In Focus

Stigma compounds the risk of unsafe abortion

By Manu Shrivastava

The stigma of abortion affects young girls and women, communities, medical practitioners, MTP providers, lawyers, activists, even grassroots workers. Largely stigmatised in urban and rural India, the taboo associated with abortion often prevents women from seeking safe and legal MTP services.

It stops them from talking about their experiences to guide other women. Out of fear and shame, women don’t even report malpractices and deficiency in services that are rampant in abortions given the ‘secrecy’ surrounding it. It is the single-most reason for the associated cost of an MTP escalating to exorbitant amounts owing to the hugely unregulated practice.

According to a study by The Lancet Global Health on the incidence of abortion and unintended pregnancy in India, an estimated 15.6 million abortions were performed in 2015. This means an abortion rate of 47 per 1,000 women aged 15–49, similar to the abortion rate in neighboring South Asian countries.

Of these, most of the abortions (81 per cent) were achieved using pills or drugs (medical abortion) obtained either from a health facility or another source; 14 per cent were performed surgically in health facilities (surgical abortion); the remaining 5 per cent were performed outside health facilities i.e using unsafe methods.

Despite a good abortion law in place, many vulnerable women continue with unwanted pregnancies or undertake unsafe abortion methods. A study published in the Indian Journal of Medical Ethics revealed that 10-13 % of maternity-related deaths are directly associated with botched-up abortions.

The law in India is progressive but societal perception and the stigma associated with abortion means lack of awareness and poor implementation of the law. The amendments seek to grant legal abortion on humanitarian, social, as well as therapeutic grounds.

It is not an uncommon sight - shady banners and placards to perform abortions at bus stops, public toilets, in dingy lanes and in obscure corners of the city. There are as many illegal options available as legal to perform abortions. Illegal facilities and availability of ‘unaccounted-for’ MTP pills at pharmacies pose grave threat to lives of girls and young women who, for multiple reasons, social and financial, cannot approach legitimate clinics or medical professionals.