BENGALURU : The choice of fertility and family size is something very integral to a couple and is a completely personal and private prerogative. In the present world, nuclear families are the norm and working couples are determined to have their fertility under utmost control. But accidents do happen. Finding out that one is unexpectedly pregnant can be quite worrying.
An immediate need for a quick solution is desired. However, taking a few days to decide which way to go is prudent to avoid any hasty decisions and regrets.Usually, women would find out that they are pregnant as soon as a period is missed, which makes it very early in pregnancy. A termination may be offered until 20 weeks and a few days to decide would not change the management.
Talking to the partner/husband and family would help and can provide a lot of support. The woman, however, cannot be coerced into having an abortion and neither can the partner veto the women’s choice of having a termination.Consulting with a doctor who is qualified in providing such services and seeking counselling can help in reaching your decision. Once a decision to terminate is reached, it would be better to terminate early rather than delay. Most terminations in clinical practice take place before 13 weeks.
Women may chose to terminate the pregnancy on various grounds, of which social grounds are most common. They may range from just not being ready for it to premarital relationships, marital discord etc. Whatever the reason, the clinician who does not have any conscientious objection should be able to offer a non-judgemental treatment.
Safe termination is a very important consideration as there may be unnecessary complications. The prerequisites for a safe termination are eliciting whether there are any pre-existing risk factors such as anaemia, presence of infection or infection risk and thyroid problems. Also, it is mandatory to ascertain that the pregnancy is indeed within and not outside the womb (ectopic pregnancy). Whether a medical or surgical option for termination is chosen depends on several factors, including the length of pregnancy, pre-existing risks, need for urgency and emotional factors.
If the abortion is done in unsafe ways, there may be serious repercussions for the women to face such as infection, excessive bleeding, need for blood transfusion, and in rare cases, removal of the uterus or even death. Certain complications may lead to inability to bear children in the future too.
Future contraception becomes an important aspect to discuss during the initial or later consultations. In general, a cafeteria approach is taken wherein all the methods are discussed with the couple and the choice is made by them, depending on the duration of requirement, convenience of use and any risk factors.
Dr Aruna Muralidhar is Senior Obstetrician and Gynaecologist, Fortis La Femme, Richmond Road, Bangalore