‘890,000 abortions take place in Pakistan every year’

Karachi
The Shirkat Gah Women’s Resource Centre, in commemoration of Global Safe Abortion Day, organised a networking meeting on Friday to address issues of unsafe abortion
The meeting, held with the support of the Women’s Global Network for Reproductive Rights (WGNRR), was attended by several organisations and individuals with experience in advocating safe abortions and those who wish to take up this initiative in the future.
Uzma Farooq of Shirkat Gah gave an overview of the global and national state of unsafe abortions. She shared that 22 million unsafe abortions take place every year globally, resulting in the death of some 47,000 women, as stated in the World Health Organization’s (WHO) recent guidelines for safe abortion.
She also noted that unsafe abortions were far more common in developing countries, where there are usually legal restrictions on the procedure. Complications from unsafe abortion include hemorrhage, sepsis, peritonitis, and trauma to the cervix, vagina and uterus.
According to study conducted
by the Population Council and Guttmacher Institute in 2005, 890,000 abortions take place in Pakistan every year. Under Pakistani law, abortions are permissible in the first four months of pregnancy for preserving life or providing necessary treatment and, after four months, on condition of saving the woman’s life.
Studies have shown that there is a lack of awareness about the legality of the procedure on the part of legal professionals and medical service providers. Reasons for women resorting to unsafe abortions include, but are not limited to, a lack of knowledge and access to family planning; contraceptive failure; lack of autonomy over their own bodies and a lack of access to appropriate medical professional (due to fear of violence, finance, distance).
Dr Tabinda , Manager Shirkat Gah, shared that September 28 is a day for worldwide efforts against unsafe abortions. “The need of the hour is to adopt a

rights-based approach, one that has long been advocated by Shirkat Gah. Shirkat Gah has also done extensive research that proves, beyond any doubt, the scale of this problem.
“Abortion is a reality, one that needs to be dealt with in a professional manner. Women must be provided affordable and accessible service without any bias. Service providers need to understand that this [abortions] is neither against the law or religion and that every woman deserves complete health services and respect,” she observed.
A short film directed by Sheema Kermani titled “Baitiyan” was also screened. The film showed the predicament of two young girls who are seeking an abortion; the first had been raped and was from a poor family, the second from a wealthy family seeking who had become pregnant after consensual sex. The movie highlighted the problems both girls faced in obtaining the procedure, while also touching upon the biases shown by untrained service providers who perform the procedure at high fees and in unsafe and clandestine clinics.
Amina Mazhar, Country Manager of Ipas Pakistan, gave participants an overview of the Pakistan Alliance for Post abortion Care (PAPAC), along with an introduction to the essential elements of the post abortion care (PAC) framework.
“Death and disability resulting from unsafe abortions, which are a global public health challenge, are entirely preventable,” she said. Ipas, which was founded in 1973, pioneered the WHO’s Manual Vacuum Aspirator (MVA), which replaced the outdated dilation and curettage (D&C) method of uterine evacuation.
Mazhar also observed that misoprostol was increasingly being recognised as a life-saving drug for prevention of deaths from unsafe abortion and post-partum hemorrhages (PPH).
“Unfortunately, Pakistani authorities have only registered misoprostol for PPH, but not for the expanded WHO-endorsed indications for incomplete abortion or miscarriage.”
The Pakistan Alliance for Post abortion (PAPAC) is a national network of service delivery organisations, NGOs, government agencies, donors, UN bodies and professional associations, which aims to reach wider stakeholders, including the media and community-based organizations.
PAPAC members, by sharing information, experiences and collaborating on strategic thinking and planning, hope to ensure increased access for women to quality post abortion care and related reproductive health services, including family planning.
Dr Marium Waqas, Programs Coordinator, Ipas Pakistan spoke about the organisation’s Values Clarification and Attitude Transformation (VCAT) workshops, which help address the stigma and taboo surrounding abortion. The goal of VCAT workshops is for individuals to explore, question, affirm and support their positions with respect to the need for and provision of abortion and related care, such that awareness of and access to comprehensive, woman-centered, high-quality reproductive healthcare can increase.