Despite Being Legal Indian Women Don't Have Access To Safe Abortion; Why?

The fact that abortion in India is legal under various circumstances is commendable. Legalising abortions means that women have access to safe abortions and do not have to resort to unsafe abortions or harmful at-home abortions. While the United States fights for the right to abortion, India has been taking steps towards more progressive abortion rights. So why aren’t more women in India having legal abortions and resorting to at-home abortions?

Abortion has been legal in India since 1971 through the Medical Termination of Pregnancy (MTP) Act, yet it is still stigmatised and considered to be taboo.

The National Family Health Survey 2019 -21 reported that 27 per cent of abortions were performed at home by the woman herself. In rural areas, 28.7 per cent of abortions are conducted at home and in urban areas, 22.1 per cent of abortions are conducted at home.

What Are The Barriers To Safe Abortion?

Unsafe abortions are a leading cause of maternal death that can be avoided. Even though abortion has been legal for more than 50 years, scarce access to treatments serves as a roadblock to safe abortions.

A report using data from 2015 said that an insufficient number of facilities offering abortion care, shortage of equipment and supplies, lack of certified staff, lack of knowledge among women regarding abortions, and the stigma surrounding abortions served as barriers to abortions.

The report was focused on data from the states of Assam, Madhya Pradesh, Bihar, Gujarat, Uttar Pradesh, and Tamil Nadu. A majority of the facilities in the states turned away at least one woman who was seeking to terminate her pregnancy a year before the survey was taken.

• 22 to 53 per cent of the facilities reported that they turned away a woman because the provider considered them too young, they were unmarried or had no children.
• 8 to 21 per cent of the facilities refused treatment as the woman did not have the consent of her husband or a family member.

These reasons are not legal grounds for denying an abortion in India. If a woman is above 18 years of age, then only her consent is required for an abortion. Written consent from a guardian is required for an abortion if the woman is below the age of 18.

Stigma Surrounding Abortions And Its Affect

A majority of the women use ‘abortion pills’ to terminate their pregnancy. Under the Medical Termination of Pregnancy Amendment (MTPA) Act, the medication can be legally prescribed.

Even though obtaining the pills is legal, many ‘abortion pills’ can be obtained from chemists or informal providers directly without a prescription. This leaves the women to conduct an unsafe abortion without accurate and reliable information about the administration of the pills or post-abortion care.

Confusion about the status of abortion’s legality combined with stigma leads to women going outside the health care system to get abortions. The confusion regarding the process of abortions and the importance of post-abortion care can lead to maternal death.

The lack of information about abortions and facilities for abortions means that even though abortion is legal in India, more than one-fourth (27 per cent) of the women seeking to terminate their pregnancy. Abortions are so stigmatised in society that women would rather put themselves at risk by carrying out an unsafe abortion at home rather than face the stigma of getting an abortion.

Unsafe Abortions In India

55 per cent of abortions are performed by doctors, and 27 per cent of abortions are performed by the woman herself. Why are so many women taking abortion into their own hands and not consulting doctors?

As pharmacies and chemists continue to hand out abortion pills without requiring a prescription, many women put their privacy over their health and attempt unsafe abortions at home. Unfortunately, they are unaware of the side effects caused by the pill and do not know the appropriate time to take the pill.

Going to a doctor or gynaecologist might lead to family members asking questions that a woman does not wish to answer. If a woman wishes to get an abortion and believes that her family and relatives might judge her or disapprove, she may believe that the risk of being found out by going to a doctor is too great. Instead, an unsafe abortion using an easily accessible pill may feel like the right choice.

Abortions require after-care and medical supervision, and the stigmatisation of abortions leads to women risking their health for the sake of privacy and not being judged.

While India should celebrate its progressive laws regarding abortions, it's also imperative that the public is informed about the laws and that abortion is destigmatised. Only then unsafe abortions can be stopped and maternal deaths can be reduced.

Views expressed are the author's own

Suggested Reading: 27 Percent Of Abortions In India Done At Home, What Makes Indian Women Take Such A Risk?