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Sansad TV: The Global Debate- The Abortion Debate

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Introduction:

Around 36 million women across the United States are on the verge of losing their right to legal abortion. A draft document, leaked a couple of weeks ago, suggests that the Supreme Court has decided to overturn the 1973 Roe v. Wade decision which legalized abortion across the country. In this summary we will concentrate on Indian perspective and insights on it.

Family planning and maternal health

  • The recent round of the National Family Health Survey 2019-2021, shows that 3% of all pregnancies in India result in abortion.
  • More than half (53%) of abortions in India are performed in the private sector, whereas only 20% are performed in the public sector — partly because public facilities often lack abortion services.
  • More than a quarter of abortions (27%) are performed by the woman herself at home.
  • In another a fact-finding study published in The Lancet in 2018, 73% of all abortions in India in 2015 were medication abortions, and even though these may have been safe — many of these are illegal as per the MTP Act, if they occur without the approval of a registered medical practitioner.
  • Another 5% of all abortions were outside of health facilities with methods other than medication abortion.
  • These risky abortions are performed by untrained people under unhygienic conditions using damaging methods such as insertion of objects, ingestion of various substances, abdominal pressure, etc.

Indian Penal Code:

  • It says, voluntarily causing a woman with child to miscarry is an offence attracting a jail term of up to three years or fine or both, unless it was done in good faith where the purpose was to save the life of the pregnant woman.
  • A pregnant woman causing herself to miscarry is also an offender under this provision apart from the person causing the miscarriage, which in most cases would be a medical practitioner.

Medical Termination of Pregnancy (MTP) Act, 1971:

This law is an exception to the IPC provisions above and sets out the rules for accessing an MTP.

  • This law has been amended twice since, the most recent set of amendments being in the year 2021.
  • However, the law does not recognise and/or acknowledge the right of a pregnant person to decide on the discontinuation of a pregnancy.

Change in law:

  • Despite a sustained government push over years, contraceptive use in India is not very popular.
  • According to a 2018 study by the Guttmacher Institute, 50% of pregnancies in six of the larger Indian states — Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu and Uttar Pradesh — are unintended.
  • Data from the National Family Health Survey 4 show that just 8% of couples in the country use modern contraceptive methods; only 53% use any method at all.
  • It found that 55% pregnancies in Assam, 48% in Bihar, 53% in Gujarat, 50% in Madhya Pradesh, 43% in Tamil Nadu and 49% in Uttar Pradesh are unintended.
  • According to a 2016 study published in The Lancet by the Guttmacher Institute and the World Health Organization, an estimated 56 million abortions took place globally each year between 2010 and 2014.
  • In 2015, a study in The Lancet Global Health, also by Guttmacher Institute and IIPS, estimated that 15.6 million abortions were performed in India in 2015.
  • This translates to an abortion rate of 47 per 1,000 women aged 15-49, which is similar to the abortion rate in neighbouring countries.
  • The number of pregnancies ranged from 1,430,000 in Assam to 10,026,000 in Uttar Pradesh.
  • Estimation of unintended pregnancies is important because many of them result in abortions and the availability of cheap and safe abortion services is one of the indicators of a robust health system.

Conclusion

  • There is an urgent need in our country to shift the discourse on abortions from just being a family planning and maternal health issue to one of a sexual health and reproductive rights issue.
  • The situation in India shows that one law alone is insufficient and we must raise the bar on reproductive justice. We must improve our health systems to ensure good quality and respectful abortion care.
  • As the focus on abortion rights in the U.S. rages, we call upon all to self-reflect and to stand in solidarity with people in the U.S. and other places where reproductive rights are in jeopardy.
  • Reproductive injustice anywhere is a threat to the lives of people everywhere.