Induced abortions in low socio-economic settlements of Karachi, Pakistan: rates and women's perspectives.

OBJECTIVE The aim of the study was to determine rates on induced abortions and to identify the perceived and actual reasons for terminating an unplanned pregnancy, health care providers sought, methods used and post-abortion complications. SETTING Three squatter settlements of Karachi, Pakistan. SUBJECTS Interviews were conducted on 1,214 ever-married women in the reproductive age group (15-49) with a reproductive history of at least one pregnancy, irrespective of outcome. METHODS A cross-sectional survey from June-August 1997 was conducted in three selected squatter settlements of Karachi. RESULTS The abortion rate for the past year was 25.5 per 1,000 women of reproductive age group. The post-abortion complication rate reported was 68.5% (61/89), of which fever and heavy vaginal bleeding was the most commonly reported complication (54.1%). CONCLUSION The results indicate that women are aware of the high mortality and morbidity risk resulting from seeking an unsafe abortion but nevertheless opt for this approach to attain their goal of small family size rather than for a modern method of contraception. Furthermore, healthcare providers, irrespective of legality issues, provide such services due to demand. We suggest that family physicians and other relevant health care providers be trained for post-abortion care including post-abortion family planning counseling with an emphasis on emergency contraceptives.