Yeshey Lhadon 

Recently, a 25-year-old unmarried woman in Thimphu went to her friend. She was desperately looking for abortion pills. She could not find them in medical stores in Thimphu.

Staff at one of the medical stores said that both men and women visited the drugstores looking for misoprostol, a drug that’s used to abort pregnancy during the early days.

A staff of Namsey Pharmacy, Choki Wangmo, said: “We get at least six people a week who come for abortion pills. Normally, we don’t get as many customers looking for abortion pills.”

Kuenphen Medical Supplies, another medical store in Thimphu, turned away two women looking for abortion pills this week.

Pharmacist could lose license if he or she sold abortion pills. A staff said: “Some customers are frustrated and are pestering us to get them the pill. We advise them to consult the doctors.”

The national referral hospital’s (JDWNRH) OPD also got some cases of women coming in to seek abortion advice.

JDWNRH’s medical superintendent Dr Gosar Pemba, said that the hospital would become a partner in crime if it helped women to terminate their pregnancy.

The Penal Code of Bhutan states that  a defendant shall be guilty of the offence of illegal abortion, if the defendant unlawfully aborts or induces expulsion of an embryo or foetus or prevents a child from being born alive, except the act is caused in good faith for the purpose of saving the life of the  mother or when the pregnancy is a result of rape or incest, or when the mother is of  unsound mental condition.

“We have law on one hand and problems on the other, thus many land up in Phuentsholing availing unsafe abortion services,” said Dr Gosar Pemba.

A gynaecologist at JDWNRH, Dr Sonam Gyamtsho, said that people wanted to abort their baby because of social or family pressure, failed family planning method or unstable financial conditions. “We are helpless when women come crying and panicking because of unwanted pregnancies. The mothers go through huge psychological trauma if they are not ready to be mothers. Some go under depression and become suicidal. But we always prioritise mother’s life.”

Since the law doesn’t allow women to abort their babies, the hospital sends them for counselling to the forensic department. Dr Sonam Gyamtsho also said that termination of pregnancy was allowed on medical grounds of a mother or if the fetus is grossly abnormal or in case of intrapartum death (death of a fetus inside womb).

JDWNRH has also noted increasing trend in incomplete abortion over the years. About 400 women visited JDWNRH with a partial miscarriage complication in 2018 and about 316 cases in 2019. “We can’t say how many cases are spontaneous miscarriage or induced miscarriage after taking abortion pills,”said Dr Sonam Gyamtsho.

However, JDWNRH received almost negligible miscarriage cases during lockdown. Dr Sonam Gyamtsho said: “May be most of the women were inaccessible to abortion pills due to movement restriction during lockdown that we saw only few cases. But after the relaxation of lockdown, incomplete miscarriage cases are on the rise. Maybe they managed to get abortion pills now.”

He also said that they don’t dig the history of their patient’s miscarriage to encourage women to have trust in the health system. “Patients usually deny having induced the miscarriage by taking abortion pills. But we always want them to come to us and let us do half of the job. Cleaning their uterus,” said Dr Sonam Gyamtsho.

He said the risk of not visiting hospital after induced miscarriage could lead to infertility among women in the future including pelvic pain or suffer infection and perforated uterus. “Some might even die. About 98 percent wouldn’t face complications, however, the rest are at high risk,” said Dr Sonam Gyamtsho.

The lack of abortion services in the country has left many women with no choice other than carrying their pregnancy forward due to which many women tend to go underground, refusing to avail sex and reproductive health services at the hospital, leading to increased case of abandoned newborns.

Dr Gosar Pemba said that the hospital could only advise those pregnant women to seek help from National Commission for Women and Children (NCWC) and encourage them to deliver their baby in the hospital and put up for adoption later.