NFHS Findings - Does It Really Show The Complete Picture On Safe Abortions?

The NFHS 5 data is no doubt useful for serving as a basis of policy formulation but it should be read being mindful of its limitations. While we celebrate improvement in the country’s fertility, increased sex ratio what does the data say on Safe Abortions?

When it comes to sexual and reproductive rights, India is one of progressive countries with the most liberal legislation, however, it does have its restrictions. A progressive Medical Termination of Pregnancy (MTP) Act that upholds a woman’s autonomy and choice is the need of the hour. As we are well aware that the current Act in existence is conditional, as it is an exception to the IPC Section 312 that criminalises abortion, also called induced miscarriage, in any form, except for saving the woman’s life and does not recognise women’s agency to exercise their reproductive rights. The social stigma associated with abortion juxtaposed with scarcity of knowledge about woman's rights, has resulted in several harrowing incidents. Women’s rights often take a backseat, even when they remain at a higher risk of death and morbidity.

The fifth round of the National Family Health Survey (NFHS-5), released by the Ministry of Health and Family Welfare, shows an overall improvement in the country’s fertility, increased sex ratio, family planning, and health parameters, there are areas of concern with regard to safe abortion data which remains inadequate. This signifies that we are completely missing one important point. Different parameters about how abortions are sought, which states had maximum abortions cases, how many abortion seekers went to court, and why and where were denials from the provider’s side for providing abortion services have been completely missing from NFHS findings since a long time. What the data does capture are the characteristics of abortion. NFHS-5 reports are yet to be released, however, as per NFHS-4 report, 10% of all pregnancies preceding the survey resulted in abortion, miscarriage, or stillbirth. While abortions accounted for 3%, miscarriage accounted for 6% of the total pregnancies, a common type of non-live birth. The survey findings might also be indicative of the inaccessibility, as although the abortion rate remains low at 2.7% among 15-19 years old pregnant women, more than 10% result in miscarriage. Also, the report pointed out that more than 26% of the abortions were performed by the woman herself at home and 19% women reportedly had complications from the abortion, leaving us room for questions worth pondering upon.

While abortions accounted for 3%, miscarriage accounted for 6% of the total pregnancies, a common type of non-live birth. The survey findings might also be indicative of the inaccessibility, as although the abortion rate remains low at 2.7% among 15-19 years old pregnant women, more than 10% result in miscarriage.

In India, where abortion has been legal since 1971, people still need more awareness with regard to the legalities of abortion practices. There are a lot of gaps that need to be filled. As per a legal report by Pratigya Campaign, a coalition civil societies and activists, in (May 2019 – August 2020) there were 243 cases covered over 15 months in High Courts and one appeal before the Supreme Court. Moreover, June 2016 – April 2019 covered a total of 175 cases before the High Courts over three years. From the 243 cases which were before the various High Courts, two were appeals from the order of a Single Judge before the Division Bench. This emphasises the need for the law to stay up with the changing times. Access to safe abortion must become a legal right for pregnant persons within the first trimester. The opinion of the doctor that the pregnant person is consulting must be considered as primary and the only one required. The setting up of medical boards which has been done by the Courts while handling cases of this nature has only created further obstacles for pregnant persons in accessing safe and legal abortion.

Suggested Reading:

NFHS-5 Data Shows Drop In India’s Fertility Rate and Population Stabilising: Report

There is a need to read between the lines and analyse the data to understand the larger issues of access to safe abortion care and women’s rights, which at present remain largely untouched.

The true measure of success of the amendments would be to address and bridge the existing accessibility gap by creating robust mechanism for a smooth implementation. A lot of work remains to be done in terms of access, putting in place a rights-based approach, translating from paper to practice, behavioral change campaigns at different tiers to drive the message home.

Debanjana Choudhuri is a gender and climate justice expert, vocal about SRHR and energy access. The views expressed are the author's own.