Induced abortion: the unrecognized epidemic - abstract

ABSTRACT

A survey was conducted on 526 pregnant women attending 2 major general hospitals in Trinidad during late 1992 to early 1993 to determine the incidence of attempted termination of pregnancy, the popularity of the methods, the sources and agents as well as the immediate outcome following the attempt. Five hundred and six (96.0 percent) had unplanned pregnancies, and 168 (31.9 percent) had made an attempt to terminate the pregnancy. Chemical methods were twice as popular but physical methods were more successful (41.0 percent vs 34.8 percent); 25/56 physical attempts were done as backyard abortions with a failure rate of 88.0 percent. Medical practitioners were more likely to be successful (66.0 percent). Four women (7.1 percent) used self-administered physical methods. The pharmacist was the most popular source to offer chemical agents (32.1 percent) followed by the patient acting on her own (22.3 percent), a friend (19.6 percent) and the doctor (18.7 percent). The main agents offered were unknown while tablets (35.7 percent), herbs and bush (23.2 percent), misoprostol (22.3 percent), hormones (25.8 percent) and aloes (5.3 percent) were identified. Misoprostol and hormones were offered mainly by the pharmacist and had a success rate of 56.0 percent and 44.8 percent, respectively. Herbs and bushes offered by lay persons were generally unsuccessful. The high level of unplanned pregnancies and attempted terminations is a major public health issue. It reflects the deficiency in effective contraceptive practices and the preference of women to use "hind sight" birth control. The easy availability of potentially harmful drugs, in particular misoprostol, over the counter demonstrates the poor control of drug marketing and irresponsible behaviour. Unless the relevant authorities are sensitized to the magnitude of the problem induced abortion will remain the unrecognized epidemic (AU)