A cross sectional study to assess the effects of unsupervised use of illegal over the counter pill for medical termination of pregnancy a cosmopolitan city of Central India

Background: In India, lack of awareness about the potential adverse effects of medical termination of pregnancy (MTP) pills and their easy over the counter illegal availability facilitates unsupervised usage. The objective of the study was to analyze the percentage of cases of incomplete abortion associated with unsupervised use of illegal over the counter MTP pill. Methods: This cross sectional observational study is conducted at tertiary level medical college Indore, India, from January 2011 till December 2011. Data of all patients who came during this duration for MTP, D and C for incomplete abortion/retained product of conception or with complications of medical abortion was analyzed prospectively. Results: Total 45 MTP and 60 D and C for incomplete abortion/retained products occurred in year 2011 out of which 44.44% of MTP were done for patients who had received medical abortion pills but not aborted. A staggering 80% of these patients received the pill over the counter without the prescription of the doctor. 61% of D and C performed were for incomplete abortion occurring due to medical abortion pills which were received over the counter. Three percent of the D and C were septic abortions out of which none was following instrumentation but all were following unprescribed medical abortion. Only 1.7% MTP was due to contraception failure, and the rest were due to unwanted pregnancy. 57.77 % women accepted post MTP contraception. Conclusions: Majority of patients who underwent MTP and D and C in this study have received over the counter pills for medical termination of pregnancy before seeking medical advice. Contraception acceptance remains the same. Over the counter availability of medical methods for termination of pregnancy represents a significant public health problem. Administrative measures, media publicity for and reduced cost of methods of contraception, strict legal rules for prescription and sale of medical methods of pregnancy termination is warranted.