With a bulk of the women opting for abortion having pregnancy terminated outside health facilities, the Centre must consider bringing abortions under its health insurance programme, Ayushman Bharat, to improve institutional care for abortions and curb avoidable maternal deaths.
A recent WHO study in 36 countries finds that two-thirds of the sexually active women who wanted to avoid fertilisation didn’t opt for any method of contraception. This was mainly due to concerns over side-effects, “underestimation” of such methods where the women didn’t feel confident in a contraception route available, and other health concerns. The poor use of contraceptives has led to one in four pregnancies being unintended. Globally, 74 million women belonging to low- and middle-income households have unintended pregnancies annually, which results in 25 million unsafe abortions and 47,000 maternal deaths. WHO highlights unintended pregnancy as a major cause for miscarriage, malnutrition, illness, abuse, neglect, and deaths. The shocking figures underscore the need for making access to safe, modern family planning techniques easier, if maternal and child health is to be improved.
A 2018 Lancet study found that of 15.6 million abortions in India in 2015—the rate of abortion was 47 per 1,000 women aged 15-49 years—22% were in health facilities, 73% abortions were through medications outside of health facilities, while 5% were outside of health facilities and without medications. With a bulk of the women opting for abortion having pregnancy terminated outside health facilities, the Centre must consider bringing abortions under its health insurance programme, Ayushman Bharat, to improve institutional care for abortions and curb avoidable maternal deaths. While bringing abortions under a government programme will help get rid of the stigma attached, the latter will also need constant awareness efforts. The government must also work on increasing the awareness levels amongst frontline health workers to help push up use of contraception and bring down incidence of unsafe abortions. More important, efforts have to be made to get men to share the burden of contraception, else, the reproductive health and rights of women will be shortchanged.