Despite Legalization, High Rates Of Unsafe Abortion In India

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In 1971, India was among the first countries in the world to legalize abortion. The Medical Termination of Pregnancy (MTP) Act permits termination up to 12 weeks after consultation with one doctor and up to 20 weeks with the recommendation of two doctors. Rare exceptions are made after the 20-week mark with the approval of the Court, and only in dire circumstances, such as when the life of the mother is at stake.

Abortion is legal in India, but there are still high rates of unsafe abortion

But despite the fact that abortion has been legal for nearly half a century, most Indian women (about 75%) procure abortions outside of legitimate health facilities, and 50% of abortions performed in India are considered unsafe or risky.

If abortion has been legal for five decades, what contributes to the extraordinarily high number of unsafe procedures? The primary reason is that women are obtaining abortions outside of health facilities, usually procuring the abortion pill through an informal vendor. While the abortion pill is highly safe and effective when used correctly, many Indian women lack the proper information about how to have a medical abortion and what to do if complications arise. Additionally, as is the case in other countries where women get abortion pills outside of legal means, there is no way to guarantee that the pills they get are actually abortion pills.

Also, if complications do happen, many women are hesitant to visit a health facility because of the cultural stigmatization against women who have abortions. As Vinoj Manning of Ipas, a global safe abortion activist, explained about India’s attitude toward reproductive health: “As a culture and society, we refuse to talk openly abortion. So a woman who wants to terminate her pregnancy often has no one to turn to.”

Additionally, even women who do visit health facilities in India are often unable to receive reproductive health care, due to the severe lack of trained providers and proper equipment. Simply put, many health facilities do not have the infrastructure to provide reproductive health care. Women are then left with no choice but to obtain an abortion through nontraditional means, which sometimes leads to unsafe procedures.

Finally, the MTP Act itself is problematic in that restricting abortion to up to 20 weeks means many women who discover their pregnancies late have to obtain abortions illegally. In India, this is especially true for young rape survivors who often do not realize they’re pregnant until after the 20-week mark. In 2017, a 10-year-old rape survivor was infamously denied an abortion by the Indian Supreme Court, since she was past the 20-week mark and enough doctors believed the 10-year-old would “survive” the labor and birth.

But for reproductive health advocates who want to increase access to abortion in India, there was a glimmer of hope in a 2017 Supreme Court decision that a woman’s right to make reproductive health choices falls under a constitutional guaranteed fundamental right to privacy. It is unclear how this decision will affect access to reproductive health services in India, but many advocates see it as a step in the right direction.

Preventing unsafe abortion in India by sharing reliable information

Health advocates in India see increasing the availability of information and communication about abortion as a potent solution that can empower women to safely terminate their pregnancies—inside or outside a healthcare facility. Specifically, women in India need accurate, comprehensive information about medical abortions and how to take the abortion pill. HowToUse recognizes this need and will continue to provide information to women in India and other countries about how to safely and effectively terminate pregnancies with the abortion pill.

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