Why are abortions the answer? Prevalence, knowledge and attitude towards induced abortions among women attending a secondary level health care facility in Tamil Nadu, Southern India

Background: In India, from 2010 to 2011, government statistics on family welfare recorded 620,472 abortions in government-approved institutions. On the downside, a study conducted by the Indian Council of Medical Research (ICMR) in rural areas, found that abortions by uncertified health care personnel/in unapproved institutions were twice as many as in the approved ones (13.5 v 6.1 per 1000 pregnancies).This could be attributed to low levels of modern contraceptive use, being only 48% in 2007-08 (DLHS-3).  The aim was to assess prevalence, knowledge and attitude towards induced abortions among women who attend a secondary health center, in Tamil Nadu, India Methods: The study was a hospital-based cross-sectional study, done in the Out-patient department of a secondary level health care facility in Vellore, in September 2015. The women attending the secondary level health care facility; who were then  pregnant or just post-delivery and those who had greater than two years of inter-pregnancy interval; were eligible to be enrolled in the study. Results: Only 27 out of the 175 women (15.4%) used any form of contraception. We found a rate of 72.69 abortions per 1000 married woman years in our study. Out of the 175 women, 29 (16.5%), 95% CI (10.9%, 22.1%), reported to have had at least one induced abortion; the main reason was unwanted pregnancy 22 (75.86%). Most women 116 (66.3%) had poor knowledge and attitude on induced abortions. Conclusions: We conclude that contraceptive use should be strongly advocated to women for birth planning and prevention of unwanted pregnancy and subsequent induced abortions.