Abortion: Disaster for birth control

Since she looked older, I asked her how many children she had previously had. She replied that this was her first. During my course of history taking I inquired if she had any previous abortions. “Yes. Six,” she replied. Although I have encountered numerous women who undergo recurrent abortions, the ease with which she answered made me uneasy. It was not a mandatory question and she could have declined to answer. But when I asked her why she chose to not continue her earlier pregnancies, she replied, “circumstances were just not right.”



Everyday hundreds of women undergo abortions in Nepal. Why does this “good news” for some turn out to be a nightmare for others? When the lady in question (one of my patients) informed me about her “not right circumstances,” I found her excuse to be flimsy and hard to accept—especially that of the circumstances not being right six times before! Ever since legalization of abortion in 1868 in the UK and in 2004 in Nepal, debates have been making rounds on abortion. Those of them who argue for it say that a single cell will one day turn into a human being and people should have the right to decide for it. Many others do not buy this logic.



To me, all these debates sound highly abstract because here I am referring to abortion as a measure of family planning. When there are multiple family planning methods already available, why do women still resort to the last option? Nowadays, couples opt to not have kids “so soon.” They wait for that right moment when everything is secure for them and if anything happens ahead of schedule, they accept the physical and the mental pain of the procedure, rather than giving that about-to-develop new life a chance—a chance to change that imperfect situation into a perfect one.



For a majority of people, abortion means a simple medical procedure carried out by doctors where there is some counseling done beforehand regarding future medical complications. But that is just a formality. The “slightly painful procedure” of abortion, that takes about 10 to 15 minutes to complete under anaesthesia, is cheap in government-owned healthcare facilities across Nepal. Most importantly, it is legal now. Many young girls are even resorting to more favorable discrete methods such as over-the-counter contraceptive pills.



These pills, widely misused nowadays are even sold by various pharmacies without a prescription. Some of these over-the-counter contraceptive pills have not been approved by the Food and Drug Administration (FDA). Unsupervised use of oral contraceptive pills can easily lead to complex irreversible complications including infertility and even cancer. Worse is the fact that only few are aware that a single abortion can lead to multiple complications, both immediate and in the long run. Recurrent abortions can cause chronic problems ranging from pelvic inflammatory disease (PID) to inflammation of the reproductive organs to ectopic pregnancies to even infertility, and premature death as well.



Even during the 21st century, in most countries, it is ironical that women are still poor, pregnant, and powerless. Having worked in a tertiary care centre, I have come across a number of women who are well informed about various family planning measures but still take to abortion as the last resort for birth control. The reason for this is nothing but their arrogance. They fail to realize that their arrogance actually costs an unborn child his/her life. The same haughtiness combined with desperation fuels illegal abortive practices that kill hundreds of lives, before they are born, in our country.



What compels a mother to abort her child? A closer look at our own socio-economic context may help us explore the answer of this question. There are varied reasons for people to opt for abortion. There may be someone who does not want another daughter. Young modern women use abortion as a form of contraception trying to “correct a mistake.” Some women, who at this moment fail to picture themselves as elegant urban mothers providing their children a “secure future” may succumb to the temptation. Whatever the reasons, before going for abortion women, and also men, should consider the risks involved in it. In the first place they should take greater care to not get pregnant. If abortion is carried out as a method of family planning, then it will prove to be not only a wrong approach but also much more dangerous and fatal cure for mothers’ health.



The writer is currently working as a resident doctor at Kathmandu Medical College



shreyashiaryal@gmail.com

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