RASHTRIYA ASHOK MANCH provides need based affordable clinical services to the community across 11 states in the country through its 31 comprehensive Reproductive Health (RH) Care service clinics. The services are recognised by the concerned district officers in the state. Clinics are accredited and doctors empanelled for sterilization procedures. All clinics are also approved under the Medical Termination of Pregnancy Act.
1. COUNSELLING: Counselling is the key component of service delivery provided at all the clinics through competent counsellors, based on the client’s need. It enables and assists them in making the correct choices according to their need and achieve their reproductive health goals, covering a wide range of RH care.
The emphasis is on children by choice, birth spacing, safe sex and fertility awareness, infertility management, early detection of cancer etc.
2. GYNAECOLOGICAL CONSULTATIONS:
a) General Gynae Problems: There is a need for our young girls and women to come out of the “culture of silence” associated with women’s reproductive health issues. To manage various minor gynaecological problems associated with menstrual cycle/bleeding, pain, infection etc, consultations with experts are available in all clinics.
b) Reproductive Tract Infections (RTI) / Sexually Transmitted Infections (STI) management: Services for prevention, diagnosis and treatment of the clients (both female and male), including their follow up care is provided in the clinics.
c) Pre-menopausal & Menopausal gynae problems: Many older women may face problems associated with their menstrual cycles. Consultations are available in Special clinics for women between 40-45 years (pre-menopausal) & 46-60 years (menopausal) to manage these issues.
d) Adolescent – Sexual & Reproductive Health problems: Special clinics dedicated to adolescents and the youth with emphasis on knowledge about sexuality and reproduction, safe sex to prevent STI and unwanted pregnancy, address their Reproductive Health issues etc.
3. ABORTIONS: All the clinics provide Medical Termination of Pregnancy (MTP) safely up to 20 weeks, both medical abortion (abortion with medicines) and surgical abortion by following set standards and latest techniques, assuring full confidentiality of the clients. However, Sex Selective Abortion is not done at any of the clinics. All clinics perform abortions mostly as a day care procedure with assured privacy and confidentiality All clients opting for abortion are fully counselled, screened medically, which is then followed by the basic laboratory tests.
The procedure is carried out by competent doctors, using the method acceptable to her and which is also appropriate. Post-procedure, clients are offered/administered the contraception of their choice which they would have voluntarily accepted prior to the procedure. Free of cost follow-up for any complaint or problem is offered to the clients for 42 days.
The various procedures by which abortions are carried out in RASHTRIYA ASHOK MANCH are as follows:
a) Medical Abortions: Medical Abortion, i.e. abortions with medicines, is offered under medical supervision in all RASHTRIYA ASHOK MANCH clinics. It is a safe procedure if done under medical supervision. It avoids surgical intervention and general anaesthesia. Medical Abortion is done within 63 days of missing a period by giving two abortion inducing drugs orally on day 1 and 3. In about 5% of cases, it may not be successful and may require evacuation by about 5% of cases, medical abortion may not be successful and the woman may require surgical aspiration (EVA). In such cases, EVA is provided by RASHTRIYA ASHOK MANCH clinic, free of cost.
b) Surgical Abortions: The uterus is emptied by Manual Vacuum Aspiration (MVA), a suction method or by surgical evacuation with instrument (EVA/D&E). The procedure can be done under local or sedation anaesthesia. General anaesthesia may be given in some cases. It is done as a day care procedure in almost all cases.
4 . MANAGEMENT OF INCOMPLETE ABORTIONS: Incomplete abortions, which may have occurred naturally or may be the result of a failed medical abortion initiated elsewhere, are also managed at all the RASHTRIYA ASHOK MANCH clinics. Incidences of incomplete abortions after women having taken pills without medical supervision, has now become rampant. All RASHTRIYA ASHOK MANCH Clinics currently treat a large number of women who present themselves with incomplete abortions after self initiated abortions. Often, their condition is not good. There is a need for women and their families to be aware that medical abortions done without medical supervision can have serious and life threatening consequences.