Study on intervention necessary for preventing rejection of MR clients.

A study was conducted in Bangladesh to estimate the number of women refused menstrual regulation (MR) procedures to assess the reasons for the rejections and to identify institutional shortcomings. Data were collected from the records of 11470 women refused MR and from a follow-up survey. It was found that most of the women lived in rural areas and were married and that their mean age was 26.2 years. Over half of the clients and 75% of their husbands were educated and nearly all were Muslims. Only 10.4% were using contraception when they became pregnant and 58.6% had never used contraception. Only 1.1% had been pregnant for more than 10 weeks. The major reason for rejection was duration of pregnancy. Women were inhibited from seeking the procedure in a timely fashion because they were unaware of the pregnancy did not understand the time limitations for the procedure or had difficulty accessing the service. Most women learned about MR from a relative/friend/neighbor. Family planning workers were the source of information for only 9.4%. Almost a third of the women tried to undergo the procedure elsewhere before coming to the center (70.1% of these tried traditional abortionists). Data were obtained from 196 of the 207 clients chosen for the follow-up survey. Of these 44.9% continued the pregnancy 37.7% continued to seek abortion and 16.8% reported spontaneous abortion. One of the 207 women died due to septic abortion and 61.8% of those attempting abortion suffered complications. Five of the 88 resulting children died within a month of birth. Based on these data it is recommended that information on MR be widely disseminated that record-keeping be systematized and reporting required that MR services be streamlined that the flow of logistics be assured that MR be performed until 10 weeks gestation rather than eight and that a national follow-up study of rejected clients be conducted.