Pregnancy Termination in a Rural Subdistrict of Bangladesh: A Microstudy

Context: In Bangladesh, menstrual regulation is legal and is provided at government health facilities through the 10th week of pregnancy, but some women, especially those in rural areas, still obtain illegal abortions from untrained providers. Little is known about the circumstances leading to pregnancy termination, about how a provider is chosen and about the physical, economic and social consequences of termination. Methods: Forty-one married women in the Sample Registration System database who were identified as having had a pregnancy termination between 1990 and 1995 were asked detailed questions about the reasons for their termination, the decision-making process, the means and the consequences of termination. Results: Four in five respondents said they had terminated their pregnancy because they wanted no more children or wanted to delay their next birth; these respondents generally cited the economic well-being of their family. Almost six in 10 had used a trained provider; the remainder had relied on an untrained provider or had induced their own abortion. Those who used untrained providers cited familiarity, confidentiality and proximity as reasons; few seemed concerned about safety. Only five of the women had been practicing contraception at the time they became pregnant; those who had not been using a method often cited side effects (either experienced or anticipated) as a reason for nonuse. Conclusions: Better education about and management of contraceptive side effects would help to reduce pregnancy termination in rural Bangladesh. In addition, women need more information about possible health consequences of relying on untrained providers for pregnancy termination.