Unsafe abortion: journey from unmet needs to denial for contraception


  • Reeta Singh Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur, Uttar Pradesh, India
  • Pankhuri Shukla Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur, Uttar Pradesh, India
  • Vani Aditya Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur, Uttar Pradesh, India
  • Ruma Sarkar Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur, Uttar Pradesh, India




Unsafe abortion, Unmet needs, Unsupervised MTP, Self-intake of abortifacient, Postabortal contraception


Background: Easy over the counter availability of abortion pills leads to unsupervised rampant use of the pills which further results in physical and mental health complications and social and financial burdens for women, communities and health systems.  Aims and objectives were to study the sociodemographic, obstetric and clinical profile of the women presenting with unsupervised intake of abortifacient, and to study the acceptance of post abortal contraception and also the method of contraception accepted.

Methods: This present study was carried out in women with history of unsupervised self-intake of abortifacient and presenting with complain of bleeding per vaginum and various other complications in the emergency or outpatient department of obstetrics and gynaecology between October 2022 to September 2023 at Nehru Hospital, BRD Medical college, Gorakhpur. Complete personal, sociodemographic and obstetric history was obtained. Complete general and systemic examination was done and all routine investigations were sent.

Results: A total of 197 women were enrolled in this study. In our study majority 39.48% (n=77) of women were between 25-30 years age. 56.34% (n=111) belonged to low socioeconomic strata and 69.54% (n=137) resided in urban area. 42.63% (n=84) were gravida 3 or more. 22.8% cases took abortifacient pills beyond 9 weeks of gestation. All patients procured the contraceptive from local practitioner, quacks, medical stores and chemists without any consultation from gynecologist. Most frequent complain was Chronic bleeding per vaginum with RPOC (n=112, 56.85%). Majority patients had moderate to severe anemia and 53.8% (n=106) required blood transfusion. 2.03% (n=4) presented with features of sepsis and 2.03% (n=4) presented with ruptured ectopic. Majority (n=160, 81.21%) didn’t opt for post abortion contraception.

Conclusions: One major contributor to unsafe abortions is the easy availability of abortion pills. These pills should be restricted from over-the-counter sales and made available to the public only through authorized MTP centres with a proper prescription.


World Health Organization. Unsafe abortion, authors. Global and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in 2003. 5th edition. Geneva. 2007. Available at: https://www.who.int/publications-detail-redirect/ 9789241501118#:~:text=An%20estimated%2021.6%20million%20unsafe,women%20aged%2015%E2%80%9344%20years. Accessed on 12 March 2024.

UNFPA’s State of World Population Report 2022: SEEING THE UNSEEN: The Case for Action In The Neglected Crisis Of Unintended Pregnancy. Available at: https://india.unfpa.org/en/seeing-unseen#:~:text= SEEING%20THE%20UNSEEN%3A%20The%20Case,about%20their%20own%20health%20care. Accessed on 12 March 2024.

Nation Family Health Survey 2019-2021. Compendium of Fact Sheets. Available at: https://main.mohfw.gov.in/sites/default/files/NFHS-5_Phase-II_0.pdf. Accessed on 12 March 2024.

World Health Organization. Unmet need for family planning (%). Available at: https://www.who.int/data/gho/ indicator-metadata-registry/imr-details/3414#:~:text= Women%20with%20unmet%20need%20are,intentions%20and%20their%20contraceptive%20behaviour. Accessed on 12 March 2024.

Kumari L, Indhumathi. Study of outcome of cases of self-medication with mifepristone with or without misoprostol for medical abortion. Int J Clin Obstet Gynaecol. 2020;4(6):236-41.

Thakur N, Verma RS, Nagaria T. Selfadministration of Abortion Pills and its Maternal Outcome in Tertiary Care Center. J South Asian Feder Obst Gynae. 2023;15(2):142-6.

Bhalla S, Goyal LD, Bhalla S, Kaur B. Self-administered medical abortion pills: evaluation of the clinical outcome and complications among women presenting with unsupervised pill intake to a tertiary care hospital in Malwa region of Punjab, India. Int J Reprod Contracept Obstet Gynecol. 2018;7:1537-42.

Singh P, Dhurwey N, Patel J. Demography, clinical profile and outcomes of self-prescribed abortion pills among women, experience from a tertiary care teaching hospital in central India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology.;12(10):2.

Pal R, Gupta PK, Tyagi S. Determinants of Unsupervised Medical Termination of Pregnancy Pill Usage Among Women: A Cross-Sectional Study From North India. Cureus. 2023;15(11):e49321.

Srivastava M, Srivastava A, Namrata K. Abortion pills as over-the-counter drugs- a boon or a curse. J Evol Med Dent Sci. 2018;7(07):820-3.

Kumari R, Tirkey S, Kumari A. Over-the-Counter Use of Medical Abortion Pills: A Prospective Cohort Study. J Clin Diagnost Res. 2023;17(8):10-3.

Khanam Z. Self administration of abortion pills and their implications. AOGD Bulletin. 2021;21(3):42-5.

Agarwal N, Gupta M, Agrawal A. Self administration versus supervised use of medical abortion pills: impact on women’s health. J Pharm Negat Results. 2022;475:82.

Indumathi HK, Patil SB, Radhika, Savitha C, Nayana MS. Study of acceptance of post-abortal contraception in a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2021;10:3379-82.

Munshi KS, Thaker RV, Shah JM, Mewada BN. Self-medication of abortion pills and its complications: an observational study. Int J Reprod Contracept Obstet Gynecol. 2018;7(1):205.






Original Research Articles