Abortion in India under #LockDown

Worldwide, each year, there are approximately 50 million abortions. At least one-in-five of these is performed in India.

Lancet IndiaA recent report in The Lancet indicates an estimated 15 million abortions across India in 2015, and of these about 75%, ~11 million, were medical abortions (MA) procured and administered outside of health facilities.

The law governing abortion in India is similar to that in GB, (or at least it was up until March 30th, 2020).

Abortion in India is covered under the Medical Termination of Pregnancy Act 1971 and the Medical Termination of Pregnancy (Amendment) Act 2002. These Acts state that abortion is legal if performed to save the life of a woman, or to preserve her physical or mental health, or in the case of fetal abnormality. Medical abortion is legally permitted. The law stipulates that any abortion can only be provided by a registered medical practitioner working in either a national hospital or in an appropriately approved facility. By implication, and as noted in the Lancet report, provision of MA by a pharmacist, or procurement online and self-administered by a woman is illegal.

India has yet to make any change to legislation to permit remote abortion consultations, as has now been granted in GB, #AbortionAtHome.

As noted above, each day in India approximately 30,000 women have been procuring, illegally, their own self-managed abortion. #StayHomeSaveLives is now affecting this. Clinics are no longer providing abortion services, which is the same as in GB.

There are no officially mandated remote abortion services, unlike GB, and of course women are not allowed to leave their homes, so are unable to procure the abortion pills at a local pharmacy.

@Hidden_Pockets hosted a tweetchat today to discuss access, or lack of it, to essential Sexual and Reproductive Health products and services during the lockdown across India. The lockdown there is much tighter than here, and enforced by police and the army, so it is scary and risky for a woman to go out alone, even more so for those who are young and unmarried. There are growing concerns about lack of access to and availability of sanitary pads, condoms, oral contraception, and emergency contraception and the abortion pills.

SRHR organisations are calling on governments everywhere to change legislation, to:

  • Classify safe abortion and contraception as essential
  • Allow remote access, e.g. with #telemedicine
  • Remove unnecessary waiting times
  • Permit pharmacies to provide services.

There seems to be a strong public health, harm reduction, case for making such changes, for all countries to follow GB’s lead and to permit, for a limited time, #AbortionAtHome. Though such a significant change will not be welcomed by all, and its impact deserves to be closely monitored and evaluated.

 

About Kevin Duffy

Interim Management and Consulting - Healthcare Development. Kevin has thirteen years senior management experience in the development and delivery of healthcare services in Africa and South Asia.
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