Doctors say incidence of spontaneous abortion has risen alarmingly of late and has become a national phenomenon. The factors responsible for spontaneous abortion in villages and cities may be different, says senior gynecologist and obstetrician Dr Bhola Rijal. He said rising water and air pollution, stress, obesity, sedentary lifestyle, and late marriage are responsible for growing reproductive health problems. [break]
He also said he found strong link between foreign employment and miscarriage in Nepal. "Husbands, who go abroad for employment do not bring home remittances only but also various sexual transmitted diseases, which they transmit to their wives causing infections in the uterus. A woman with an infected uterus cannot conceive and by chance if she is able to conceive then again the fetus does not have long life," said Dr Rijal, who is also the chairman of Om Hospital, Kathmandu.
According to him, late marriage, multiple sex partners, and high rates of induced abortions have added to the problem. For Smita, however, the ordeal was still not over yet. "We felt so disappointed and dejected because we lost one of the most precious things," said Smita, 34. "It was important for me to conceive as soon as possible once again so that we could overcome the sense of loss," she added. But, she suffered three miscarriages in a row.
Figures provided by the Maternity Hospital, Kathmandu, reveals that cases of miscarriage jumped from 1,109 in 2006 to 1,825 in 2011, a whopping 60 percent rise in five years. While Om Hospital, one of the leading hospitals in the Valley providing gynecology-related services, does not keep a separate record of spontaneous abortions, the government too maintains records of only induced abortions.
Ambika Prasad Neupane, an officer at Family Planning and Health Division, said the data provided by the Maternity Hospital is an indicator of the gravity of the problem. "Maternity Hospital is the largest government hospital to take up such cases."
Gynecologist and obstetrician Dr Nutan Sharma observes that the cases of spontaneous abortions have in fact doubled during the period [between 2006 and 2011]. "In my experience, spontaneous abortions have more than doubled in the last one decade. It is so at least in the urban area," said Sharma, who is associated with B&B, Kantipur and Alka hospitals.
Similarly, Dr Meena Jha, who has been practicing at the Maternity Hospital for last 17 years now, says spontaneous abortions are on a continuous rise and this phenomenon is not actually related to urban areas alone. "Those who come here for treatment are basically the women living in the capital but they hail from various parts of the country," she said. "And spontaneous abortion is a rising problem in our hospital," she added.
Dr Sharma elaborates that in early 30s, chance of pregnancy is only slightly lower than in late 20s and the risk of miscarriage only slightly higher. But then, miscarriage risk gradually rises throughout the 30s. "After 35, women cannot conceive as easily and even if she conceives, risk of miscarriage is high. Similarly, if they go for induced abortions earlier, the women are more likely to suffer a miscarriage when they really want a baby."
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