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Feature Women’s health

Unsafe abortion: why restricting abortive drugs only makes a bad situation worse

BMJ 2013; 346 doi: (Published 31 May 2013) Cite this as: BMJ 2013;346:f3159
  1. Meera Kay, freelance journalist, Bangalore
  1. meerakay{at}

Most abortions carried out in India are unsafe, and the pace of improvement is slow. So why is access to safe abortive drugs so restricted? Meera Kay reports

Abortion is legal in India but access to safe abortion facilities remains a distant dream for ordinary Indian women. Instead, women who seek abortion encounter stigma, discrimination, and rejection. The social taboo attached to rape, domestic abuse, and sex outside marriage can result in unwanted pregnancy and leave women in need of a confidential abortion service. In most cases providers are untrained and practise unsafe abortion methods. Many women do not know how to find a safe abortion provider. Poverty and illiteracy also cause women to seek unsafe abortions.

Persistent problem

Data from government statistics on family welfare in India record that 620 472 abortions took place in 2010-11 at approved institutions.1 These data report a low incidence of abortion among Indian women. The Consortium on National Consensus for Medical Abortion in India—a national association of gynaecologists, non-governmental organisations, and policy makers—say that these numbers are gross underestimates because hospitals record only legal and reported abortions.2

Accurate data on the number of unsafe abortions conducted in India do not exist because it is done clandestinely by untrained individuals or by the pregnant women themselves.

Only two fifths of abortions in India are considered safe.3 A study on illegal abortion in rural areas, conducted by the Indian Council of Medical Research (ICMR) found that more than twice as many illegal abortions occurred as legal ones (13.5 v 6.1 per 1000 pregnancies).4

Associated maternal mortality

Suchitra Dalvie, gynaecologist and coordinator of Asia Safe Abortion Partnership and CommonHealth, highlights how women’s access to safe abortion is severely restricted in India. “According to the Consortium on National Consensus for Medical Abortion in India, every year about 11 million …

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