Menstrual Regulation in Bangladesh: is the law effective enough?

Meena, a 17-year-old girl went to a traditional birth attendant to terminate her unwanted pregnancy. The attendant inserted a tree branch into her uterus. This caused severe pain and heavy bleeding. Although the pregnancy was terminated, when in later years she tried to get pregnant, she was told that the unsafe abortion method had damaged her uterus.

Like her, every year, around 572,000 women suffer from unsafe abortion in Bangladesh (research data from the Guttmacher Institute).

Bangladesh is dealing with the topic of abortion in different ways. In the history of Bangladesh, abortion was legalized after the liberation war for those women who had been raped during the war. Later in 1976, Bangladesh National Population Policy tried to legalize abortion for the first trimester but was able to expand it only to allow when a woman’s life was in danger. Menstrual Regulation (MR) was introduced to the people of the Bangladesh in 1979. It has been practiced since then effectively as an alternative to abortion. However the penal code from 1860 is still in place, which means that an induced abortion is illegal unless the woman’s life is at risk.

Now the question arises, what is Menstrual Regulation? It is a procedure that uses manual vacuum aspiration to control fertility so it is not possible to be pregnant after missing period. In Bangladesh, it can only be performed with a maximum limit of 10 – 12 weeks after a woman’s last period and without a test to confirm pregnancy.

MR services have been decentralized and are officially available free of cost in the public sector. Despite this, according to the research, many women still end up with unsafe abortions. Although MR is free in the country, there would be additional charges if the pregnancy is beyond 10 weeks. In addition to that, low level of education and lack of awareness is also a barrier. Only 9% MR users reported getting the information from trained family planning workers. One third of the facilities that could provide MR services either lack trained staff or equipment or both. In some cases service providers turn women seeking MR services away.

Giving training to service providers on MR is not enough. They need adequate knowledge on reproductive rights and MR laws in Bangladesh. Furthermore, proper facilities and equipments are the matter of subject to provide safe MR services. Educating women on the availability of MR services and danger of unsafe abortion is required to make the MR Law more effective.