needs special permission from the courts and two other people’s consent to be able to terminate her pregnancy.

To get an abortion, there are a legal-forms one needs to fill and sign. It is important to be aware of what documents you are signing and the terms you are agreeing to. 

The Price for abortions is fixed, a first-trimester abortion is approximately, Rs.500-1000 while a second-trimester abortion cost around, Rs.2000-3000. 

It is important to know your rights and pay only the correct rate. If a doctor charges more, you are entitled to report them. 

Many doctors are known to charge Rs,10,000, and more.

Procedural Blueprint:

Courtesy of Vardaan Hospital, Delhi.

There is a procedure that mot doctors follow. You are entitled to find out the procedure before-hand and report anyone for misbehavior.

There are two methods, oral and surgical. 

Oral Method Procedure:

If the pregnancy is less than 6 weeks, a mother can opt for the oral method

  • Ultrasound – to check for the duration of pregnancy or to see if it is a tubal pregnancy
  • Medication is prescribed 
  • Blood tests are done
  • 2 doses are given 48hrs apart.

Surgical Method Procedure:

  • Ultrasounds and Blood tests
  • Depending on the duration of the pregnancy, medication is prescribed to dilute the uterus.

One of the below

  • Vacuum Aspiration.
  • Dilation and Evacuation.
  • Dilation and Curettage.
  • Suction evacuation.

Follow Up:

Courtesy of Vardaan Hospital, Delhi.

Oral Method:

  • Bleeding is common in the 24-48 hours whole taking the dose and lasts for a week
  • Tissue might retain in some cases which leads to incomplete abortion. Suctional evacuation is important.
  • Confirmation of a complete abortion is done by another ultrasound.

Surgical Method:

  • The pain during and after the process varies for each woman.

General:

  • Maintain a proper diet
  • Take proper medications on time
  • Avoid exercising and moving around a lot
  • Counseling is important to recover
  • Avoid tampons during the menstrual cycle
  • No sexual contact for at least a month.

When is Abortion not Safe?

Abortion is unsafe if a woman:

  • Is more than 70 days pregnant (counted from the first day of the last menstrual period)
  • Has bleeding problems or is taking blood-thinning medication
  • Has chronic adrenal failure or is taking certain steroid medications
  • Cannot attend the medical visits necessary to ensure the abortion is completed
  • Does not have access to emergency care
  • Has uncontrolled seizure disorder (for misoprostol)
  • Has acute inflammatory bowel disease (for misoprostol)

Risks of Abortions:

Abortion has serious effects on a woman’s body. The following are a few risks associated with abortion:

  • Heavy bleeding
  • Infections
  • Incomplete abortions
  • Damage to the cervix
  • Scarring of the uterine lining 
  • Perforation of the uterus
  • Damage to internal organs
  • Miscarriages in future pregnancies
  • Death
  • Eating Disorders
  • Suicidal thoughts
  • Guilt
  • Relationship problems
  • Depression
  • Sexual dysfunction
  • Prone to addiction

When to Call your Doctor?

It is normal to contact your doctor after an abortion with any queries. 

These are the signs of complications where calling your doctor is important:

  • Excessive Bleeding
    • Bleeding is normal, but excessive bleeding is not.
  • No bleeding in the first 24 hours.
  • Signs of infection
    • Headache
    • Muscle aches
    • Dizziness
    • Fever
  • Severe abdominal pain
  • Fever that lasts for more than 4 hours
  • Vomiting for more than 4-6hours
  • Sudden belly swelling
  • Rapid heart rate
  • Smelly vaginal discharge
  • Pain, redness, and swelling in the genital area
  • Any other unexplainable symptoms

After a surgical abortion, follow up with one or more of these medical exams:

  • A physical exam of the cervix and uterus
  • A lab test to check your hCG levels
  • Blood test for anemia