Safe Abortion for Every Woman (SAFE)

Background

In Bangladesh, 48% of pregnancies are unintended despite the impressive growth in CPR to 62%.

• Uptake of LAPM is extremely low at 8% of all methods, with switching and discontinuation common.
• There were close to 1.2 million induced abortions in 2014, a rate of 20 per 1,000 women aged 15-49.

Government regulations allow for menstrual regulation (MR) procedures up to 12 weeks and menstrual regulation with medication (MRM) up to nine weeks. Despite this liberal legal environment, there is low knowledge of the law (fewer than 50% of women reported hearing of MR) and ongoing stigma that leads many women to clandestine MR, a significant number of which are unsafe.

MR procedures in public and private facilities in Bangladesh decreased by 34% to an estimated 430,000 procedures in 2014. This decline in the MR rate is attributed to the increased use of MRM from pharmacies and drug sellers. Of the 257,000 women with complications from unsafe MR in 2014, 48% were from hemorrhaging, up from 27% in 2010 – a shift attributed to increased incorrect use of misoprostol.

Women seeking MR after 12 weeks was another cause for decline: 27% of women seeking SA from facilities were turned away as they were too late. While MSB’s MR dropped by 18% between 2010 and 2014, in line with the national decline, MSB remains a significant nation-wide provider of MR and MRM through its centers and 150,000 in annual sales of its registered combipack, Mariprist. Marirpist is the only brand of 5 combipacks on the market that is linked to a call center.