At least one in every four abortions in India was performed by the woman herself at home, whereas almost half of the women said the main reason for seeking an abortion was an unplanned pregnancy, government data for 2019-21 analysed by CNN-News18 shows.
The data also shows that the share of abortions performed by the woman herself at home has increased by one per cent from the last analysed period of 2015-16.
“More than one-quarter (27 per cent) of the abortions were performed by the woman herself at home,” the National Family Health Survey-5 (NHFS-5) report said adding that the practice of abortion at home is much more common in rural areas (28.7 per cent) than in urban (22.1 per cent).
Further, a doctor is the most preferred person who performed the abortion (in 55 per cent cases). It is followed by the woman herself (in 27 per cent cases).
“Almost half of the women (48 per cent) said that the main reason for seeking an abortion was an unplanned pregnancy, followed by her health didn’t permit continuing her pregnancy,” it added.
Also, at least 10 per cent of women reported that the last child was too young to have the next birth as the main reason for the abortion.
Public vs private
As per the NHFS-5, a majority of the abortions were performed in the private health sector (53 per cent), whereas 20 per cent were performed in the public health sector.
According to NFHS-4, a majority of the abortions were performed in the private health sector (52 per cent) and 20 per cent were performed in the public health sector. More than a quarter (26 per cent) of the abortions were reportedly performed by the woman herself at home during 2015-16.
How states have performed
In Uttar Pradesh, India’s most populous state, the highest number of abortions (34 per cent) were performed by self, followed by doctor and nurse/auxiliary nurse midwife (ANM)/lady health visitor (LHV) (about 30 per cent each). The two main reasons for seeking abortion reported by women were unplanned pregnancy (50 per cent) and complications in pregnancy (14 per cent).
Most of the abortions were performed at home (39 per cent) and in the private health sector (38 per cent). Another 24 per cent were performed in the public health sector.
In Rajasthan, most abortions were performed by self (38 per cent). This was followed by a doctor (36 per cent). The three main reasons for seeking abortion reported by women were unplanned pregnancy (61 per cent), complications in pregnancy and health did not permit (6 per cent each).
In Delhi, the two main reasons for seeking abortion reported by women were unplanned pregnancy (74 per cent) and complications in pregnancy (5 per cent). Further, nearly half (49 per cent) of abortions were performed in the private health sector and 16 per cent were performed in the public health sector. Also, over half of the abortions (54 per cent) in Delhi were carried out by a doctor.
In Tamil Nadu, the two main reasons for seeking abortion reported by women were health did not permit (31 per cent) and unplanned pregnancy (30 per cent). A large majority (65 per cent) of abortions were performed in the private health sector and 26 per cent were performed in the public health sector. Most abortions (80 per cent) in Tamil Nadu were performed by a doctor.
Unsafe abortion is a significant yet preventable cause of maternal death. Even as the medical termination of pregnancy (MTP) has been legalised in India since 1971, access to services is still a challenge, especially in the rural and remote regions of the country.
Further, the maternal mortality ratio (MMR) for India is 130/100,000 live births. Unsafe abortions account for 8 per cent of the MMR. Many of those who survive these clandestine procedures often suffer from chronic, debilitating diseases that have a bearing on the future reproductive health of the woman.
While there are several policies around safe abortion, lack of awareness that abortion is legal and is available in the health facilities is among the most common reasons for which women put their lives at risk.
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