Abortion in Bangladesh

Abortion in Bangladesh is illegal under most situations, but menstrual regulation is often used as a substitute. Bangladesh is still governed by the penal code from 1860, where induced abortion is illegal unless the woman is in danger.[1][2]

Historically, abortion has been prevalent, especially during the years following the Bangladesh Liberation War. For example, in 1972, the law allowed for abortion for those women who has been raped during the war.[2] In 1976, the Bangladesh National Population Policy unsuccessfully attempted to legalize abortion in the first trimester.[3]

Since 1979, menstrual regulation has been the favored alternative to induced abortion, and it is legally permitted because pregnancy cannot be established.[3][2] In 2012, the Drug Administration for Bangladesh legalised the combination of mifepristone and misoprotol for medical abortion.[4]

Menstrual regulation

Part of the family planning program in Bangladesh since 1979, menstrual regulation is a procedure that uses manual vacuum aspiration to make it impossible to be pregnant after missing a period.[1] It is simple and can be done with inexpensive equipment. The procedure also is performed without the use of anaesthesia.[5]

A study about menstrual regulation in 2013 studied 651 consenting women from 10 different facilities in Bangladesh, who were seeking menstrual regulation and were about 63 days or less late of their menstrual cycle. They were given about 200 mg of mifepristone, followed later by 800 mg of misoprostol. The researchers found that 93% of the women had evacuated the uterus without the use of the surgical intervention, and 92% of the women were satisfied with the pills and the rest of the treatment.[6]

Although menstrual regulation centers are centralized and free of charge, many women still lack access due to socioeconomic barriers and social stigma.[6] Centers charge additional fees if the pregnancy is beyond 10 weeks, and many women are unaware of menstrual regulation or face male opposition to the procedure. As a result, some women turn to illegal abortions.[7]

Abortion

An abortion can be legally performed by a physician in a hospital, if it is necessary to save the life of the mother. A person who performs an abortion under any other circumstances, including a woman who self-aborts, can be punished by a fine and imprisonment.[2]

Menstrual regulation allows a woman to terminate within 10 weeks of her last period, but unsafe methods to terminate pregnancy are widespread. In response, a hotline was created for women to get information about fertility control, including menstrual regulation.[8]

According to an article by the Guttmacher Institute, which studied the rural district of Matlab, illegal abortion is becoming increasingly prevalent despite the availability of safer methods of fertility control.[9]

A study by Mizanur Rahman and Julie DaVanzo showed that between 2000 and 2008, a woman was more likely to die from the complications of unsafe abortion than from childbirth itself, and that death rates from childbirth were similar of the death rates for the complications of menstrual regulation.[10]

Another study in Matlab found that between 1982 and 1998, abortion about 35 times more prevalent among unmarried adolescent girls than among married adolescent girls, and it was much higher among who were less than 18 years of age and those who passed or had more than primary education.[11]

Statistics

As of 2014, the national rate that women participate in menstrual regulation as a post-contraceptive way to control their fertility was 10 per 1,000 women aged 15–49. The national rate for induced abortion was 29 per 1,000 women in the same age interval.[1] The United Nations estimated that in 2000, the abortion rate was 4.0 abortions per 1,000 women aged 15–44.[12]

Only 42% of facilities that were expected to provide menstrual regulation services actually did so. Of the Union Health and Family Welfare Centres, which are especially relied upon in rural areas, half provided these services.[1] According to Guttmacher, about 27% of women (about 105,000) are turned away annually. In addition, in 2014, about 50% of married Bangladeshi women had not heard of menstrual regulation.[1]

In 2014, it was estimated that between 523,808 and 769,269 abortions occurred per year in Bangladesh.[4]

References

  1. 1 2 3 4 5 "Fact Sheet: Menstrual Regulation and Induced Abortion in Bangladesh". Guttmacher Institute. September 2012. Retrieved 14 March 2017.
  2. 1 2 3 4 "Bangladesh". Abortion Policies: A Global Review (DOC). United Nations Population Division. 2002. Retrieved 14 March 2017.
  3. 1 2 "Country Profile – Bangladesh". Asia Safe Abortion Partnership. Archived from the original on 11 November 2016. Retrieved 14 March 2017.
  4. 1 2 Zaidi, Shahida; Begum, Ferdousi; Tank, Jaydeep; Chaudhury, Pushpa; Yasmin, Haleema; Dissanayake, Mangala (2014). "Achievements of the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences in South-Southeast Asia". International Journal of Gynecology & Obstetrics. 126: S20–S23. doi:10.1016/j.ijgo.2014.03.015. PMID 24743025.
  5. ↑ Laufe, Leonard E. (October 1977). "The Menstrual Regulation Procedure". Studies in Family Planning. 8 (10): 253–256. doi:10.2307/1966015. JSTOR 1966015. PMID 929663.
  6. 1 2 Alam, Anadil; Bracken, Hillary; Johnson, Heidi Bart; Raghavan, Sheila; Islam, Noushin; Winikoff, Beverly; Reichenbach, Laura (June 2013). "Acceptability and Feasibility of Mifepristone-Misoprostol For Menstrual Regulation in Bangladesh". International Perspectives on Sexual and Reproductive Health. 39 (2): 79–87. doi:10.1363/3907913. JSTOR 41959959. PMID 23895884.
  7. ↑ Islam, Mohammad Amirul; Padmadas, Sabu S.; Kabir, Mohammad (6–10 November 2004). Evaluation of reported induced abortion in Bangladesh: Evidence from the recent DHS. 132nd Annual Meeting of the American Public Health Association.
  8. ↑ "Safe Abortion Hotline Launched for Menstrual Regulation in Bangladesh" (Press release). International Campaign for Women's Right to Safe Abortion. 23 October 2013. Archived from the original on 2014-10-24. Retrieved 2014-10-24.
  9. ↑ "In Bangladesh, Unsafe Abortion is Common Despite Availability of Safer Pregnancy Termination Procedure" (Press release). Guttmacher Institute. 22 September 2014. Retrieved 14 March 2017.
  10. ↑ DaVanzo, Julie; Rahman, Mizanur (September 2014). "Pregnancy Termination in Matlab, Bangladesh: Trends And Correlates of Use of Safer and Less-Safe Method s". International Perspectives on Sexual and Reproductive Health. 40 (3): 119–126. doi:10.1363/4011914. PMID 25271647.
  11. ↑ Ahmed, M. Kapil; van Ginneken, Jeroen; Razzaque, Abdur (February 2005). "Factors associated with adolescent abortion in a rural area of Bangladesh". Tropical Medicine and International Health. 10 (2): 198–205. doi:10.1111/j.1365-3156.2004.01362.x. PMID 15679564. S2CID 10742624.
  12. ↑ "World Abortion Policies 2013". United Nations. 2013. Retrieved 14 March 2017.
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