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Are Abortions Really On The Decline In India?

The available numbers could be telling only part of the truth.

17/05/2017 6:34 PM IST | Updated 17/05/2017 7:25 PM IST
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HAZIPUR, INDIA - APRIL 6, 2010: Babita Devi 23 yrs and husband bharat prasad with two kids going for abortion as she decides for come to a clinic and not goverment hospital as she wants cleanlyness and safety of her as priority and not money on April 6, 2010 in Hazipur, India. (Photo by Priyanka ParAshar/Mint via Getty Images)(Photo by Priyanka Parashar/Mint via Getty Images)

An RTI query has revealed that for the first time in this decade, the number of abortions in Mumbai has fallen. But are abortions on the decline in the country as a whole?

"Going by the data that we have from the Ministry of Health and Family Welfare (MoHFW), the trend has show an increase in abortions," says Poonam Muttreja, Executive Director of the Population Foundation of India. MoHFW data shows that despite a general declining trend in the mid-2000s, there was an uptick in the last few years for which data was available.

"However, these numbers underestimate the actual incidence of abortion for several reasons," Ms. Muttreja said. For instance, she pointed out, they exclude abortions done by physicians who do not work in certified facilities, those performed by health professionals who do not have specific training or by untrained providers, and those using abortion pills without a prescription.

Another set of data comes from women themselves, through household surveys. Based on this data, nationally, the abortion rate — the number of abortions for every 100 pregnancies — has been on the decline. While data on abortion from the latest round of the National Family Health Survey is not yet available, data from the District Level Health Survey shows that abortion rates declined in most states in the period between 2007-08 and 2012-13.

Nationally, in 2014, 1.7% of all pregnancies in rural areas and 3.1% in urban areas resulted in an abortion, according to the National Sample Survey Office. This is a globally low number; the United States, for instance, has an abortion rate that is close to 15%.

Abortion rates in India were highest among women under the age of 20 in urban areas — 13.6% of pregnancies in that age group — but this wasn't the case in rural areas where early marriages mean fewer premarital and/or unwanted pregnancies. There was no clear relationship between income or caste of the woman's family and the likelihood of an abortion.

There is in all probability under-reporting of abortion on account of the stigma attached to it, the NSSO says. The relatively higher rate of reported "spontaneous abortions" as compared to "induced abortions" could be on account of the reporting of abortions as miscarriages, India's District Level Health Survey found in 2007-8. Twice as many spontaneous abortions as induced abortions were reported in that survey. "Women in the age group 15-19 years, Jain and from the highest quintile of wealth index reported relatively higher levels of spontaneous abortion," the survey stated. "In addition, women who reported more induced abortion belonged to the 35-39 years age group, had 10 or more years of schooling and were the highest wealth quintile."

Abortion remains highly restricted in India. The governing law, the Medical Termination of Pregnancy Act (1971), permits abortions before 12 weeks of pregnancy by a registered medical practitioner or before 20 weeks of pregnancy with the approval of two registered medical practitioners, but only if the mother or child's mental or physical health is in danger. A slightly more liberal amendment is under consideration, but still does not allow abortion if the woman simply wishes to terminate the pregnancy. Just last week, an HIV positive rape survivor was denied an abortion by the Supreme Court in India because she was 26 weeks pregnant, having lost crucial weeks to the legal process.

13% of married women still report an unmet need for contraception according to the latest National Family Health Survey, and female sterilisation remains the overwhelming mode of contraception in India.

Abortions Are On The Decline In India But That's Not The Whole Story

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