Make abortions safe: The women in Pakistan depend on healthcare workers to do their part

This article was exclusively written for The European Sting by Ms. Tashfeen Nasira, a third-year medical student currently studying at Amna Inayat Medical College, Sheikhupura, Pakistan. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

The Islamic Republic of Pakistan, a deeply conservative nation with a population of 220 million, has an abortion rate of 50 per 1,000 women which is the highest in South Asia. According to the World Health Organization, an abortion, when carried out under the observation and care of trained medical professionals, is considered a safe healthcare intervention. When carried out by untrained persons, however, the procedure can become life threatening.

Abortion in Pakistan is legal in very limiting circumstances and is heavily influenced by the country’s religious and cultural norms. Legal ramifications aside, the societal perception of abortion as a form of killing an unborn child and its association with pregnancy outside of a wedlock has made the procedure a social taboo. This has led to opening the door wide open for illegal, back-alley abortion providers.

It is reported that nearly 900,000 of the 2.4 million pregnancies in 2002 were terminated by induced abortions. According to studies, legal restrictions on safe abortions do not reduce the incidence of abortion. However, the maternal mortality rate is higher where such restrictions are put in place. This was confirmed by a national survey which revealed that about 200,000 women were hospitalized the same year for abortion complications with the exact number estimated to be much higher.

Access to safe abortions is recognized as a human right not only by regional courts like the European Court of Human Rights and the African Commission on Human and Peoples’ Rights but also by international bodies like the United Nation Human Right Committee. Much needs to be done to bring this into practice, especially in developing countries like Pakistan.

As healthcare workers and advocates for Women’s Health we can raise awareness through community outreach programs and by being actively involved with NGOs that work to improve women’s health in Pakistan. We can write to political leaders, and respective courts of law to take notice of the rising maternal mortality rate and call for better policies.

To combat the knowledge gap, healthcare workers can collaborate with Pakistan’s education commissions to add a mandatory reproductive education course with a focus on contraceptive methods and family planning. Furthermore, door-to-door awareness campaigns can be carried out in the rural areas, where they can advise women on the use of contraception and supply them with it.
As most healthcare providers in Pakistan believe abortion to be illegal and immoral, and hospitals hesitate to perform them, widespread social and print media campaigns can be run to raise awareness and clarify their misconceptions.

Basic Health Units for post-abortion care should be set up to provide accessibility to timely, evidence-based healthcare. As post-abortion care is not an abortion procedure nor is it criminalizing, it would remove the hesitancy healthcare professionals feel in providing the best possible care and therefore reducing maternity mortality rate.

Access to reproductive rights and autonomy over their body and lives is the fundamental right of every woman, regardless of religion, race and cultural background and is achievable through our combined efforts.

References:
• Abortion in Pakistan. Guttmacher Institute. https://www.guttmacher.org/report/abortion-pakistan#fn0 Published 2022. Accessed July 24, 2022.
• Abortion. Who.int. https://www.who.int/news-room/fact-sheets/detail/abortion Published 2022. Accessed July 24, 2022.
• United Nations Population Division, Abortion Policies: A Global Review, New York: United Nations, 2002.
• Shah I, Åhman E. Unsafe Abortion: Global and Regional Incidence, Trends, Consequences, and Challenges. Journal of Obstetrics and Gynaecology Canada. 2009;31(12):1149-1158.

About the author

Ms. Tashfeen Nasira is a third-year medical student currently studying at Amna Inayat Medical College, Sheikhupura, Pakistan. She is a member of the International Federation of Medical Students’ Associations, a cordial partner of The Sting. She has a great passion for writing and aims to increase awareness about disparity in healthcare and improve its accessibility to low income households and minorities in her country and worldwide through it.