The conservative estimates of limited accurate and evidence-based data shows that globally around 10-15% abortions take place during the second trimester period. For populous regions like Asia, these estimates translate into huge absolute numbers, making second trimester services as one of the priorities for addressing women’s health. Yet across South Asia, India is the only country that allow second trimester abortion followed by Nepal where it is permissible but only in cases of rape, incest and health risks to the woman.
As per the global turn away study (Bixby Centre) ti measure the incidence and reasons for denial of abortion under normal circumstances in four countries including Bangladesh and Nepal and South Asia, 2%-45% are denied legal abortion care in these countries. Around 14% women are turned away for high gestational age in Nepal. (Gerdts et al., 2014)
In 2014, at least 6% of all maternal deaths in Asia were unsafe abortions. COVID19 pandemic has further weakened the already debilitated reproductive health including safe abortion services by disrupting supply chain and manufacture of quarantine, women have even lesser options and minimal access to the service delivery points. The disruption of these essential service due to COVID 19 will result to highest number of contraception methods switch and discontinuations, extended periods of women bearing unwanted pregnancies, delay in seeking abortion services and highest need for the second-trimester services than ever. As per the recent Guttmacher Institute estimates, 10% proportional decline is predicted in the use of short and long-acting reversible contraceptive methods in Lower Middle-Income Countries (LMICs). Countries where seeking abortion services beyond the first trimester is restricted, women will be forced to continue their unwanted pregnancies till its full or resort to unsafe options. As per estimates, about 4.6 million women in the region are treated for unsafe abortion related complications each year. Reduced access would result in an additional 49 million women with an unmet need for modern contraceptiones and an addition 15 million unintended pregnancies over the course of a year.
While CSOs and women rights groups are demanding for self-management and hone-based abortion services (up to first trimester), it is equally important to also recognize the need for the women who alreadt cross or nearing approved gestational limit. COVID19 is an unprecedented challenge that as accentuated the urgency for recognizing women’s right to life, health, bodily autonomy and agency. The pandemic has brought to the forefront the consequences that lack of access can have on a women’s health. Considering the severity and urgency of the issue, it is time for countries to use the human rights framework to extend the gestational limit for abortion services during the pandemic and its impact period.
By Mr. Deepesh Gupta
Sr. Project Advisor – SRHR & Focal point Abortion, IPPF SARO