Why India needs to address the silence around safe abortion

Orthodox social norms, conflating laws and social stigma have made conversation around abortion a taboo in Indian societies. To improve women's autonomy at the community level, they need to be made aware of safe, legal sources, and society needs to learn non-judgemental ways to handle the issue

Updated: Mar 15, 2023 05:31:39 PM UTC
Abortion is still a taboo topic in many parts of the country, especially in rural India, and individuals may face social stigma and shame if they seek abortion services. Image: Shutterstock

Abortion is a much-debated topic, and everyone seems to have their own perspective, often without keeping the pregnant person at the centre. While India has one of the progressive amendments to the abortion law, the information does not seem to have percolated. The Indian context is quite complicated. It is rooted in orthodox social norms, conflating laws, social stigma, and taboos. Abortion seekers here not only have to navigate the social norms, but they also have to scour for factually correct information.

The hurdles towards getting a non-judgemental safe abortion service are still very many. The Medical Termination of Pregnancy (MTP) Act of 1971 was amended, for the first time in 50 years, in 2021 with some progressive provisions. However, it remains a medicalised law that does not fully prioritise women's rights.

Despite the changes, the lack of awareness about the legality of abortion in India persists. This lack of awareness emphasises the need for safe sources of information to be easily accessible and highlights women's autonomy at the community level.

A survey conducted by the Foundation for Reproductive Health Services India pointed out that, despite the amendment to MTP Act 1971, 95 percent of Indian women were unaware of the legal conditions under which abortion could be availed. More importantly, the maximum gestation period being raised from 20 to 24 weeks under ‘special circumstances' was also not known to abortion seekers. This shows there are gaps when it comes to awareness of sexual and reproductive health rights despite India being called ‘progressive’ compared to many Western countries. To back this up, there are studies published in the Lancet Global Health which state that unsafe abortions account for 13 percent of maternal deaths in India. Moreover, 78 percent of abortions among adolescents are unsafe and carry a high risk for complications. Additionally, two million adolescent Indian women have an unmet need for modern contraception, such as pills.

In such a scenario, one of the most significant barriers to accessing safe and legal abortions is the lack of reliable information available to women. When individuals seek an abortion, they usually contact their allies or local doctors.

In many cases where a support system isn’t available, women may turn to unsafe methods of terminating a pregnancy because they are unaware of their legal options or don’t have access to reliable healthcare facilities.

Many individuals also don’t receive comprehensive sexual education, which may include information about contraception and safe abortion practices. This lack of education can lead to misinformation and misconceptions about abortion.

Then, abortion is still a taboo topic in many parts of the country, especially in rural India, and individuals may face social stigma and shame if they seek abortion services. This can lead to a reluctance to discuss information about abortion.

Now, despite being legal under ‘special circumstances’, there are still restrictions around abortion in the country. This can lead to serious health complications such as incomplete abortion, infections, haemorrhages or death.

To ensure women have access to safe and reliable information on abortion, we must address the root causes of this information gap. This includes addressing the stigma surrounding abortion and providing comprehensive sex education to young people. In addition, it is essential to ensure that healthcare providers, including ASHA workers, are trained to provide non-judgmental, unbiased information on abortion. Women should also have the access to a range of healthcare options, including contraception and safe abortion services.

Also Read- Women's rights: The decline and the fight back

It is essential to understand that abortion is legal in India under certain circumstances, including if the pregnancy poses a risk to the woman's physical or mental health; if the pregnancy is the result of rape or incest; or if there is a foetal anomaly. For this reason, the role of technology in providing safe sources of information cannot be overstated.

In today's digital age, women have access to a wealth of information through mobiles, TV, and social media, but the quality and accuracy of this information can vary widely. This is where online resources such as telemedicine and mobile applications can play a crucial role in providing women with safe and reliable information on abortion. These resources can provide women with information on their legal options, help them find safe and legal healthcare providers, and even provide support during and after the abortion procedure.

While the recent amendment to the MTP Act 1971 is a step in the right direction towards ensuring safe and legal abortions, this will not be a success if women are uninformed about their rights.

The National Family Health Survey (NFHS) shows that around three percent of total pregnancies in India end up in abortions. One can only hope that these three percent are carried out safely and legally. Moreover, over a quarter (27 percent) of all abortions in India are performed by women themselves in their homes, according to NFHS – 5.

So what should be done? Central and State governments must build the capacity of medical service providers such as doctors and frontline workers and sensitise them on abortion. They should invest in means to spread the information through posters and pamphlets and utilise digital apps like WhatsApp and Facebook for awareness building.

It's time for our society and lawmakers to acknowledge this reality and take concrete steps towards creating an environment where women can make informed choices about their bodies without fear of stigma, judgement, or harm.

The writer is a Gender Specialist working with Foundation for Reproductive Health Services India.

The thoughts and opinions shared here are of the author.

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