Indmedica Home | About Indmedica | Medical Jobs | Advertise On Indmedica
Search Indmedica Web
Indmedica - India's premier medical portal

Indian Journal of Community Medicine

Characteristics of primigravid women seeking abortion services at a referral center, Manipur

Author(s): Devi Ibetombi T, Akoijam BS, Nabakishore N, Jitendra N, Nonibala Th

Vol. 32, No. 3 (2007-07 - 2007-09)

ORIGINAL ARTICLE

Year : 2007 | Volume : 32 | Issue : 3 | Page : 175-177

Characteristics of primigravid women seeking abortion services at a referral center, Manipur

Devi Ibetombi T1, Akoijam BS2, Nabakishore N3, Jitendra N1, Nonibala Th1
1 PPP Center, Imphal, Manipur, India
2 Department of Community Medicine, Regional Institute of Medical Sciences, Imphal, Manipur, India
3 Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur, India
Date of Submission 17-May-2006
Date of Acceptance 02-Jul-2007

Correspondence Address:
Akoijam B S
Community Medicine Department, RIMS, Imphal, Manipur - 785 004
India

Source of Support: None, Conflict of Interest: None
How to cite this article:
Devi IT, Akoijam BS, Nabakishore N, Jitendra N, Nonibala T. Characteristics of primigravid women seeking abortion services at a referral center, Manipur. Indian J Community Med 2007;32:175-7
How to cite this URL:
Devi IT, Akoijam BS, Nabakishore N, Jitendra N, Nonibala T. Characteristics of primigravid women seeking abortion services at a referral center, Manipur. Indian J Community Med [serial online] 2007 [cited 2007 Nov 30];32:175-7. Available from: http://www.ijcm.org.in/text.asp?2007/32/3/175/36820

Abstract

Objective: To explore the characteristics of primigravid women seeking abortion services and find out the reasons for undergoing abortion. Materials and Methods: A cross-sectional study based on data collected in 5 years was carried out. All primigravid women who came to avail of the abortion services were included and their characteristics were recorded. Reasons for undergoing abortion in their first pregnancy were ascertained. The information was gathered by personal interview conducted by a trained person. Results: There were 11,141 MTP cases in the 5 years, with 740 (6.6%) women coming for abortion in their first pregnancy. There was a decrease in these cases during the years under study. Most of the women belonged to the 15-24 years age group. The majority of the women were from rural areas. Abortion services were less sought by women who were educated up to graduation or above. The majority of the women were unmarried. A little more than half of the women sought abortion services with 12 weeks of gestation or more. Parents referred these women for abortion services more than their partners. Sociocultural factor was the commonest reason for undergoing abortion among these women. Conclusion: Pregnancy in unwed girls was the main reason for seeking abortion services. They lack adequate knowledge of contraceptive methods. There is a need for encouraging adolescent health services including sex education.

Keywords: First pregnancy abortion, Manipur, primigravid abortion, referral center

Introduction

Many countries accepted abortion as a medical and social necessity and liberalized their laws on abortion. Since abortion has been legalized, the number of legal and registered induced abortions has been increasing steadily. Around 50 million abortions are carried out all over the world. In Asia, 10 million unsafe abortions are performed per year. Unsafe abortions constitute about 13% of the maternal deaths.[1] An annual report indicated that 12.3 million women underwent legal abortion in India in 2000-2001.[2]

This study was contemplated to determine the frequency of primigravid abortion, characteristics of these women and the reasons for seeking abortion services by these women. The study also looked into the pattern of primigravid abortion in the last 5 years.

Materials and Methods

The study was a cross-sectional design based on the data collected prospectively from the respondents at the postpartum center for the first-time abortion seekers. All data on abortion during January 2000 and December 2004 were included, and the target population (data) was women with first-pregnancy abortion (primigravid abortion). The data on socio-demographic characteristics, history of pregnancy and its outcome and knowledge on RCH, particularly on contraceptive methods, for those women undergoing abortion were collected using a common pro forma by a medical social worker supervised by one of the investigators (TID). Reasons for abortion were also probed before the procedure. Consent was obtained for interviewing separately. Consent for undergoing abortion was taken separately by the center staff as per the guidelines.

Results

There were 11,141 abortions in the 5 years, with 740 (6.6%) women seeking abortion in their first pregnancy. [Table - 1] shows the characteristics of the women coming for abortion. Most of the women belonged to the age group of 15-29 years (89.3%), and 65% of the women were from rural areas. The majority of the women were Hindus (66.8%). Only 53 women (6.6%) were educated up to graduation and above. The majority of the women were unmarried (75.9%). More than half of the women came for abortion with more than 12 weeks of gestation.

Most of these primigravid women were referred by their parents (47.8%), followed by their partners (22.6%), husbands (14.2%), friends and relatives (13.8%) and in-laws (1.6%). The main reason for undergoing abortion in their first pregnancy was socioeconomic status. Year-wise distribution of reported abortion in primigravidae showed a decreasing trend ( P < 0.001) - from 8.3% in 2000 to 4.2% in 2004. Most of the women undergoing abortion for the first time were either ignorant (21.6%) or had poor knowledge (66.5%) about the contraceptive methods. Only 11.9% of the women had good contraceptive knowledge.

Discussion

Manipur has crude birth rate of 18.3/1000 and crude death rate of 5.4/100 as per SRS 2001. RCH round 2 survey, 2002-2004, showed mean age of girls at marriage as 24.1 years. The figure of 6.6% women undergoing abortion in their first pregnancy in the 5 years' period cannot be neglected, especially in the context of the movement "Make every mother and child count." It could also be taken as an indication of the negligence of proper adolescence sexuality education and calls for action. Finding of younger age group women forming the majority of the first-time abortion seekers is an expected one but needs documentation. Similar trends were also reported in studies from Vietnam, China and other Asian countries.[3],[4] Higher percentage of Hindu women could be explained by the proportion of Hindus in the community, though there are evidences of differences in the attitude towards sex in different communities. Lower percentage of highly educated women might be because of the proportion of younger women and favorable attitude associated with education. More number of women from the rural area accessing the abortion services could be because of the need to maintain anonymity. For the same reason, women from the urban area might prefer private clinics.

This study showed that the maximum number of women undergoing abortion in their first pregnancy were unmarried (74.9%). This is evident because our society does not accept such relationships. Again, this was the reason why these abortions were referred by their parents and partners. Very few married women underwent first-time abortion because of health and economic reasons. One study also highlighted the same reasons for undergoing abortion.[5] Only one case was seen where she sought abortion services as she wanted to separate from her husband. The reasons for undergoing abortion with advanced gestation were reluctance/ fear to reveal their pregnancy initially and ignorance, and there could have been an arrangement to settle the problem through marriage and that might have taken the time. This is contradictory to the findings of Gupta and colleagues, where most of the women undergoing abortion came within 6 weeks of pregnancy.[6]

There was a steady and significant decrease in the number of primigravid abortions in the study years - from 8.3% in 2000 to 4.2% in 2004. This decrease could be due to many reasons. There has been a campaign regarding adolescent health and sex education in the state with the advent of HIV epidemic in the recent years. It might be due to increased awareness about sexuality and safe sex. It could also be due to the fact that these women are accessing private clinics, as there is mushrooming of private clinics in the recent past.

As for the lack of contraceptive knowledge among these women, it could be due the lack of education regarding contraceptive methods among adolescents. Though it is a component of adolescent health education, it is not being pursued fervently. This is in contrast to a previous report from the state, where the women seeking abortion services had good knowledge about contraceptive methods.[7] However, this study addressed only women with first-pregnancy abortion, mainly unmarried girls; whereas the previous study was among women with different parities undergoing abortion.

Conclusion

Majority of the primigravid women who come for abortion were unmarried (76%). Therefore, there is a need to strengthen adolescent health services in the region.

References

1. WHO. Safe motherhood: A newsletter of world wide activity. World Health Organization: Geneva; 2000. p. 1-16.
2. Annual Report, 2000-2001. Ministry of Health and Family Welfare, Government of India.
3. Belanger D, Hong KT. Young single women using abortion in Hanoi, Viet Nam. Asia Pacific Pop J 1998;13:3-26.
4. Wei C. Socio-economic determinants of induced abortion in China. Asia Pacific Pop J 2004;19:27-38.
5. Babu P, Nidhi N, Ravi K. Abortion in India: What does the National Family Health Survey tells us. J Family Welfare 1998;44:45-54.
6. Gupta S, Gupta R, Sachdeva L. Socio-demographic factors affecting termination of pregnancy. Indian J Com Med 1993;18:86-8.
7. Thangjam N, Akoijam B, Ashananda L, Hanjabam S, Yumkhaibam S. Characteristics of women seeking abortion services in a semi urban set up. J Med Soc 2001;15:11-5.

Tables

For larger view, click on image

Table 1: Characteristics of the study subjects

Table 1: Characteristics of the study subjects

Access free medical resources from Wiley-Blackwell now!

About Indmedica - Conditions of Usage - Advertise On Indmedica - Contact Us

Copyright © 2005 Indmedica