Post Abortion Care for value exploration
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Unsafe abortion is one of the major factor contributing to maternal mortality
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Post Abortion Care for value exploration
- 1. Public health consequences of abortion in Myanmar
- 2. Taking a glance at abortion situation High unmet need ↑Unwanted pregnancy ↑Unsafe abortion 17.7% (2007) CPR in 2007: 41% 66/1,000 (2007) MMR in 2007: 316/100,000LB 1, 2 (FRHS – 2007) 11% of pregnancies in married adolescent (15-19) end in abortion1 25% of hospital admission due to abortion – unsafe2
- 3. Country’s legal and sociocultural context Law: abortion is illegal except when necessary to save women’s life Population policy: Pronatalist Religious based belief: abortion as killing a human being Social factor: pregnancy of an unmarried woman as taboo
- 4. How women end their pregnancies? (Pummeling, Sticks and Kathy Pan) TBAs- 44% Bamboo sticks Bicycle spoke Cotton buds Bird feather quill Twig from tree Fertility and pregnancy loss, Dr. Cynthia Maung and Suzanne Belton Self-30% Thway Say “Hot” medicine
- 5. Where and who did abortion? TBAs’ home Private clinic Home % interviewed youth indicated 1 78% 40% 36% 1 Family and Youth survey, 2004 country report, Department of population Unsafe abortion Incomplete abortion Bleeding Infection
- 6. What are the consequences of abortion? Bleeding Infection Trauma Hospitalization Mortality ↑Cost Unsterilized and unskilled acts ensue in incomplete and septic abortion:
- 7. How to manage the consequences and prevention of such an event? Consequences: B I T Emergency treatment Management Unwanted pregnancy Family planning Barriers and concerns Counseling Post Abortion Care
- 8. Where PAC services are available? Emergency treatment Services available in some hospitals Difficult to reach the facility
- 9. Consequences of abortion Maternal deaths due to abortion related condition: 15 – 24% in rural area (2005 NCSMM) Maternal deaths due to abortion related condition: 60% in hospital setting (hospital based data1) 1 Integration of PAC: roles of TMO and midwives in Myanmar, Thein Thein Htay et al, 2003
- 10. If emergency treatment services are available in primary level, which will be the most suitable? D & C MVA Misoprostol Severe Complication EfficacyEase of use 2 – 4% 1 – 2% Physician Trained Health worker >95% >95% Rare Trained Health worker >90%
- 11. How does Misoprostol work? Bleeding after delivery Bleeding after abortion Use of the drug Cheap, easy to store, transport and use
- 12. Thanks
Editor's Notes
- The percent with an unmet need for family planning is the number of women with unmet need for family planning expressed as a percentage of women of reproductive age who are married or in a union. Women with unmet need are those who are fecund and sexually active but are not using any method of contraception, and report not wanting any more children or wanting to delay the birth of their next child.