India must shift the discourse on abortion rights

News: Recently, two women public health practitioners who have studied and worked in India and the United States have voiced their solidarity with women in both countries for their abortion rights..

Abortion Statistics

Global

According to the WHO, 6 out of 10 of all unintended pregnancies end in an induced abortion. Around 45% of all abortions are unsafe, and around 97% take place in developing countries.

India

According to the National Family Health Survey 2019-2021, 3% of all pregnancies in India result in abortion.

More than half of abortions in India are performed in the private sector, whereas only 20% are performed in the public sector because public facilities often lack abortion services.

Around 27% of abortions are performed by the woman herself at home. Around 73% of these were medication abortions. Another 5% of all abortions done outside of health facilities were done with methods other than medication abortion.  Most of these abortions were illegal as per the MTP Act.

A recent study found that sex-selective abortions in India could lead to 6.8 million fewer girls being born between 2017 to 2030.

Obstacles

The MTP Act 1971 and then amended in 2021 makes ‘medical termination of pregnancy’ legal in India under specific conditions. The Act primarily protects medical practitioners as “induced miscarriage” is a criminal offence under the Indian Penal Code (IPC).

What are the issues?

The acceptance of abortion in Indian society is situated in the context of population control and family planning.

Many women face a lack of access, systemic barriers, social norms and cultural preferences, and even criminal liability. Therefore, many women continue to die due to unsafe abortions.  As per a 2014 study, abortions account for 10% of maternal deaths in India.

After more than 50 years of the MTP Act, women and transgender persons face major obstacles in accessing safe abortion care because

First, most of them are not even aware that abortion is legal or know where to obtain one safely;

Second, the MTP Act does not recognise abortion as a choice. There is a lack of choice and bodily autonomy of women. The decision of abortion is solely decided by the approval of medical professionals even in the first few weeks of the pregnancy;

Third, The Act mentions only ‘pregnant woman’. It fails to recognise that transgender persons and others can also become pregnant.

Fourth, unmarried and transgender people continue to face stigma and can be turned away from health facilities, forcing them to resort to unsafe care;

Fifth, mandatory reporting requirements under the Protection of Children from Sexual Offences Bill (POCSO), 2011 against child sexual offences, impact privacy and hinder access of adolescents to safe abortion services;

Sixth, many are still coerced into agreeing to a permanent or long-term contraceptive method as a prerequisite for getting abortion services;

Seventh, health-care providers may impose their own morality. They may insist on ‘husbands’ or ‘parental’ consent for abortion.

Eighth, despite laws prohibiting sex determination, the illegal practice persists. The unregulated ultrasound clinics have mushroomed in India. They continues to facilitate the illegal practice of sex determination, resulting in unsafe abortions and female foeticide.

Way Forward

There is an urgent need for a perspective from an abortion for the purpose of a family planning and maternal health to an abortion which is done on the basis of a sexual health and reproductive rights.

India must amend the law and raise the bar on reproductive justice. In addition, the health systems should be improved to provide good quality and respectful abortion care.

Reproductive injustice anywhere is a threat to the lives of people everywhere.

Source: The post is based on an article “India must shift the discourse on abortion rights” published in the “The Hindu” on 26^th May 2022.