Abstract

Spontaneous abortions (SA) occur in 10-15% of clinical pregnancies, but still are subject to continuing investigations because of paucity of rural, community based information. Objectives: To know demography, health seeking practices, opinions of rural tribal women. Material Methods: Community based study was carried out by door to door visits in 118 villages, 65 in Melghat region of Amravati, 53 villages near Sewagram of Wardha, Maharashtra, India. Information from women of 15-44 years who had SA within 5 years was collected. Focus Group Discussions were also held in villages with women, irrespective of age, whether they had SA. Results: In villages near Sewagram, of 549 women who had SA, 331 (60.29%) did not use health facility for SA care,329 managed by family members, 2 traditional birth attendants, 218 used health facilities. (17.6% Medical college, 16.93% Private hospitals, 2.36% Sub-centers, 1.63% District Hospital, 1.09% Primary Health Centers, Private Specialists 11.83%). In Melghat, 1217 reported SA, and 1212 were managed by family, 5 used health facilities, [3DH, one MC, one PH]. In villages near Sewagram 72%, in Melghat region 99.58% said abortions were uneventful. Village vital records revealed 1.3 - 4.5% SA in Melghat, 2.6-5% in Sewagram villages. FGDs revealed women had ignorance, misconceptions, about abortions, more in Melghat. In their traditional wisdom, women had some scientific knowledge, but did not talk about need of care, prevention of complications and possibility of recurrence. Conclusion: Research about traditional therapies, reverse pharmacology, private sector for abortion care, policies, programs and services, is needed.