Byline: Aneela Sultana
Induced abortion is perhaps the oldest method of fertility control. Induced and unsafe abortion are more common in cultures where women have unmet contraceptive needs and their access to reliable birth control methods to prevent an unwanted pregnancy is limited.1 Generally, women tend to seek unsafe abortions where it is stigmatized and where safe abortion services are inaccessible or unaffordable (WHO, 2012). Global estimates reveal that around 25 million unsafe abortions take place each year,, and a large number of them (97%) takes place in poor and marginalized settings (Ganatra B et al, 2017). The majority of women who undergo unsafe abortions are those who are unable to exercise their sexual and reproductive rights (World Health Organization, 2010).
Induced abortions contribute significantly towards maternal morbidity and mortality (Darroch et al, 2017). Global statistics indicate that around 13% of all maternal deaths occur due to unsafe abortion (WHO, 2014). Unfortunately, death is not the only cost women have to pay due to unsafe abortion. A large majority of women who opt for clandestine procedure for self induced abortion have to experience various health complications such as haemorrhage, sepsis, uterine damage, sterility and even psychological trauma.
Discourse on fertility control is most significant when it comes to the health and well-being of childbearing women. A woman's decision to choose contraceptives and induced abortions are strongly influenced by the social circumstances and relationships around them. Garcia-Moreno and Claro (1994) also emphasized this social reality that women everywhere around the world lack reproductive freedom and unable to regulate their sexual lives and lack control over their own bodies.
Though seeking abortion is medically risky and harmful, yet women's inaccessibility to rely on family planning methods due to any social or personal reason is likely to outweigh the risks associated with induced abortion.
Working on sensitive issues like induced abortion is not easy particularly in traditional societies like Pakistan where it is stigmatized, secret and illegal. There are very few studies done on the prevalence, methods, magnitude and associated risk factors of induced abortion, so the present study aims to describe those strategies which rural women employ to stop or limit childbearing.
Abortion is a highly controversial issue and reliable data on the incidence of abortion is somehow insufficient and does not address the societal processes related to the problem. Due to the social stigma associated with abortion, women are reluctant to talk about this. It further reflects women's inability to exercise reproductive freedom which tends to be the most powerful determinant of their health and well-being.
The present study was carried out with the major objective to investigate those factors which compel women to put their health at risk and opt for induced abortion. In other words, this study centralizes women within their cultural contexts to allow their voices and concerns to be heard.
The data presented in this article was collected from village "Choha Shah Ghareeb" in Tehsil Hassanabdal of district Attock in the Punjab province as part of doctoral research work on cultural discourse on women's reproductive rights. The study was carefully planned by choosing anthropological methods of inquiry that mainly included participant observation, key informants, in-depth and face-to-face interviews and case studies.
In order to explore women's perception of induced abortion and to gain a deeper understanding of the causes related to it sixty married women child bearing age were selected through purposive sampling who were abortion seekers.. To obtain holistic information and to optimize the credibility of field data two focus group discussions (FGDs) were also held with traditional birth attendants (TBAs) and Lady Health Visitors (LHVs) to explore service delivery aspects and complications related to the practice of induced abortion.
Results and Discussion
Indigenous perspective of Abortion and Miscarriage
Women perceived induced abortion as a great sin. Aulaad (progeny) is considered 'Blessings of God' and any attempt to induce an abortion is believed as defiance to God's will. Women who seek abortion services feel guilty about it and try to keep it surreptitious. According to them, such act is performed in majboori (of necessity) when the...