OBJECTIVE Community based prospective study was carried out to know about the occurrence of miscarriages in context of Biomass fuel use by rural tribal, pregnant women. DESIGN Cross-sectional analysis. SETTING Villages and Dr. Sushila Nayar Hospital, Utavali, Melghat, Amravati Maharashtra. POPULATION Study in 100 villages, all pregnancies included. METHODS After approval of the institute’s ethics committee, study was conducted in 100 villages. After base information, villages were divided into 50 study, 50 controls, subdivided into 40 study villages with advocacy for protection from ill effects of Biomass fuel, 40 non-advocacy controls and 10 study villages where in addition to advocacy Chimneys were fixed on roofs of huts with no windows, for exit of smoke and 10 controls where neither advocacy was done nor Chimneys were fixed. MAIN OUTCOME MEASURES Change in occurrence of miscarriage with Biomass fuel use. RESULTS In 50 study villages, of 1005 pregnancies, 2.8% reported miscarriages and in 50 controls, of 1097 pregnancies 3.1% had miscarriage. Of 2700 pregnancies in 40 Advocacy study villages 6.6%, of 40 controls of 2700 pregnancies, 10.5% had miscarriages. In 10 villages with Advocacy as well as Chimneys, of 700 pregnancies, 2.4% had miscarriages in 10 controls, of 700 pregnancies 5.6% ended in miscarriages. In first year it could have been underreporting. CONCLUSION In rural tribal women miscarriages were not more than globally known, but Biomass fuel did affect occurrence of miscarriages.

ABSTRACT BACKGROUND Knowingcomplication, care sought is essential for understanding risks, services, program, policies for abortion care. MATERIAL METHODS Rural community based study was carried out in villages near Sewagram Wardha and Melghat, Amravati, Maharashtra, India. OBJECTIVE To know magnitude of abortion complications, care sought by rural tribal women. RESULTS In Sewagram villages 3.30%, in Melghat 0.32% reported complications with spontaneous abortions (SA) and 1% in Sewagram villages, 0.1% in Melghat with induced abortions (IA). In Sewagram villages of 24 (4.3%) who had complications of SA, 33.3% each (1.4% of SA)reported vaginal bleeding, abdominal pain, weakness 29.16%(1.2%SA),backache%(0.7% of SA),fever 12.5%(0.5% of SA),vaginal discharge 8.33% (0.3% of SA), other complications 8.33% (0.36% of SA). Of 7 (3.9% of all 177), who had complications after IA, 57.1% (2.2% of all IA) reportedvaginal bleeding, 28.5% (1.1% of IA) abdominal pain. In Melghat 4 reported complications after SA (0.32% SA), 2 (0.16 % SA), abdominal pain, one (0.08% SA) vaginal bleeding, one (0.08% of SA) backache.In Melghat of 2 women (3.7%) out of 27 IA cases who had complications. one had vaginal bleeding, discharge, pain,weakness, other vaginal bleeding. In Melghat2 of total 6 sought health facility care, no specialists in spite of complications. There was neither abortion related mortality nor near miss morbidity, severe morbidity. CONCLUSION Research is needed about traditional therapies, reverse pharmacology, socio behavioral issues in addition to creating awareness of abortion complications, long term sequlae, necessity of care seeking.