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CA - 0927
The Hindu journal in 2014, abortions account for 10% of
maternal deaths in India.
India must shift the discourse on abortion rights
Sonali Vaid, Sumegha Asthana, MAY 26, 2022 The recent round of the National Family Health
Survey 2019-2021, shows that 3% of all pregnancies
It is not just a family planning and maternal in India result in abortion. More than half (53%) of
health issue, but also a sexual health and abortions in India are performed in the private
reproductive rights issue sector, whereas only 20% are performed in the
public sector — partly because public facilities
As two women public health practitioners who often lack abortion services. More than a quarter
have studied and worked in India and the United of abortions (27%) are performed by the woman
States, we voice our solidarity with women in both herself at home.
countries at this precarious moment for abortion
rights. In another a fact-finding study published in The
Lancet in 2018, 73% of all abortions in India in 2015
Our public health journeys started with witnessing were medication abortions, and even though these
maternal deaths in India. One of us, on her first may have been safe — many of these are illegal as
clinical rotation, saw a woman die of sepsis, per the MTP Act, if they occur without the approval
infection in the blood, due to an unsafe backstreet of a registered medical practitioner. Another 5% of
abortion. And the other, during her rural health all abortions were outside of health facilities with
internship in Uttar Pradesh, witnessed a pregnant methods other than medication abortion. These
woman die on a wooden hand-pulled cart because risky abortions are performed by untrained people
she was unable to reach the hospital in time. The under unhygienic conditions using damaging
images of these two women with their swollen methods such as insertion of objects, ingestion of
abdomen and pale, dying faces still haunt us, as we various substances, abdominal pressure, etc. A
reflect on the privileges we enjoy as women recent study found that sex-selective abortions in
belonging to a certain class and caste in India. India could lead to 6.8 million fewer girls being
born between 2017 to 2030.
The facts
Women, pregnant people and transgender persons Many may be unaware of these disturbing
in India struggle every day to exert their choice statistics and facts. But we all know of at least one
about birthing and their bodily autonomy. Yet, adolescent girl among our family or friends or
despite this bleak reality, netizens on social media networks who had to travel to another city in order
in India claim that the country is more progressive to find a ‘non-judgmental’ obstetrician or who had
than the U.S. on abortion rights because we have to arrange money to access abortion in the private
the Medical Termination of Pregnancy Act, 1971 sector. Or, we may have heard of someone who has
(“MTP Act”). Such a self-congratulatory attitude is aborted a female foetus because the family wanted
neither in good faith nor is it factually correct. a son; or know of a mother who escaped the
pressure of such forced abortion because she did
According to the World Health Organization, six
not want to lose her pregnancy.
out of 10 of all unintended pregnancies end in
induced abortion. Around 45% of all abortions are
Obstacles
unsafe, almost all of which (97%) take place in
The MTP Act, first enacted in 1971 and then
developing countries. As per a nationally
amended in 2021, certainly makes ‘medical
representative study published in PLOS One
termination of pregnancy’ legal in India under
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specific conditions. However, this Act is framed sex determination, resulting in unsafe abortions
from a legal standpoint to primarily protect and female foeticide.
medical practitioners because under the Indian
Penal Code, “induced miscarriage” is a criminal It is a testament to class and caste divides when
offence. This premise points to a lack of choice and netizens talk of being ‘progressive’ when, 50 years
bodily autonomy of women and rests the decision after the MTP Act, women continue to die due to
of abortion solely on the doctor’s opinion. The MTP unsafe abortions. Passing one law and assuming
Act also only mentions ‘pregnant woman’, thus the job is done is far from “progressive” when so
failing to recognise that transgender persons and many face a lack of access, systemic barriers, social
others who do not identify as women can become norms and cultural preferences, and even criminal
pregnant. liability.
Moreover, the acceptance of abortion in Indian One law is insufficient
society is situated in the context of population There is an urgent need in our country to shift the
control and family planning. But, most importantly, discourse on abortions from just being a family
after more than 50 years of the MTP Act, women planning and maternal health issue to one of a
and transgender persons face major obstacles in sexual health and reproductive rights issue. The
accessing safe abortion care. situation in India shows that one law alone is
insufficient and we must raise the bar on
These are seven examples: First, they may not even reproductive justice. We must improve our health
be aware that abortion is legal or know where to systems to ensure good quality and respectful
obtain one safely; second, since the MTP Act does abortion care. As the focus on abortion rights in
not recognise abortion as a choice, they need the the U.S. rages, we call upon all to self reflect and to
approval of medical professionals even in the first stand in solidarity with people in the U.S. and other
few weeks of the pregnancy; third, unmarried and places where reproductive rights are in jeopardy.
transgender people continue to face stigma and Reproductive injustice anywhere is a threat to the
can be turned away from health facilities, forcing lives of people everywhere.
them to resort to unsafe care; fourth, mandatory
reporting requirements under the Protection of Dr. Sonali Vaid (@sonalivaid) is a physician and a
Children from Sexual Offences Bill (POCSO), 2011 public health professional. She is the founder of
law against child sexual offences, impact privacy Incluve Labs, an organization working to improve
and hinder access of adolescents to safe abortion the quality and safety of health care. She is a
services; fifth, many are still coerced into agreeing graduate of Harvard T. Chan School of Public Health
to a permanent or long-term contraceptive and is an Aspen New Voices Fellow. Dr. Sumegha
method as a prerequisite for getting abortion Asthana (@sumeghaasthana) is a physician and
services; sixth, health-care providers may impose health systems researcher. She is currently a
their own morality by insisting on ‘husbands’ or postdoctoral researcher at Georgetown University.
‘parental’ consent for abortion. Even women She holds honorary positions at the Institute for
seeking abortion care in health facilities are often Public Health Bengaluru, India and Queen Mary
mistreated and not provided medications for pain University, London. She is the co-founder of the
relief; seventh, despite laws prohibiting sex India chapter of Women in Global Health
determination, the illegal practice persists. The
mushrooming of unregulated ultrasound clinics in
India continues to facilitate the illegal practice of
Forum Learning Centre: Delhi - 2nd Floor, IAPL House, 19 Pusa Road, Karol Bagh, New Delhi - 110005 | Patna - 2nd floor, AG Palace, E Boring Canal Road, Patna,
Bihar 800001 | Hyderabad - 1st & 2nd Floor, SM Plaza, RTC X Rd, Indira Park Road, Jawahar Nagar, Hyderabad, Telangana 500020
9821711605 | https://academy.forumias.com | admissions@forumias.academy | helpdesk@forumias.academy
