Non-facility MMA (Medical Methods of Abortion) use for induced abortion: A study of women with access to safe abortion services in Lucknow.

INTRODUCTION

In 2015, Uttar Pradesh saw 83% of induced abortions occur in nonfacility settings using medical methods. Despite the availability of approved facilities, many women still opted for less safe methods. This study aims to understand the sociodemographic and reproductive factors that lead women with access to approved facilities to choose nonfacility settings for pregnancy termination.

MATERIALS AND METHODOLOGY: A cross-sectional study was conducted on women in the reproductive age group (15-49 years) attending the Obstetrics and Gynaecology OPD of a tertiary care hospital in Lucknow who responded to having an induced abortion in the 5 years preceding the interview. The study duration was 6 months from 1st July 2019 to 31st December 2019.

RESULTS AND OBSERVATIONS: The induced abortion by MMA (Medical Methods of Abortion) in nonfacility settings contributed to 47.5 per cent of all the abortions induced in the last 5 years among the women of reproductive age group with access to a facility approved for MTP. A history of previous induced abortion, no history of using any method of contraception before index conception, and age of 27 years or less, were found to be independent predictors for using MMA in nonfacility settings for inducing abortion, with aOR of 4.04 (95% CI: 1.66-9.84), 3.25 (95% CI: 1.46-7.26), and 2.38 (95% CI: 1.12-5.09), respectively.

CONCLUSION

Boosting the trust of women, especially the younger women, in approved facilities is crucial. The findings highlight the need for strategies to improve access to safe abortion services, promote contraceptive use, and address societal pressures and gender biases that influence women's reproductive decisions in the form of comprehensive abortion care (CAC). Future research could further explore these factors and develop interventions to promote safer abortion practices and prevent unnecessary abortions.