Abortion in Bhutan Compared to Abortion in India

Bhutan, a landlocked country in the Eastern Himalayas is a small country that shares international borders with India and the People’s Republic of China.

Though Bhutan is a very less populated country, yet it contributes greatly in the ratio of maternal deaths due to unsafe abortion complications amongst South Asian countries. Abortion in Thimphu, the capital city of Bhutan have been found to see maximum abortions every year followed by abortion in Sarpang and Chukha.

Though abortion in Bhutan is legal under some circumstances, yet access to safe abortions is still a challenge for Bhutanese women. And hence they often cross borders of the neighbouring countries to seek abortions when they are unable to terminate an unplanned pregnancy.

Are you too living in Bhutan and planning to cross the border for an abortion?

Are you considering visiting India for a safe abortion?

If yes, it is best to know your safe, legal and confidential abortion options in India for foreign women.

The legal status of abortion in Bhutan:

Abortion in Bhutan is governed by Bhutan’s Penal Code 146 according to which, abortion in Bhutan is illegal except for a few permissible circumstances as mentioned below.

Permissible circumstances:

Bhutan has seen several maternal morbidities and mortalities associated with maternities. As a result, abortion in Bhutan is legally restricted to circumstances when:

  • Pregnancy is a result of rape/incest. The case has to be proven in a court of law.
  • Continuing the pregnancy poses a threat to the woman’s physical and/or mental health and/or life.
  • Fetal abnormalities have been detected. (Substantial risk to the child born will be seriously handicapped or have congenital or physical or mental abnormalities.)
  • The woman is mentally challenged.

Abortion in Bhutan is not permissible when:

  • Pregnancy is a result of contraceptive failure.
  • Pregnancy is unwanted due to social or economic reasons of the family.

Simply, abortion in Bhutan is not an open option when an ongoing pregnancy is unplanned or unwanted.

Consent for abortion:

Even in legal circumstances, to avail of legal abortion in Bhutan, the consent of both the parents is essential. This paves difficulty for unmarried girl abortions in Bhutan.

Bhutan’s state religion is Buddhism which also disapproves of abortion unless it is performed to save the woman’s life. This further complicates a woman’s situation who is carrying an unwanted pregnancy and adds to her stress.

Gestation age:

For permissible abortions in Bhutan, the age allowed is up to 20 weeks of pregnancy.

Doctor’s prescription:

In Bhutan, legal abortion needs a prescription from two state doctors who are registered medical practitioners. However, only in emergency events, certification for abortion is permissible by a single doctor.

Penalties associated with abortion in Bhutan:

In events where abortions are performed in restricted situations, the act is considered a misdemeanor. The woman and the helping doctor both are liable to punishment. The penalty for an unsafe abortion is minimum imprisonment for a year and maximum for up to three years.

The helping doctor may have to face suspension or cancellation of his medical practice license.

Women in Bhutan resort to unsafe abortions:

Unwanted pregnancies are often associated with stress when women are unaware of their best choices. Many women lack knowledge of the legality of safe abortion, many others fail to seek safe abortions due to lack of facilities and yet many others resort to unsafe abortions due to fear of stigmatization.

In events of rape/incest where abortion is legal, a woman has to prove it besides the court of law and abortion permission be granted only if found to be a victim of an immoral act leading her to get pregnant. In this way, the confidential matter for some unmarried girls or women when comes to the public may sometimes be regarded as a matter of disgrace within the families and/or societies/communities.

Due to these and many other personal reasons, women of Bhutan often resort to unsafe methods of abortion and put their health and life at risk.

In Bhutan, the maternal fatality rate is 1.4% with abortion complications being one of the major reasons. And little you may know that abortion complications are preventable. But in panic and hurry, women often fail to recognize the side-effects of unsafe abortion and the associated complications. And they end up being victims of complications of unsafe abortions which could have been prevented in the first place.

Travelling to Bangalore, India from Bhutan for a legal, safe and confidential abortion:

Safe abortions can be a reality for Bhutanese women. But little do they know of their safe options. This post is to shed light on these safe abortion options for women from Bhutan in Bangalore, India.

Bhutan to Bangalore and vice versa can be reached via various travel modes, flight, train and by road. When visiting India for an abortion, it is best if you can get a direct flight to Bangalore. Elsewise, you can reach any Indian city and from there you can easily travel to Bangalore via a domestic flight. For instance, you can take up a flight for Kolkata from Bhutan and then from Kolkata to Bangalore. This is a short trip and you can easily book your tickets accordingly.

Plan a day to rest in a nearby hotel and then you can book a flight back a day after.

The legal status of abortion in India:

Abortion in India is legal for women under a wide range of circumstances owing to liberal abortion laws. Here, you can avail a legal abortion in events:

  • Pregnancy is an outcome of contraceptive failure. (This is the most common reason that results in unplanned pregnancies not only in Bhutan but throughout the world.)
  • Pregnancy is a result of rape or incest.
  • Pregnancy poses a threat to the woman’s life or physical/mental health.
  • Fetal impairment has been detected.

As per the latest MTP Act of India, the gestation length for abortion is up to 20 weeks in general circumstances and up to 24 weeks in special cases, such as the detection of fetal anomalies. Besides, you need not be married for a legal abortion. You can also avail of a legal unmarried girl abortion in India.

Another benefit of travelling to India is that here only the woman’s consent is needed for an abortion. No spousal or parental consent is necessary if the woman is an adult, i.e., above 18 years of age.

Abortion in Bangalore options for women from Bhutan:

As mentioned above, it is quite easy to travel to Bangalore where you can easily reach one of the best abortion clinics, American Hospital Bangalore via a cab or any local transport from your hotel or the airport.

Many women from Middle East countries and other South Asian nations visit here for safe abortion services. The hospital has earned a reputation for being the most experienced team and has highly qualified doctors, nurses and paramedics on their team.

Here, you can avail of an abortion safely since all the abortion procedures and practices followed are as per recommendations and guidelines issued for Comprehensive Abortion Care by the World Health Organization (WHO).

Recommended methods of abortion:

There are three methods of abortion recommended by the WHO according to the length of pregnancy. These are:

  1. The medical method of abortion
  2. Vacuum aspiration method of abortion
  3. Dilatation and Evacuation (D&E) method of abortion

The medical method of abortion:

This method is also known as the Medical Termination of Pregnancy (MTP) method and is the first and the easiest method for terminating very early pregnancies, less than 6-8 weeks, only. It makes use of safe abortion pills that are approved for terminating pregnancies.

The two pills that have been approved include Mifepristone and Misoprostol. The first pill, Mifepristone is an anti-progestin, i.e., it blocks the action of Progesterone.

After conception, a woman’s body needs a higher level of progesterone for sustaining the pregnancy. It is secreted by the ovarian corpus luteum. On administration of Mifepristone (oral or vaginal), the Progesterone’s action is blocked and the growth of the embryo is stopped.

Then, the next pill Misoprostol is administered the next day or after a desired number of hours. It brings uterine contractions which ultimately result in the expulsion of the fetus just like you have your periods every month.

Never self-administer abortion pills.

No wonder, many women and couples in Bhutan try to avail abortion pills through unsafe means. But, before you pop in abortion pills without a doctor’s recommendation, you should know that you are putting your health and life a great risk. Here, are a few complications of self-administration of abortion pills. Also mentioned are the preventive measures to how these complications can be prevented.

The Complication associated with incomplete abortion:

When you self-administer abortion pills beyond the recommended gestation length, i.e., beyond 8 weeks, the size of the embryo has increased than that could be completely removed through the vaginal route.

This can lead to an incomplete abortion. This means some products of gestation may remain in the uterine cavity. An incomplete abortion is presented by vaginal spotting, abdominal pains, sometimes fever (in case of pelvic infection). If not treated timely, it can even be fatal.

Incomplete abortions are required to be completed through surgical means.

The advice: The complication of an incomplete abortion is preventable. Do not self-administer abortion pills. You can visit AHB, where the doctor will first ascertain whether the length of your pregnancy permits the Medical Method of abortion or not.

Moreover, since the MTP method is only 95% – 98% efficient, there is a chance of incomplete abortion even when the pills are administered very early, i.e. in the feasible period of up to 8 weeks.

For a woman coming from Bhutan for an abortion, even if she is early, there is another abortion method that is both efficient and safe and can give her the confidence of a completed abortion before she returns. Keep reading further to know more about your abortion in Bangalore options.

The complication associated with an ectopic pregnancy:

In normal pregnancies, the fertilized egg travels down the fallopian tube and implants in the uterus. But in some cases, it fails to reach the uterus and remains in the tube, most commonly and in other rare events, somewhere else in a nearby organ. The case when the embryo starts growing within the fallopian tube is known as tubal pregnancy and it can even be fatal.

Now, the most important thing for you to know before you self-administer abortion pills in Bhutan is that in case you are pregnant but your pregnancy is ectopic (tubal pregnancy), abortion will not take place on administering abortion pills. This may sound surprising to you, but it is true.

Mifepristone will block the action of Progesterone stopping the growth. But, misoprostol will not be able to remove the embryo but uterine contractions. This is because the embryo is not in the uterus. You might experience pain and moderate bleeding also due to abdominal spasms which can give you a false impression of an abortion.

But the reality is that embryo is still in the tube and if it remains there, it can lead into a burst tube further leading to internal bleeding and even death. This is presented at first generally by syncope when the woman faints due to internal bleeding. A case of an ectopic pregnancy deserves immediate medical attention in which the burst tube and the connecting ovary are removed through a surgical procedure to save the woman’s life.

The advice: An ectopic pregnancy complication is also preventable. In case the location of pregnancy is determined as soon as you find out that you are pregnant, ectopic pregnancy is detectable via a transvaginal scan.

The good news is that early enough, ectopic pregnancy can be treated medically by pills.

The bad news is that if not detected early, it can impact your fertility and future pregnancies. And this is which is why, you should never take up abortion pills without ascertaining that the pregnancy is intrauterine.

Again, it may be difficult for you to get a transvaginal ultrasound for the location of pregnancy in Bhutan. But at AHB, the doctor first checks both the length and the location of a pregnancy before prescribing the best abortion method for any woman.

Vacuum Aspiration method of abortion:

This method of abortion is a safe abortion procedure recommended by the WHO for terminating pregnancies that are less than 12 weeks.

In this method, the embryo is gently sucked out using a slender medical device with an aspirator. This suction can either be created manually or by an electric motor.

For a woman coming from Bhutan for an abortion who is less than 12 weeks pregnant, this may be the preferred method of abortion.

Here is what you can expect from a vacuum aspiration procedure at AHB:

  • At American Hospital Bangalore, Vacuum aspiration is the most preferred method of abortion by foreign women. This is because it is a gentle and painless procedure not lasting more than 3-10 minutes.
  • The abortion is performed under anaesthesia making it absolutely painless.
  • Since the procedure is small, you will be discharged the same day in an hour or so, after which you can take a rest in your hotel and return the next day.
  • The most satisfying thing is that since the abortion is carried out by a highly qualified and internationally trained abortion team, the procedure is nearly 100% efficient. Hence, you can have the confidence of a complete abortion unlike the medical method of abortion which is less efficient and can keep you waiting for up to a week before the confidence of a complete abortion.

Complications with vacuum aspiration method of abortion:

Though the procedure is entirely gentle, it needs to be performed only by the registered medical practitioners who have received training for performing these medical procedures. Untrained and non-professionals may not carry out the procedure with precision leading to complications of incomplete abortion.

There are many chances of pelvic and other kinds of infections associated with unsafe abortion procedures.

The Advice: You may opt for a Gentle care abortion procedure at a certified abortion clinic only.

Dilatation and Evacuation (D&E) method of abortion:

It is the surgical abortion procedure recommended by the WHO for terminating late-stage pregnancies, i.e., the ones that have progressed beyond 12 weeks but are still in the legally permissible age of 20 weeks.

In this method, the uterine perforation is done and all the gestation products are removed by scraping off the uterine lining and embryo removed.

Here is what to expect for a woman from Bhutan from a D&E procedure of abortion at AHB:

  • At AHB, D&E abortion is done by specially trained doctors and with precision which makes the procedure nearly 100% efficient.
  • The abortion is performed under anaesthesia and hence is a gentle and painless procedure.
  • The procedure takes not more than 30 minutes and you can expect to get conscious in just a little time after the procedure.
  • You will be discharged the same day, after which you can relax in your hotel room and return the next day or as and when scheduled.
  • You will receive complete care before, during and after the abortion to help you recover soon.

Complications with the D&E method of abortion:

Since the procedure is invasive, there are chances of internal injury, haemorrhage and other complications which can put a woman’s physical health, reproductive health, mental health and even life in danger.

Hence, the procedure must be performed only at a registered and certified abortion clinic by the gynaecologists/doctors who have received the necessary qualification and desired training to perform surgical procedures.

The advice: At AHB, the abortion team has extensive experience besides all of them being highly qualified in their respective domains. Furthermore, they are all internationally trained.

If your gestation length is beyond 12 weeks and the doctor considers D&E to be the best method of abortion for you, then you may consider choosing the best MTP centre where you can avail a safe, legal and confidential abortion.

You may consider scheduling an appointment at AHB which shall be the earliest possible date to avoid any delay. At AHB, your health is in safe hands. Furthermore, your abortion details and your personal details all are safe. According to the hospital’s non-disclosure policy, all your details will be kept safe.

Now, you know your best options as to how you can avail a safe, legal and confidential abortion. Hence, never resort to an unsafe method of abortion. It can adversely impact your health and life.

For any unaddressed or personal queries, feel free to call the helpline number at AHB where you will receive complete guidance and comprehensive abortion care that starts pre-abortion and lasts until complete recovery.

Related links:

  1. Safe, Confidential and Legal Abortion in India
  2. Unwanted pregnancy – what are your options in India?
  3. Post-abortion care for rapid and safe abortion recovery
  4. How is Gentle Care Abortion different from surgical abortion at any abortion clinic?
  5. How to choose where to get a safe, legal and confidential abortion in India?