By: Dr. Farah Aslam

The World Health Organization (WHO) defines unsafe abortion as “a procedure for terminating a pregnancy performed by persons lacking the necessary skills or in an environment not in conformity with minimal medical standard or both”. According to the WHO, this definition embodies concepts first outlined in a 1992 WHO Technical Consultation. Since then in all official documents for estimation of rates and complications of unsafe abortion, WHO always stressed upon the liberalization of abortion laws in countries where such laws are according to their beliefs or customs, so as to prevent the widespread complications associated with this procedure (see world wide estimations and complications of unsafe abortion released by WHO since 1997).  Now, it has been admitted in 2014 bulletin (From concept to measurement: operationalizing WHO’s definition of unsafe abortion) “ In light of this, WHO has historically used a pragmatic operational construct that measures safety in terms of only one dimension___ legality___ in developing its regional and global estimates of rates of unsafe abortion”. In these officially released facts and figures, it has been proven by data collected from different regions of the world, that open laws and freedom for a woman to adopt this procedure are the measures to prevent a segment of population from complications associated with this procedure and that liberal laws can ensure the safety and wellbeing of a woman, who wants to terminate her pregnancy with or without any legal reason or not.

However, on the other hand, a number of organizations, mostly in the developed world, were working and studies have been conducted to unearth some facts. Based on those evidences and authentic researches it has been demonstrated that induced abortion, whether safe or unsafe, embossed inerasable scars on women’s health. This procedure, even if carried out in a safe environment by professional health providers in a country where the law permits it, develops a number of physical and psychological complications to aborting women. This fact has now been established that “induced abortion inherently poses hazardous effects to women’s physiological and psychological health”. “Induced Abortion can adversely affect a woman’s health”.

We have done two researches on this topic; the first is an analytic approach to compare the worldwide rates and bring forth the health hazards, and the second one is a study on the complications of induced abortion and other contraceptive methods based on data collected from 300 women from Karachi (Sindh, Pakistan). In the latter paper, data reveals complications in more than 70% of the aborting women; out of them more than 60% of the procedures were carried out by trained health providers in a healthy environment, (calculated responses have been detailed in the survey report).

Internationally conducted researches and surveys have concluded the fact that induced abortion imposes a number of precarious effects on women’s health. Many of them are of an acute nature, while others are remote health problems, which remain alive with the affected woman and cast a dark shadow on her health. The woman has to live with vague and untreatable types of health problems. A preponderance of the women belong to lower middle and lower socioeconomic strata and were semi or uneducated, hence had been captured by media campaign without having fear of being manipulated or experimented.

 Internationally, researches have indicated a number of doubts in the studies done to prove induced abortion a safe and less harmful and some times a flawless proceeding. Professor Joel Brind is a prominent name amongst those who are engaged to challenge the results and conclusion drawn and presented by international health organizations and institutes. Joel Brind, Ph.D is a professor of Human Biology and Endocrinology at Baruch College, City University of New York; Co-Founder of the Breast Cancer Prevention Institute, Somerville, NJ. In 1996, he published a meta-analysis of retrospective studies and proved a positive association between induced abortion and breast cancer. He has written a number of articles, of statistical worth, in which he casts serious methodological doubts on the studies done worldwide by international organizations. In the same way, many other working groups have suggested concerns and review over the claims made by WHO and other institutes.

Whether as a result of these factual findings and truth explorations or due to some other reason, in its 2014 bulletin, WHO concedes that: “illegal abortion is not synonymous with unsafe abortion, as indicated by the original definition:… legality or illegality of services, however, may not be the defining factor of their safety.”  

In a country like Pakistan where the infra health structure is poor; maintenance and keeping records, follow up of patients of such crucial diseases does not exist, and most of all, substantial researches on this topic under supervision of local resources and without interference by foreign funding, are none. There is unavailability of any data to health problems suffered by women who have had abortion(s) once or more than that in their lives. In such a suppressed scenario, any claim, built on out sources, cannot depict the true picture. Hence, there is a dire need of empirical researches and data maintenance with the pure sentiment and ambition of securing women’s health, operated and supervised by local sincere and technical persons. Moreover, a check on the messages conveyed by publicity modes is essential, as it may divert and misguide the majority of ignorant women. Only then, we can take over the causes and solutions of the problem.      

 In Pakistan, like many other countries, law permits abortion when there is any serious threat to the mother in case of continuing pregnancy, in rape or some severe anomaly in fetus that may transmit or create some complications to the generation. But, unfortunately it has become a common practice to go to any health facility, whether governmental or private, to get rid of pregnancy. There is neither any legal check system nor any authority available to inquire the rationale of abortion and nothing any awareness programme to warn the women for the adherent health hazards. All these illegal malpractices are going on under national and international shelters and no one explains or accountable for this illicit practices.  The question is, when the time will come and authority would take, action to curb all these perpetrators, making our women be experimented and manipulated without their consent and proper knowledge and when the law would be properly enacted and practiced?