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Abortion: First, Understand

By Jackie Powder

In Bangladesh, abortion is illegal, although women have access to a government-sanctioned procedure known as menstrual regulation—uterine evacuation by manual vacuum aspiration—which is widely viewed by Bangladeshi women as a "cleansing" to restore regular menstruation, regardless of pregnancy status.

Even with the availability of this procedure, more than 71,000 Bangladeshi women are admitted to hospitals each year with abortion-related complications, frequently the result of unsafe methods to end a pregnancy, such as ingesting herbs provided by a kobiraj, or traditional healer.

Through discussions with young couples in Bangladesh's rural Jessore district, postdoctoral fellow Jessica Gipson, PhD, aims to better understand their decisions regarding fertility, contraception and pregnancy in hopes of improving reproductive health education and the safety of abortion services.

Despite the widespread availability of contraception in Bangladesh, data from a five-year study of more than 3,000 couples from 1998 to 2003—analyzed by Gipson as part of her research—found that 29 percent of pregnancies were terminated by couples who said they wanted no more children.

While most couples reported making fertility and abortion decisions jointly, some women acknowledged that they used contraception or had a menstrual regulation without their spouse's knowledge. "At least within this domain of their lives, women seem to wield a lot of power," says Gipson, who holds a Charlotte Ellertson Postdoctoral Fellowship in Abortion and Reproductive Health.