Unwanted pregnancies, abortion up in Bali

Bali is seeing a rising number of unwanted pregnancies indicated by the increase in demand for
abortions.

In 2011, the Indonesian Family Planning Association (PKBI) helped 722 women have safe abortions, an increase from 641 women in 2010.

The number of patients requesting medical abortions is usually twice that of the clinic’s capacity, indicating that the number of unwanted pregnancies that could not be aborted is much higher.

“In this clinic, we can only help patients who show their marriage documents and come with their husbands,” said I Ketut Sukanatha, director of the local chapter of the PKBI.

Another requirement is that the pregnancy should not exceed three months.

In most cases, unwanted pregnancies are related to contraception, either because the reproductive-age couples are not disciplined or they don’t use contraception at all, or the contraception fails to work properly.

“There is a high number of married couples who prefer not to use contraception. They rely on the calendar system and coitus interruptus method, both of which are not very reliable in preventing pregnancy,” Sukanatha said.

He said there were also many unmarried couples coming to the clinic for abortions, but the clinic refused to provide them with the service. Instead, clinic staff offered the couples counseling aimed at convincing them to have the child. The PKBI also has a special clinic called Kisara Youth Clinic (KYC) to handle teenage cases. This clinic receives patients with unwanted pregnancies.

On average, 30 patients with unwanted pregnancies come to the clinic per month. That equates to 80 percent of total patients received by the clinic per month.

“This year, we will start the program Choice, which will not differentiate the patients based on their marital status but on their ages,” Sukanatha said, adding that the program was established to cover unmarried couples that could not get similar treatment in the old
program.

It is also part of efforts to reduce dangerous, illegal abortions, he said.

Dr I Ketut Pasek, head of the health service division at the KYC, said that the number of youth patients coming to the clinic for abortions was always high compared to those who came for other treatment.

KYC helps teenagers by giving counseling and assistance to talk to their parents.

It also handles emergency cases, such as bleeding in pregnancy, as long as there is approval from the parents.

“The first option is to continue the pregnancy and the second one is to educate teenagers about contraception,” Pasek said.

I Nyoman Mangku Karmaya, an activist in reproductive issues, said that in many cases, abortion was carried out because pregnancies were the result of contraception failure, rape, incest or severe mental problems.

Abortions could also be carried out for high-risk pregnancies and genetically-disabled fetus.

“Many unwanted pregnancies end up undergoing unsafe abortions because there is no access and regulation,” Karmaya said.

Data from the World Health Organization reports around 210 million pregnancies worldwide every year, with 46 million (22 percent) of them ending in abortion.

The number of unsafe abortions reached 20 million per year, 95 percent of which occurred in developing countries.

According to Karmaya, the number of unsafe abortions in Indonesia reached 750,000 to 1 million per year, 11 percent of which resulted in the deaths of mothers.

If the government could not provide access for safe abortions, then it should try to reduce discrimination against teenagers experiencing unwanted pregnancies, such as by allowing them to continue their education.

Presently, pregnant teenagers are usually expelled from school due to “bad conduct”.