Pregnancy termination in a rural subdistrict of Bangladesh: A microstudy

Context: In Bangladesh, menstrual regulation is legal and is provided at go vernment health facilities through the 10th week of pregnancy, but some wom en, especially those in rural areas, still obtain illegal abortions from un trained providers. Little is known about the circumstances leading to pregn ancy termination, about how a provider is chosen and about the physical, ec onomic 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 terminatio n. Results: Four in five respondents said they had terminated their pregnancy because they wanted no more children or wanted to delay their next birth; t hese respondents generally cited the economic well-being of their family. A lmost 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 untra ined providers cited familiarity confidentiality and proximity as reasons; few seemed concerned about safety. Only five of the women had been practici ng contraception at the time they became pregnant; those who had not been u sing a method often cited side effects (either experienced or anticipated) as a reason for nonuse. Conclusions: Better education about and management of contraceptive side ef fects would help to reduce pregnancy termination in rural Bangladesh. In ad dition, women need more information about possible health consequences of r elying on untrained providers for pregnancy termination.