Abstract

ABSTRACT Background: Despite liberalization and legalization of abortion in India, over the counter sale and self-administration of abortion pills or do it yourself practice has shown rapid increase which at times may endanger the woman’s life. Aims: The available literature was reviewed with aim to focus on estimating the magnitude of unsafe medical abortion practice, its consequences, the profile of users, the knowledge among providers and consumers and to conclude with the interventions likely to improve the clinical scenario. Review result: The electronic media was searched for the articles on abortion pills in India; the suitable articles pertaining to our queries were selected and the data was analyzed. Review result showed that 48% of total pregnancies were unintended. 73% was the estimated incidence of unsupervised medical abortion. Most of the women were young, uneducated, multigravida residing in the rural area. The lack of awareness regarding legal status of abortion and lack of access to safe abortion facilities were the prime factors responsible for self administration of abortion pills. Analysis revealed that the chemists acted as service providers in 61.66% of cases. Pills were consumed by the standard protocol in 36.33% cases only and 57.66% patients reported within 10 days of pill intake. The outcome was complicated with severe anemia and shock in 15.8% and 10.6% cases respectively. Ignorance and apprehension led to increase in surgical evacuation (68%), thereby reducing the efficacy of these pills. Conclusion: It is emphasized that self administration of abortion pill in women is safe as long as the women are provided with accurate information and have easy access to health facility if need arises. Clinical significance: The review has enlightened us with certain important facts responsible for the present scenario and various measures which can be taken to improve the situation like implementing certain interventions to impart consumers and providers with accurate information, to increase access to safe abortion services by strengthening the infrastructure at PHC and CHC level and training the staff especially mid health workers and authorizing them to provide safe abortion services to meet the increased demand.