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Safe abortion services during COVID pandemic in Nepal

Citation

Aryal, Shreyashi; Nepal, Samata; Pant, Sagun Ballav (2021), Safe abortion services during COVID pandemic in Nepal, Dryad, Dataset, https://doi.org/10.5061/dryad.3tx95x6fc

Abstract

Objective: To analyze the pattern of Safe Abortion Services at a tertiary healthcare center during the first six months of the COVID-19 pandemic in Nepal.

Study Design: This is a cross-sectional analytical study.We compared the pattern of safe abortion services between the first three months of the pandemic when a lockdown was implemented and the second three months when the lockdown was eased. Demographic and obstetric profile of women, their abortion choices, method of termination, difficulty in accessibility, and level of psychological distress were studied.

Results: A total of 52 women were provided SAS during the study period. The number of women coming for SAS during lockdown was 47.1% less than that after easing of the lockdown. During the lockdown, women came at a later period of gestation with a mean of 9.5 weeks compared to 7.5 weeks in the later three months. Because of fear of COVID-19, 19.2% (n=10) women opted for termination of pregnancy. Increased need of contraception was felt but 40% (n=12) had problems of accessibility. More women had probable serious mental illness during the lockdown period (p=0.008).

Conclusion: The lockdown during the pandemic decreased the number of women coming for SAS due to barriers in accessibility. Contraceptive needs are also increased but access is difficult. Medical abortion has been the more sought after method. Psychological distress is prevalent and fear of COVID-19 has become a common reason for termination of pregnancy.

Methods

Demographic and obstetric profile of these women, their abortion choices including reason fortermination of pregnancy and method of termination, difficulty they are facing relating to access to these services, and their level of psychological distress were studied. A self-designed proforma was used for data collection and interview technique was used. Interviews were taken by the attending gynecologist who underwent an orientation program before data collection. The Kessler psychological distress tool, “K-6 tool,” which is a self-administered toolvalidated for Nepal, translated by experts in Nepali language. This tool was used to find the level of psychological distress. The K-6 tool is a 6-item self-report measure of psychological distress used to assess risk for serious mental illness in the general population answerable in 5 pointscale. Using a 30-day reference period, respondents rated how often they felt nervous, hopeless, restless or fidgety, so sad that nothing could cheer them up, that everything was an effort, and worthless.

The number of women coming for SAS three months prior to the beginning of the lockdown was analyzed using hospital medical records.

Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) v16. Results are presented in mean and SD, percentages.Relationship between categorical data was analyzed using chi square test. P value of <0.05 was considered as significant.