According to theory, an abortion occurs when a pregnancy is ended before the foetus is viable, or able to live on its own.1 Abortions of any kind is known as a septic abortion when it is worsened by infection.2. "A procedure for the termination of unwanted pregnancy, either by untrained or in a hospital," is how the World Health Organisation defines septic abortion.meet the minimal requirements of medicine, or both."3 Women seek abortions for a number of reasons, including birth control.Despite the Medical Termination of Pregnancy Act (MTP-Act), 1971, which liberalised consensual abortion, unlicensed abortions are still often carried out in India by unskilled individuals like as traditional birth attendants or dais, putting pregnant women at further danger for death.

The MTP Act addresses who can conduct an abortion, where it can be performed, and the circumstances in which a pregnancy can be ended.5 Of the 210 million pregnancies that happen annually, an estimated 80 million are unwanted1. According to an ICMR research conducted in India, the number of safe (legal) and unsafe (illegal) abortions performed per 1000 pregnancies was 6.1 and 13.5, respectively.1.

There is a high proportion of unsafe abortions and a low percentage of overall contraceptive usage.Six Preventive medicine uses septic abortion as a paradigm for primary, secondary, and tertiary prevention.7. It is apparent that around two thirds of abortions occur outside of approved health services, performed by unlicensed, frequently inexperienced individuals8Because antenatal clinics often book patients after confirming foetal viability and because patients who make the effort to book early at these clinics are likely interested in becoming pregnant, the frequency of abortions in these situations is lower than other cited figures.9. With this background in mind, the current study was conducted to assess the women under investigation's awareness and usage of septic abortion.

The current study was a longitudinal one that ran from January to July 2017 at the obstetrics and gynaecology department of the MKCG MCH, Berhampur. Through straightforward randomization, a total of 100 septic abortion patients were chosen for the investigation. Abortion is generally regarded as septic, while clinical definitions vary, when there is a rise in fever of at least 100.4F for 24 hours or more, unpleasant or purulent vaginal discharge, and other signs of pelvic infection, such as discomfort and pain in the lower abdomen. Study patients were women who enrolled for treatment inside and had characteristics of a septic abortion. The foundation for the diagnosis of septic abortion included investigations, exams of the abdomen and vagina, and peroperational conclusions. Every woman gave their verbal assent, and the cases' confidentiality was upheld. Every lady was personally interviewed using a pre-made questionnaire in order to get all of the personal data related to the incidents.

Table 1 Shows Age And Septic Abortion

Out of 100 cases of septic abortions, majority(66%) of patients were in the age group of 20-29years, followed by 14% to age group <20 yearsand13%to agegroups30-40years.

Table 2 Shows Knowledge About Contraception

Out of the 100 cases studied, majority of the cases(i.e.46%)had no knowledge of contraceptive devices. Out of the remaining, 22% knew about pills, 19% cases knew about tubectomy, 7% knew about barrier methods and 6% knew about IUCD.

Table3 Shows Knowledge Of Contraception (Rural, Urban)

Out of the100 cases studied, rural Women comprised of 82 cases in which Maximum number of cases(53.66%) had no knowledge about contraception,While46.34%had some knowledge. Urban women comprised of 22 cases in which 88.89% had knowledge about contraception and 11.11% had no knowledge.

Table4 ShowsSourceOf Knowledge About Contraception

Out of the 100 cases interviewed, only 54 cases could respond regarding their source of knowledge regarding contraception. Majority of the cases got the knowledge of contraception through media and health personnel.(PHC-22.22%, Radio22.22%, ANMs/ASHAs-18.52%, Television (18.52%). 11.11% got the knowledge through stage drama/ nautankee. 7.4% learnt from friends, relatives and others sources of communications.

Table5 Shows Knowledge Of MTP Act

Out of the100 cases studied, the majority of women had no knowledge of MTP Act. Among 82 rural women 90.25% had no knowledge about MTP Act and only 9.75% had knowledge. Out of 18 urban women 83.3% had knowledge about MTP Act, while 16.7% had no knowledge. Urban population had greater knowledge of MTP Act than rural population.

Table6 Shows Type Of Person Conducting Abortion

Out of 100 cases studied, the following distribution been observed in the incidence of persons conducting septic abortion: In 52 cases(52%), there was of history of intervention by dais. In 42 cases (42%), there was a history of sisters/ paramedical staff intervention and in 6 cases(6%), general practitioners(MBBS) intervention was there.

Table 7 Shows Devices Used For Abortion

Out of the 100 cases of septic abortion, in 60 cases(60%),instrumentationwasused,in16cases(16%) laminariatent was used, in 10 cases (10%)abortionstickwasused,in3cases(3%)laminariatent with instrumentation was used, in 2cases(2%)suctionwasused,in1case(1%),broomstick was used, and in 8 cases (8%), device used was not clear.

Table8 Shows Parity And Septic Abortion

Out of 100 cases, Multipara constituted the major part with 66 cases (66%). Total number of cases, who were primigravida was 34(34%).

Table9 Shows Period Of Gestation And Septic Abortion

Out of 100 cases, in 55 cases (55%) abortion wasinducedwithin12-20weeksofgestation.This was followed by 30 cases (30%) who undergone abortion at gestation period less than 12 weeks. 15cases (15%) undergone abortion after 20 weeks of gestation.

When carried out by uneducated or unqualified individuals, MTP may be quite dangerous. However, for qualified professionals, it is a rather safe and simple process. Similar to Kore et al.'s findings, the majority of patients in our research were in the 20–29 age range. In 52% of the instances in our analysis, dais performed the pregnancy termination, with paramedical workers following closely behind at 42% and general practitioners at 41% (MBBS). Sharma and colleagues (2011) reported comparable findings, indicating that 67.7% of infections were caused by untrained individuals, including dais, at home or in other unsanitary locations.

Similar insights have been made by a few other writers.(11–14) According to our research, stick insertion (10%) and laminariatent (16%) were the next most popular methods of interference, with instrumentation accounting for 60% of all methods. Different Techniques like a broomstick, medication, suction and evacuation, etc. were utilised. According to Sood et al. (2015), the methods of termination included suction or curettage by unskilled staff, foreign body insertion by 7.5% of the sample, and instrumentation by untrained midwives (62%).

The results of this study demonstrate that septic abortion is a significant but often ignored health issue, especially in our nation's rural communities. This is mostly as a result of a lack of knowledge about the use of contraceptives, a lack of appropriate health education and communication, a shortage of providers of abortion services who are properly educated, and a lack of easily accessible, discreet, high-quality abortion facilities. High rates of maternal mortality and morbidity result from all of these circumstances. As a result, there is a significant unmet demand for simple access to safe and reliable

methods of abortion and contraception.

Boost women's mental, social, and educational standing to enable them to take contraceptives that they believe to be safe and side effect-free and to prevent coerced sexual encounters.16 There's a lot of interest in spreading knowledge of secure MTP. More qualified ANMs, AWWs, and ASHAs should have access to private counselling in order to facilitate safe MTP. MTP service centres that are comprehensive and discreet are necessary. The establishment of high-quality MTP service centres by the private and non profit sectors should be promoted, and all medical personnel must pledge to avoid unsafe abortions. Numerous lives will be saved by early complication detection and timely referral to tertiary centres.

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