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plus1\p@ minus1\p@ \parsep 2\p@ plus\p@ minus\p@ \itemsep 1pt} } \makeatother \fvset{frame=single,numberblanklines=false,xleftmargin=5mm,xrightmargin=5mm} \fancyhf{} \setlength{\headheight}{14pt} \fancyhead[LE]{\bfseries\leftmark} \fancyhead[RO]{\bfseries\rightmark} \fancyfoot[RO]{} \fancyfoot[CO]{\thepage} \fancyfoot[LO]{\TheID} \fancyfoot[LE]{} \fancyfoot[CE]{\thepage} \fancyfoot[RE]{\TheID} \hypersetup{citebordercolor=0.75 0.75 0.75,linkbordercolor=0.75 0.75 0.75,urlbordercolor=0.75 0.75 0.75,bookmarksnumbered=true} \fancypagestyle{plain}{\fancyhead{}\renewcommand{\headrulewidth}{0pt}} \date{} \usepackage{authblk} \providecommand{\keywords}[1] { \footnotesize \textbf{\textit{Index terms---}} #1 } \usepackage{graphicx,xcolor} \definecolor{GJBlue}{HTML}{273B81} \definecolor{GJLightBlue}{HTML}{0A9DD9} \definecolor{GJMediumGrey}{HTML}{6D6E70} \definecolor{GJLightGrey}{HTML}{929497} \renewenvironment{abstract}{% \setlength{\parindent}{0pt}\raggedright \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt \textcolor{GJBlue}{\large\bfseries\abstractname\space} }{% \vskip8pt \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt } \usepackage[absolute,overlay]{textpos} \makeatother \usepackage{lineno} \linenumbers \begin{document} \author[1]{Dr. Shaifali Patil} \author[2]{Dr. Nimain Mohanty} \author[3]{Dr. Nidhi Kurkal} \affil[1]{ Dept. of Obstetrics and Gynecology} \renewcommand\Authands{ and } \date{\small \em Received: 6 December 2012 Accepted: 5 January 2013 Published: 15 January 2013} \maketitle \begin{abstract} Medical Termination of Pregnancy is today treated as a convenient method of family planning. However the negative aspects have become more obvious in the following years. The desire for a male child exists in most sections of Indian society, irrespective of the socio-economic status which has reemphasized the misuse of MTP and the act. Aims and Objectives: To determine various criteria?s for termination of pregnancy in a tertiary health centre, the acceptance of contraception and the opinion of women on the legalization of prenatal sex determination. Materials and Methods: This was a cross sectional study conducted in MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India, including 200 patients who attended the OPD for MTP over a period of 1 year Discussion: Abortion has been and continues to be one of the most widely employed methods of fertility control in the world. A growing number of studies provide direct and indirect estimates of the incidence of sex-selective abortions ranging from 3-17% over different reference periods, i.e. two years preceding the survey to lifetime. Conclusion: Among the entire criterion, it was found that the effect of age, gravid status, parity and number of female offsprings significantly affected the reasons for termination of pregnancy. Aims andObjectives: To determine various criteria's for termination of pregnancy in a tertiary health centre, the acceptance of contraception and the opinion of women on the legalization of prenatal sex determination.Materials and Methods: This was a cross sectional study conducted in MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India, including 200 patients who attended the OPD for MTP over a period of 1 year Discussion: Abortion has been and continues to be one of the most widely employed methods of fertility control in the world. \end{abstract} \keywords{} \begin{textblock*}{18cm}(1cm,1cm) % {block width} (coords) \textcolor{GJBlue}{\LARGE Global Journals \LaTeX\ JournalKaleidoscope\texttrademark} \end{textblock*} \begin{textblock*}{18cm}(1.4cm,1.5cm) % {block width} (coords) \textcolor{GJBlue}{\footnotesize \\ Artificial Intelligence formulated this projection for compatibility purposes from the original article published at Global Journals. However, this technology is currently in beta. \emph{Therefore, kindly ignore odd layouts, missed formulae, text, tables, or figures.}} \end{textblock*} \let\tabcellsep& \section[{Introduction}]{Introduction}\par he most important social event in the lives of most people is the birth of their own child. Despite the advances in the modern world, even today, for many women in developing nations, the sole purpose and meaning of their existence is associated with motherhood. Societal goals of reducing poverty, maternal and infant mortality, unwanted births and abortions are all affected by control of fertility.\par Before the Medical Termination of Pregnancy (MTP) Act, an unwanted pregnancy in both the rural as well as urban parts of the country was managed by resorting to illegal abortion, infanticide, or abandonment of the neonate. Medical Termination of Pregnancy has today become a way of life and unfortunately has been accepted worldwide as a convenient mode of temporary contraception. The Indian Parliament liberalized the abortion laws of the country due to the socio-economic necessity. MTP is a great social boon to women and their affected families as it does not destroy their social Authors ? ? ? ? ¥ §: MBBS, MD, DGO, Asso. Professor, Dept. of Obstetrics and Gynecology, MGM Hospital, Navi Mumbai. e-mails: patilshaifali@gmail.com, nimain.mohanty@gmail.com, nidhikurkal@gmail.com, borse.rama@gmail.com future as would otherwise happen in conservative societies.\par Patterns of sexual and reproductive behavior in India have changed significantly over the years. However, out of wedlock births are still considered a taboo. Family planning services were available long before the legalization of the MTP act in India. Although the community accepted these methods due to various government incentives, the awareness of contraception in the country in the lower classes of society and adolescents is yet to improve. With the MTP act being implemented, it was feared that it would be used as an alternative to family planning methods.\par MTP services are available today even in the most remote areas of the country. However the negative aspects became more and more obvious in the following years. The mentality of the desire for a male child existed in most sects of Indian society irrespective of the socio-economic state. The rates of sex selective abortions and female foeticide increased dramatically with the advent of ultrasonography. The Government thus introduced the Pre Conception and Pre Natal Diagnostic Techniques Act in 1994(PCPNDT) and made the prenatal ultrasound diagnosis of sex determination illegal.\par Unfortunately illegal MTPs and prenatal sex determination continues to be carried out widely by untrained and unlicensed hands in spite of the Government and social organizations efforts against this obnoxious practice. \section[{II.}]{II.}\par Aims and Objectives 1. To determine various criteria's for termination of pregnancy in a tertiary health centre. 2. To see the role of contraception as a method of or prevention of conception 3. To determine if termination is used as a mode of contraception 4. To determine if knowledge of foetal sex would have changed the decision to terminate pregnancy 5. To determine if sex of living issues affected the decision of termination of pregnancy 6. To know if sex determination was done in any one of their prior pregnancies 7. To know the patient's preference for sex determination The desire for a male child exists in most sections of Indian society, irrespective of the socio-economic status which has reemphasized the misuse of MTP and the act.\par Aims and Objectives: To determine various criteria's for termination of pregnancy in a tertiary health centre, the acceptance of contraception and the opinion of women on the legalization of prenatal sex determination.\par Materials and Methods: This was a cross sectional study conducted in MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India, including 200 patients who attended the OPD for MTP over a period of 1 year Discussion: Abortion has been and continues to be one of the most widely employed methods of fertility control in the world. A growing number of studies provide direct and indirect estimates of the incidence of sex-selective abortions ranging from 3-17\% over different reference periods, i.e. two years preceding the survey to lifetime.\par Conclusion: Among the entire criterion, it was found that the effect of age, gravid status, parity and number of female offsprings significantly affected the reasons for termination of pregnancy.\par 8. To know the effect of education, socio-economic status and marital status on contraception and opinion on termination of pregnancy if male/female child in utero.\par III. \section[{Materials and Methods}]{Materials and Methods}\par ? This was a study conducted in MGM Hospital, Kamothe, Navi Mumbai ? The study included 200 patients ? All the patients who attended outpatient services for MTP were included in the study ? This was a cross-sectional study ? The Stratified Random Sampling Method was used for patient selection All the patients who attended our outpatient services as well as the indoor patients who were admitted for MTP regardless of mode of contraception or no contraception after termination of pregnancy were selected. The selection criteria were not dependant on age, education, socio-economic status or marital status. In our study we found that financial reasons were the most common reason for termination of pregnancy overall. Among all parameters, the reasons for termination of pregnancy between 20-29 years of age, 36.1\% were financial followed by spacing, between 30-39 years as well as above 40 years of age was financial (48.4\%, 41.7\% respectively). Below the age of 20 years 40\% of the reason was due to rape and another 40\% was due to social reasons. Foetal anomalies accounted for only 0.3\% of all the pregnancies terminated. Comparing the gravid status, the subjects who were 3rd gravida had a maximum termination (40.4\%) followed by the 2nd gravida (29.4\%). Among primigravidas, 60\% of the subjects gave social reasons as the explanation for opting for MTP, 48.5\% for spacing in gravida 2, and for financial reasons in gravida 3, 4 and beyond (43.9\%, 49.3\% and 44.4\%). Primipara women mostly opted for MTP for spacing (45.1\%), 46.5\% and 57.7\% of second and third parity women gave financial reasons. In our study we found that age, gravid status as well as parity significantly affected the reasons she opted for medical termination of pregnancy. \section[{IV.}]{IV.} \section[{Observations and Statistical Analysis}]{Observations and Statistical Analysis}\par We also compared the acceptance of contraception and we found it to be significantly associated with the level of the patients education with 71.4\% of the subjects educated beyond the secondary level who accepted contraception as compared to 30.8\% of the uneducated subjects who did so. We also considered the opinion of all the women regarding legalization of sex related termination of pregnancy and the only parameter that was significant was parity with women who were primiparous maximally opined that they would opt for termination if the foetus was female in contrast with those with 3rd parity who were indifferent in 85.7\%.\par V. \section[{Discussion}]{Discussion}\par Abortion has been and continues to be one of the most widely employed methods of fertility control in the world1, 2. Today 6 out of 10 of the world's population live in countries where abortion is available 'on request' during the first trimester or where the language of the law encourages broad liberal interpretation. It was found that in cases of multiple repetitive abortions there was ambivalence towards contraception3. Pregnancy always is not synonymous with a desire for motherhood. It could be a neurotic expression full of guilt that shows that these women did not overcome a childish rivalry with their mothers.\par The first country to make abortions available for social reasons was the USSR in 19204. Gradually over the years abortion laws became more and more liberalized. In India, The Medical Termination of Pregnancy Act was enforced from 1st April 1972. Prior to this women resorted to illegal and unsafe methods to abort their pregnancies by unwarranted hands leading case of foetal anomalies which are incompatible with life, the act permits termination upto 20 week of gestation albeit only after the opinion of two qualified registered medical practitioners5,6. However access to safe abortion services remained limited for the vast majority of Indian women, particularly in rural areas. An overwhelming proportion of induced abortions (6.7 million annually as per indirect estimate7) take place in unauthorized centers, which provide abortion services of varying degrees of safety. Thus the act was amended on 2002 in which the authority for approval of registration of MTP centers has been decentralized from the state to the district level 8, 9. In the year 2003, the Government introduced a further amendment to MTP to a very high rate of morbidity as well as mortality due to the complications of septic abortions. The MTP act in India in a nutshell gives the liberty to every woman who is above 18 years and of sane mental constitution to legally opt for termination of pregnancy within 12 weeks of gestation on the grounds of failure of contraception, financial reasons, alleged rape, if the fetus is incompatible with life or if the pregnancy causes mental or physical anguish to the mother or in cases where the \section[{Conclusion}]{Conclusion}\par Our study revealed that factors like the woman's age, her gravidity, parity, the sex of her offsprings as well as the number of living issues she had significantly affected her decision and reasons for termination of her pregnancy. Education played a significant role in the acceptance of contraception of a woman whereas the number of living issues she had did affect her opinion on the legalization of sex determination antenatally. Adolescent pregnancy termination in Indian society was highly influenced by the marital status of the patient. As evident in the study, all the adolescent pregnancy termination were in those who were unmarried. The thirst of the male child continues to dominate our society. Even one living male child boosted the decision of termination of pregnancy in contrast to couples with only female issues who were hesitant to undergo an abortion.\par There was a marked increase in the percentage of contraceptive use by raising the standard of living with the help of proper education thus decreasing the incidence if termination of pregnancy as already evidenced in developed countries.\par The preference of a male child still prevails widely over most parts of the country leading to the obnoxious and illegal practice of female feticide. Financial instability is yet the commonest cause for medical termination of pregnancy followed by spacing.\par It is not one factor alone that determines the cause but a combination of factors which influence each other as well as drive a woman to opt to terminate her pregnancy.\par A growing number of community-and facility based studies provide direct and indirect estimates of the incidence of sex-selective abortions. A number of studies in different parts of India report a prevalence of sex-selective abortion ranging from 3-17\% over different reference periods, i.e. two years preceding the survey to lifetime23-26. Facility-based studies report a much higher prevalence, for example, two in five women with one or more daughters, but no living sons had had an abortion in a Patiala (Punjab, India) hospital27.\par The most common reasons for MTP is either financial or an unplanned pregnancy28. Several other studies indicate that most abortions are sought to limit family size or space the next pregnancy23, 24.\par The acceptance of contraception too has been found to be associated with the level of the woman's education as well as the previous number of male issues. If a male child was among the living issues, contraception was accepted and used earlier29. Fertility and contraceptive use in developing countries are associated with various markers of socioeconomic status, the most prominent of which is women's education30, 31; the well documented link between female education and use of contraception plays an important role in development of family planning policies in lower income countries.\par In parts of South Asia, and elsewhere, women have a considerably lower social status and autonomy than men31, 32, and their low status and autonomy seems to be associated with lower fertility control. Several reports showed a positive association between women's autonomy and contraception use33,34. Improving women's education has been seen one way to increase their status and autonomy, and it has been proposed that autonomy acts as a mediator of the link between education and contraception use 31, 35. According to WHO, in countries where contraception was widely available such as England and Wales, USA and the Netherlands, almost half of the abortions are in women less than 25 years of age whereas in those nations with no tradition of contraceptive use, and with limited availability of contraception, and sterilization, the women were above 35 years of age 21. A survey done in West Bengal, India22 revealed that the maximum number of MTPs was done in the age group of 25 -29 years\par The Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) (PNDT) Act that made antenatal sex determination and sex selective abortion illegal in India, was passed in 1994. It came into effect in 199617. Amendments have also been introduced in the PNDT Act of 1994 which was necessitated as the PNDT Act had failed to curb the practice of testing for sex determination and consequent sex-selective abortion in the country18. With the recent amendment to the PNDT Act, preconception and pre-implantation procedures for sex selection are banned in the country. The Amendment stipulates compulsory maintenance of written records by diagnostic centres/ doctors offering sonography service. Local authorities have also been given powers to ensure the enforcement of the Act19. However the sex ratio in India has continued to fall as Yet another obstacle faced was the sex discrimination in India. The desire for a male child is unfortunately yet very prevalent. With the practices of dowry among other things, a female child is supposed to be a burden to society whereas a male child is assumed to give security to the family10. This bias manifests as neglect of girls and women resulting in their early death 11, 12, 13, female infanticide 14, 15 and more recently, antenatal sex determination and female feticide16.\par Rules which has rationalized the criteria for physical standards of abortion facilities. \begin{figure}[htbp] \noindent\textbf{}\includegraphics[]{image-2.png} \caption{\label{fig_0}}\end{figure} \begin{figure}[htbp] \noindent\textbf{}\includegraphics[]{image-3.png} \caption{\label{fig_1}E}\end{figure} \begin{figure}[htbp] \noindent\textbf{}\includegraphics[]{image-4.png} \caption{\label{fig_2}}\end{figure} \begin{figure}[htbp] \noindent\textbf{1} \par \begin{longtable}{P{0.17509903791737408\textwidth}P{0.0014431239388794568\textwidth}P{0.05676287492925863\textwidth}P{0.1096774193548387\textwidth}P{0.066383701188455\textwidth}P{0.09524617996604415\textwidth}P{0.1452744765138653\textwidth}P{0.03655913978494624\textwidth}P{0.08370118845500849\textwidth}P{0.057243916242218446\textwidth}P{0.02260894170911149\textwidth}} \multicolumn{6}{l}{husband to terminate her pregnancy. The Act defines}\tabcellsep \multicolumn{5}{l}{pregnancy causes deterioration of the maternal physical}\\ \multicolumn{6}{l}{the place and the requirements of the medical}\tabcellsep \multicolumn{5}{l}{condition. A woman need not take the consent of her}\\ \multicolumn{6}{l}{practitioner who can terminate her pregnancy and in}\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ \multicolumn{3}{l}{Parameters 1}\tabcellsep 2\tabcellsep 3\tabcellsep 4\tabcellsep 5\tabcellsep 6\tabcellsep 7\tabcellsep 8\tabcellsep P\\ \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep Value\\ Age\tabcellsep \tabcellsep <20\tabcellsep 20-29\tabcellsep 20-29 yrs\tabcellsep 30-39\tabcellsep > 40 yrs\tabcellsep <20 yrs\tabcellsep 30-39\tabcellsep 20-29 yrs\tabcellsep 0.035\\ \tabcellsep \tabcellsep yrs\tabcellsep yrs\tabcellsep 12/233\tabcellsep yrs\tabcellsep 3/12\tabcellsep 2/5\tabcellsep yrs\tabcellsep 1/233\tabcellsep \\ \tabcellsep \tabcellsep 2/5\tabcellsep 79/233\tabcellsep (5.2\%)\tabcellsep 44/91\tabcellsep (25\%)\tabcellsep (40\%)\tabcellsep 2/91\tabcellsep (0.4\%)\tabcellsep \\ Gravid\tabcellsep \tabcellsep 1\tabcellsep 2\tabcellsep 3\tabcellsep 4\tabcellsep 3\tabcellsep 1\tabcellsep 3\tabcellsep 3\tabcellsep 0.0000\\ Status\tabcellsep \tabcellsep (60\%) 9/15\tabcellsep (48.5\%) 49/101\tabcellsep (6.5\%) 9/139\tabcellsep (49.3\%) 35/71\tabcellsep (23.7\%) 33/139\tabcellsep (20\%) 3/15\tabcellsep (2.2\%) 3/139\tabcellsep (0.7\%) 1/139\tabcellsep 235\\ Parity\tabcellsep \tabcellsep >3\tabcellsep 1\tabcellsep 2\tabcellsep >3\tabcellsep 2\tabcellsep 0\tabcellsep 1\tabcellsep 1\tabcellsep -7\\ \tabcellsep \tabcellsep 7/52\tabcellsep 55/122\tabcellsep 11/149\tabcellsep 30/52\tabcellsep 32/149\tabcellsep \tabcellsep 3/122\tabcellsep 1/122\tabcellsep \\ \tabcellsep \tabcellsep (13.5\%\tabcellsep (45.1\%)\tabcellsep (7.4\%)\tabcellsep (57.7\%)\tabcellsep (21.5\%)\tabcellsep \tabcellsep (2.5\%)\tabcellsep (0.8\%)\tabcellsep \\ H/o\tabcellsep \tabcellsep MTP\tabcellsep SA\tabcellsep MTP\tabcellsep MTP\tabcellsep SA\tabcellsep 0\tabcellsep SA\tabcellsep SA\tabcellsep 0.389\\ \multicolumn{2}{l}{previous abortions No. of male}\tabcellsep 3/33 (9.1\%) 2\tabcellsep 12/46 (26.1\%) 1\tabcellsep 3/33 (9.1\%) 1\tabcellsep 14/33 (42.4\%) 2\tabcellsep 12/46 (26.1\%) 2\tabcellsep 0\tabcellsep 2/46 (4.3\%) 1\tabcellsep 1/46 (2.2\%) 1\tabcellsep 0.079\\ offsprings\tabcellsep \tabcellsep 3/38 (7.9\%)\tabcellsep 55/185 (29.7\%)\tabcellsep 10/185 (5.4\%)\tabcellsep 20/38 (52.6\%)\tabcellsep 10/38 (26.3\%)\tabcellsep \tabcellsep 1/185 (0.5\%)\tabcellsep 1/185 (0.5\%)\tabcellsep \\ No.\tabcellsep of\tabcellsep >2\tabcellsep 1\tabcellsep >2\tabcellsep 2\tabcellsep >2\tabcellsep 0\tabcellsep 1\tabcellsep 0\tabcellsep 0.032\\ female offsprings Socio-\tabcellsep \tabcellsep 2/11 (18.2\% ) <1000\tabcellsep 54/174 (31\%) 1000-\tabcellsep 1/11 (9.1\%) <1000\tabcellsep 28/58 (48.3\%) <1000\tabcellsep 3/11 (27.3\%) 1500-\tabcellsep 1000-\tabcellsep 4/174 (2.3\%) <1000\tabcellsep >2000\tabcellsep 0.706\\ \multicolumn{2}{l}{economic Status (\$/year) Educational}\tabcellsep 4/15 (26.7\% ) Primary\tabcellsep 1500 29/93 (31.2\%) >Secon\tabcellsep 1/15 (6.7\%) >Seconda\tabcellsep 7/15 (46.7\%) Uneduc\tabcellsep 2000 26/123 (21.1\%) Primary\tabcellsep 1500 1/93 (1.1\%) Primary\tabcellsep 1/15 (6.7\%) Uneduc\tabcellsep 1/111 (0.9\%) Secondar\tabcellsep 0.121\\ Status Primary 10 th grade\tabcellsep -\tabcellsep 6/60 (10\%)\tabcellsep dary 5/11 (45.5\%)\tabcellsep ry 1/11 (9.1\%)\tabcellsep ated 78/169 (45.9\%)\tabcellsep 16/60 (25\%)\tabcellsep 2/60 (3.33\%)\tabcellsep ated 5/169 (2.9\%)\tabcellsep y 1/104 (1\%)\tabcellsep \\ \multicolumn{2}{l}{Secondary}\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ \multicolumn{2}{l}{-12 th grade}\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ \multicolumn{4}{l}{a) Acceptance of Contraception}\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{Table 2}\tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ \tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{Socio Economic}\tabcellsep Yes\tabcellsep No\tabcellsep \tabcellsep Total\tabcellsep \tabcellsep \\ \tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{Status (\$/annum)}\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ \tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{< 1000}\tabcellsep 5(55.6\%)\tabcellsep \multicolumn{2}{l}{4(44.4\%)}\tabcellsep 9(4.5\%)\tabcellsep \tabcellsep \\ \tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{1000-1500}\tabcellsep 19(33.9\%)\tabcellsep \multicolumn{2}{l}{37(66.1\%)}\tabcellsep 56(28\%)\tabcellsep \tabcellsep \\ \tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{1500-2000}\tabcellsep 28(36.8\%)\tabcellsep \multicolumn{2}{l}{48(63.2\%)}\tabcellsep 76(38\%)\tabcellsep \tabcellsep \\ \tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{>2000}\tabcellsep 33(58.9\%)\tabcellsep \multicolumn{2}{l}{23(41.1\%)}\tabcellsep 56(28\%)\tabcellsep \tabcellsep \\ \tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{Dependant on Parents}\tabcellsep 0\tabcellsep 3\tabcellsep \tabcellsep 3(1.5\%)\tabcellsep \tabcellsep \\ \tabcellsep \tabcellsep \tabcellsep Total\tabcellsep \tabcellsep 85(43.1\%)\tabcellsep \multicolumn{2}{l}{112(56.9\%)}\tabcellsep 200\tabcellsep \tabcellsep \end{longtable} \par {\small\itshape [Note: E Termination]} \caption{\label{tab_1}Table 1 :}\end{figure} \begin{figure}[htbp] \noindent\textbf{} \par \begin{longtable}{} \end{longtable} \par {\small\itshape [Note: p-0.099 (not significant) b) On the basis of educational status]} \caption{\label{tab_2}of Pregnancy in a Tertiary Hospital Setting, a Holistic Review of Various Factors}\end{figure} \begin{figure}[htbp] \noindent\textbf{3} \par \begin{longtable}{P{0.3032663316582914\textwidth}P{0.14095477386934674\textwidth}P{0.2221105527638191\textwidth}P{0.1836683417085427\textwidth}} Education\tabcellsep Yes\tabcellsep No\tabcellsep Total\\ \multicolumn{2}{l}{Uneducated 32(30.8\%)}\tabcellsep 72(69.2\%)\tabcellsep 104(52\%)\\ Primary\tabcellsep 19(46.3\%)\tabcellsep 22(53.7\%)\tabcellsep 41(20.5\%)\\ Secondary\tabcellsep 29(60.4\%)\tabcellsep 19(39.6\%)\tabcellsep 48(24\%)\\ \multicolumn{2}{l}{>Secondary 5(71.4\%)}\tabcellsep 2(28.6\%)\tabcellsep 7(3.5\%)\\ Total\tabcellsep 85(42.5\%)\tabcellsep 115(57.5\%)\tabcellsep 200\end{longtable} \par \caption{\label{tab_3}Table 3}\end{figure} \begin{figure}[htbp] \noindent\textbf{420} \par \begin{longtable}{P{0.2868189806678383\textwidth}P{0.16731107205623902\textwidth}P{0.14490333919156415\textwidth}P{0.17776801405975395\textwidth}P{0.07319859402460457\textwidth}} 120\tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ 100\tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ 80\tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ \tabcellsep \tabcellsep \tabcellsep \tabcellsep Column1\\ 60\tabcellsep \tabcellsep \tabcellsep \tabcellsep No\\ \tabcellsep \tabcellsep \tabcellsep \tabcellsep Yes\\ 40\tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ Uneducated\tabcellsep Primary\tabcellsep Secondary\tabcellsep >Secondary\tabcellsep \\ Would Terminate if\tabcellsep Female\tabcellsep Male\tabcellsep Indifferent\tabcellsep P Value\\ Gravid Status\tabcellsep 2\tabcellsep 3\tabcellsep 1\tabcellsep 0.129\\ \tabcellsep 26/59\tabcellsep 5/77\tabcellsep 10/10\tabcellsep \\ \tabcellsep (44.1\%)\tabcellsep (6.5\%)\tabcellsep (100\%)\tabcellsep \\ Parity\tabcellsep 1\tabcellsep 2\tabcellsep >3\tabcellsep 0.008\\ \tabcellsep 29/68\tabcellsep 5/83\tabcellsep 30/35\tabcellsep \\ \tabcellsep (42.6\%)\tabcellsep (6\%)\tabcellsep (85.7\%)\tabcellsep \\ No. of male\tabcellsep 1\tabcellsep 2\tabcellsep 2\tabcellsep 0.201\\ offsprings\tabcellsep 29/112\tabcellsep 2/20\tabcellsep 16/78\tabcellsep \\ \tabcellsep (25.5\%)\tabcellsep (10\%)\tabcellsep (80\%)\tabcellsep \\ No. of female\tabcellsep 2\tabcellsep >2\tabcellsep 2\tabcellsep 0.262\\ offsprings\tabcellsep 15/34\tabcellsep 1/6\tabcellsep 19/34\tabcellsep \\ \tabcellsep (44.1\%)\tabcellsep (16.7\%)\tabcellsep (55.9\%)\tabcellsep \\ Socio-economic\tabcellsep 1000-1500\tabcellsep >2000\tabcellsep 1500-2000\tabcellsep 0.335\\ Status (\$/year)\tabcellsep 23/56\tabcellsep 4/56\tabcellsep 53/76\tabcellsep \\ \tabcellsep (41.1\%)\tabcellsep (7.1\%)\tabcellsep (69.7\%)\tabcellsep \\ Educational Status\tabcellsep Primary\tabcellsep Uneducated\tabcellsep Secondary\tabcellsep 0.412\\ Primary -10 th grade\tabcellsep 16/35\tabcellsep 5/102\tabcellsep 39/57\tabcellsep \\ Secondary -12 th\tabcellsep (45.7\%)\tabcellsep (4.9\%)\tabcellsep (68.4\%)\tabcellsep \\ grade\tabcellsep \tabcellsep \tabcellsep \tabcellsep \end{longtable} \par {\small\itshape [Note: E Termination]} \caption{\label{tab_4}Table 4 0 20}\end{figure} \begin{figure}[htbp] \noindent\textbf{} \par \begin{longtable}{} \end{longtable} \par {\small\itshape [Note: VI.]} \caption{\label{tab_5}of Pregnancy in a Tertiary Hospital Setting, a Holistic Review of Various Factors}\end{figure} \footnote{© 2013 Global Journals Inc. (US) © 2013 Global Journals Inc. (US)} \footnote{© 2013 Global Journals Inc. (US)} \backmatter \begin{bibitemlist}{1} \bibitem[Potts et al. ()]{b34}\label{b34} \textit{Abortion Cambridge}, M Potts , P Diggory , J Peel . 1977. Cambridge University press. \bibitem[Chhabra and Nuna ()]{b28}\label{b28} \textit{Abortion in India: An Overview}, R Chhabra , S C Nuna . 1994. New Delhi: Veeremdra Printers. \bibitem[Chatterjee ()]{b19}\label{b19} M Chatterjee . \textit{A report on Indian women from birth to twenty}, (New Delhi) 1990. National Institute of Public Cooperation and Child Development. \bibitem[Khanna et al. ()]{b20}\label{b20} ‘Community based retrospective study of sex in infant mortality in India’. R Khanna , A Kumar , J F Vaghela . \textit{Br Med J} 2003. 327 p. . \bibitem[Constitution of India ()]{b26}\label{b26} \textit{Constitution of India}, 1971. 1971. \bibitem[Tietze (1974)]{b31}\label{b31} \textit{Demographic aspects of abortion, World population tribune}, C Tietze . August 1974. Bucharest, Romania. \bibitem[Gupta ()]{b24}\label{b24} ‘Explaining Asia's "Missing Women": A New Look at the Data’. M D Gupta . \textit{Population and Development Review} 2005. 31 p. . \bibitem[George et al.]{b21}\label{b21} \textit{From recognition back to denial?}, S George , Tamil Female Infanticide In , Nadu . \url{URLwww.hsph.harvard.edu/grhf-asia/suchana/0224/george.html} India. \bibitem[Chowdhary ()]{b9}\label{b9} \textit{General survey of maternal mortality, morbidity, complication and sequelae of MTP}, N N Chowdhary . 1999. (Published in Manual on MTP 'an update', ed 3) \bibitem[Government of India (GOI). The Medical Termination of Pregnancy (Amendment) Bill (Bill No. XXXV) ()]{b29}\label{b29} \textit{Government of India (GOI). The Medical Termination of Pregnancy (Amendment) Bill (Bill No. XXXV)}, 2002. \bibitem[Mallik ()]{b30}\label{b30} \textit{India -Recent Developments Affecting Women's Reproductive Rights. Centre for Health and Gender Equity (CHANGE)}, R Mallik . 2002. (References Références Referencias) \bibitem[Maureen et al. ()]{b2}\label{b2} \textit{International family planning perspectives}, J Maureen , U L Graham , Xij Xiping . 1998. 24 p. . \bibitem[Leidl PSilent springs: The tragedy of India's neverborn girls. The State of World Population 2005, the promise of equality: Gender equity, reproductive health and the millennium development goals United Nations Population Fund]{b22}\label{b22} \textit{Leidl PSilent springs: The tragedy of India's neverborn girls. The State of World Population 2005, the promise of equality: Gender equity, reproductive health and the millennium development goals United Nations Population Fund}, \bibitem[Cleland et al. ()]{b8}\label{b8} ‘Links between fertility regulation and the schooling and autonomy of women in Bangladesh’. J Cleland , N Kamal , A ; Sloggett , R Jeffrey , A Basu . \textit{Girls schooling, autonomy and fertility change in South Asia}, (New Delhi, Sage) 1996. \bibitem[Vander Tak (1975)]{b32}\label{b32} ‘Major Trends is recent abortion research’. J Vander Tak . \textit{Abortion research notes} May 1975. 4 (2) p. . \bibitem[Kunegal (2000)]{b33}\label{b33} \textit{Multiple voluntary Abortion, Gynaecologic, obstetrique and fertilite}, Tamian Kunegal , I . Feb 2000. 28 p. . \bibitem[Khokhar and Gulati ()]{b1}\label{b1} ‘Profile of Induced Abortions in Women from an Urban Slum of Delhi’. A Khokhar , N Gulati . \textit{Indian Journal of Community Medicine} 2000. 25 (4) p. . (Vols.) \bibitem[Malhotra et al. ()]{b11}\label{b11} ‘Realizing Reproductive Choices and Rights: Abortion and Contraception in India’. A Malhotra , S Parasuraman , L Nyblade . \textit{International Centre for Research on Women} 2003. ICRW. \bibitem[Fathalla ()]{b14}\label{b14} ‘Reproductive Health in the world: two decades of progress and the challenge ahead’. M F Fathalla . \textit{Reproductive Health: A Key to a brighter future}, J Khanna, Pfa Van Look, P D Griffin (ed.) (Geneva) 1992. p. . \bibitem[Jain and Editorial (2013)]{b15}\label{b15} ‘Sex selection and abortion in India’. Anita Jain , Editorial . \textit{BMJ} 2013. March 2013. (Published 25) \bibitem[George ()]{b23}\label{b23} ‘Sex selection/discrimination in India: contemporary developments’. S George . \textit{Reprod Health Matters} 2002. 10 p. . \bibitem[Oomman and Ganatra ()]{b25}\label{b25} ‘Sex selection: The systematic elimination of girls’. N Oomman , B R Ganatra . \textit{Reproductive Health Matters} 2002. 10 (19) p. 88. \bibitem[Myers ()]{b17}\label{b17} ‘Sex Selective Abortion in India’. Christine Myers . \textit{Global Tides} 2012. 6. \bibitem[Ganatra et al. ()]{b12}\label{b12} ‘Sexselective abortions: Evidence from a communitybased study in western India’. B R Ganatra , S S Hirve , V N Rao . \textit{Asia Pacific Population Journal} 2000. 16 (2) p. . \bibitem[Sahi and Sarin ()]{b0}\label{b0} ‘Son factor in family planning acceptance’. K Sahi , A Sarin . \textit{Journal of Obstetrics, Gynecology and Family Welfare} 1996. 2 (7) p. . \bibitem[Ghosh ()]{b18}\label{b18} ‘The female child in India: a struggle for survival’. S Ghosh . \textit{Bull Nutr Found India} 1987. 8 (4) . \bibitem[The Medical Termination of pregnancy rules 1975, Gazette of India Pt.II, Sec (1975)]{b27}\label{b27} ‘The Medical Termination of pregnancy rules 1975, Gazette of India’. \textit{Pt.II, Sec} October 1975. 3 (1) . \bibitem[Government Of ()]{b16}\label{b16} \textit{The Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Amendment Act (Act}, India Government Of . 2003. \bibitem[Khanna ()]{b13}\label{b13} ‘Traditions and reproductive technology in an urbanizing north Indian village’. S Khanna . \textit{Social Science and Medicine} 1997. 44 (2) p. . \bibitem[Elul et al. ()]{b10}\label{b10} ‘Unintended Pregnancy and Abortion: A Community-based Study in Rajasthan -Summary Report’. B Elul , S Barge , S Verma . \textit{Population Council} 2003. \bibitem[Fikree et al. ()]{b6}\label{b6} \textit{What Influences Contraceptive Use among Young Women in Urban Squatter Settlements of Karachi, Pakistan? International Family Planning Perspectives}, F F Fikree , A Khan , M M Kadir , F Sajan , M H Rahbar . 2001. 27 p. . \bibitem[Jejeebhoy and Sathar ()]{b5}\label{b5} ‘Women's Autonomy in India and Pakistan: The Influence of Religion and Region’. S J Jejeebhoy , Z A Sathar . \textit{Population \& Development Review} 2001. 27 p. . \bibitem[Riyami et al. ()]{b7}\label{b7} ‘Women's autonomy, education and employment in Oman and their influence on contraceptive use’. Al Riyami , A Afifi , M Mabry , RM . \textit{Reprod Health Matters} 2004. 12 p. . \bibitem[Castro ()]{b3}\label{b3} ‘Women's education and fertility: results from 26 Demographic and Health Surveys’. M T Castro . \textit{Studies in Family Planning} 1995. 26 p. . \bibitem[Jejeebhoy ()]{b4}\label{b4} \textit{Women's education, autonomy and reproductive behaviour: experience from developing countries Oxford}, S J Jejeebhoy . 1995. Clarendon Press. \end{bibitemlist} \end{document}