Study finds that abortion drugs going off the shelves; chemists cite regulatory pressures
A new study has raised an alarm about how drugs used for medical abortion are going off the shelves in four Indian States.
The study ‘Availability of MA drugs across four Indian states’ found that chemists in Rajasthan and Maharashtra are not stocking MA drugs anymore and only 37.8% are stocking in Bihar and 66% in Uttar Pradesh. It was conducted by Pratigya Campaign for Gender Equality and Safe Abortion.
Those chemists who are not stocking, identified legal/regulatory barriers as the main reason for it. Non-availability of MA drugs is threatening women’s access to safe abortion, especially in a scenario where even today an estimated 10 women die in India dueto unsafe abortions, the third leading cause of maternal mortality in India. The study was conducted among 1008 chemists across Bihar, Maharashtra, Rajasthan and Uttar Pradesh.
Provision of safe, effective and accessible abortion services including Medical Abortion (MA) Drugs is a priority for promoting women’s health and reproductive rights. Medical Abortion (MA) has emerged as the preferred method of abortion care in India with an estimated 81% of the 15.6 million annual abortions being performed using MA drugs. Yet, abortion drugs seem to have started vanishing from chemists shelves.
Speaking at the launch of the report, V.S Chandrashekar, Pratigya Campaign Advisory Group member and Chief Executive Officer, Foundation for Reproductive Health Services India said, “India has achieved great success in improving access to safe abortions, thanks to the proactive steps taken by the Ministry of Health and Family Welfare over the past decade and a half. Availability of MA drugs, particularly combi packs has been instrumental in the decline of unsafe abortions. The non-availability of MA drugs can potentially reverse the gains made over the past few years.”
The study attempted to capture chemists’ awareness, knowledge and attitudes about abortions and MA drugs. 43% of chemists thought abortions were Illegal; and only 26% were aware that it is legal up to 20 weeks gestation. In Rajasthan, a whopping 60.7% chemist said abortions are illegal, followed by 51.8% in Bihar.
43% of chemists thought abortions were Illegal; and only 26% were aware that it is legal up to 20 weeks gestation. In Rajasthan, a whopping 60.7% chemist said abortions are illegal, followed by 51.8% in Bihar
15%felt that availability of combipack MA drugs contributes to gender biased sex selection with Maharashtra topping with 42.5%. “This is a wrong perception since combipacks are indicated only for use up to nine weeks gestation and the commonly used and affordable technology to identify the sex of the fetus, Ultra Sonography can detect the sex only around 13-14 weeks gestation” says Dr. Kalpana Apte, Pratigya Campaign Advisory Group member and Secretary General, Family Planning Association of India. “This misconception seems to be resulting in overregulation of MA drugs, significantly affecting availability of a safe, simple and affordable method of safely terminating a pregnancy, compromising the health, wellbeing and reproductive rights of women in India” she added.
The study estimates that very few, 9.6% of women who purchase MA drugs actually return to the chemists for advice to manage complications or contraception. This indicates that for a large majority of women who purchase MA drugs from chemists the drugs seem to be effective and those who do face complications seem to be seeking care from health facilities. Almost all chemists who have clients coming back with perceived complications refer women to a doctor, which is heartening. The study findings show that 50% of buyers came with prescriptions as against a common perception that a majority of MA drugs are purchased without prescriptions.
