Abortion in India
From Wikipedia, the free encyclopedia
Contents |
[edit] Abortion in India
The situation in India shows that legalizing abortion does not ensure that it becomes accessible. Legal abortion was introduced in 1971, when concern about burgeoning population growth became an issue for India.24 Although abortion is legal, it is estimated that four million Indian women a year still resort to illegal abortions because of social taboos, misconceptions about the law, and the lack of skilled practitioners and medical facilities.
Giving or taking prenatal tests solely to determine the sex of the fetus is being criminalized by the Indian parliament. Female children are still widely considered to be a social and financial liability in a country where the dowry system is still a part of marriage. The prenatal tests have been used to detect female fetuses, which are then aborted. Under Indian law, ending a pregnancy only because a fetus is female has already been outlawed, although the practice is common. Poor women who cannot afford the cost of either prenatal testing or abortion often resort to female infanticide.
Abortion became legal in India in 1971 in order to prevent overpopulation. However, this appears to have been unsuccessful as India now has 1.1 billion people and is the second most populus country in the world, after China. In 1994, under pressure from a coalition of activists, the Indian government changed course, outlawing the use of ultrasound machines to reveal fetus gender. In 2002, the penalties were stiffened: up to three years in jail and a $230 fine for the first offense and five years imprisonment and $1,160 for the second.
[edit] Statistics
Abortions are a major cause of maternal morbidity and mortality in India.Because most of the abortions are not reported and the sex selective abortions are carried out secretly the statistics of abortions in Indiais of varying reliability. The available statistic is grossly in adequate as the hospitals keep records of only legal and reported abortions.
[edit] Number of abortions in India
According to the Consortium on National Consensus for Medical Abortion in India, every year an average of about 11 million abortions take place annually and around 20,000 women die every year due to abortion related complications. In the following table Number of abortions reported includes legal reported induced abortions.[1]
| Year | 1972 | 1975 | 1980 | 1985 | 1990 | 1995 | 2000 |
| Number of abortions reported |
24300 | 214197 | 388405 | 583704 | 581215 | 570914 | 723142 |
[edit] Abortion by selection of gender
The Lancet study seemed to confirm that laws were not deterring families from sex selection. By analyzing national birth records and fertility histories from a 1998 Indian government survey of 1 million households, the study estimated that at least 500,000 female fetuses in 1997 were aborted. Based on that one year, they came to the 10 million figure. The study also found that families whose first child was a girl were 30 percent less likely overall to produce another girl. And if the mothers had at least a 10th-grade education, the gap was twice as large as that for illiterate mothers. having gender-based abortions have been illegal since 1994.
[edit] Female abortion
A lot of people in India are turning more towards abortion for girls because In India, there are less than 93 women for every 100 men in the population. The accepted reason for such a disparity is the practice of female infanticide in India, prompted by the existence of a dowry system which requires the family to pay out a great deal of money when a female child is married. For a poor family, the birth of a girl child can signal the beginning of financial ruin and extreme hardship. Which then they choose to have an ultrasound so they can make sure if they are having a male or female. The implication is that by avoiding a girl, a family will avoid paying a large dowry on the marriage of her daughter. According to UNICEF, the problem is getting worse as scientific methods of detecting the sex of a baby and of performing abortions are improving. Experts say that sex-selective abortions in India reduced the number of girls per 1,000 boys from 945 in 1991 to 927 in 2001.
[edit] MTP
In order to prevent the misuse of induced abortions, most countries in the world have created strict abortion laws and so has India. As per India’s abortion laws only qualified doctors, under stipulated conditions, can execute an act of abortion on a woman in a clinic or a hospital that has been approved of doing so. The Indian abortion laws fall under the Medical Termination of Pregnancy (MTP) Act, which was enacted by the Indian Parliament in the year 1971. The MTP Act, however, came into effect from April 1st, 1972 and was once amended in 1975. The Medical Termination of Pregnancy (MTP) Act of India clearly mentions the conditions under which only a pregnancy can be ended or aborted, the persons who are qualified to conduct the abortion and the place of implementation.
[edit] Indications for early medical abortion
[edit] General condition to be fulfilled
All women coming to a health facility seeking termination of pregnancy up to 7 weeks period of gestation (49 days from the first day of the last menstrual period in women with regular cycle of 28 days) provided the following aspects have been assessed and found appropriate:[2]
- frame of the mind of patient and her acceptability of minimum three follow-up visits
- ready for surgical procedure if failure or excessive bleeding occurs
- family support
- permission of guardian in case of minor as per MTP Act 1971*easy access to appropriate health care facility
Only registered medical practitioners as prescribed by the MTP Act are authorized to prescribe mifepristone with misoprostol for medical abortion (Definition 2(d) of section 2 and MTP rule 3). Mifepristone with misoprostol for termination of early pregnancy not exceeding seven weeks, may be prescribed by a registered medical practitioner as prescribed under section 2 (d) and rule 3, having access to a place approved by the Government under section 4 (b) and rule (1), for surgical and emergency back-up when such a back-up is indicated. This may include primary health care-clinic or hospital-based set-up. Initial workup, counseling, prescription and administration could be in a clinic or in the consulting room. Home administration of misoprostol may be advised at discretion in certain cases with an access to 24-hours emergency services.
[edit] Choice between Medical and Surgical Abortion
- Vacuum Aspiration (Suction evacuation) is the most commonly-used method for termination of early pregnancies. However, being a surgical technique, it is associated with risks of infection, perforation of uterus, incomplete abortion and post-procedure uterine synechiae formation (Asherman’s Syndrome).
- The success of abortion with drugs depends on multiple factors including the regimen used,dosage schedule, route of administration and gestational age. However, after counseling, the woman should be allowed to make an informed decision.
- Mifepristone with misoprostol is favourable if pregnancy is = 7 weeks.
- Surgical abortion is preferred if patient desires concurrent tubal ligation.
- If a woman fulfills the criteria for selecting either method, final choice to be given to the woman.
[edit] Contraindications for medical abortion
Where a pregnant woman has a serious medical disease and continuation of pregnancy could endanger her life. Indian MTP act lay a clear guideline under which medical abortion is contra indicated
[edit] Contraindications due to Medical Reasons
- smoking > 35 years
- anemia – hemoglobin < 8 gm %
- suspected /confirmed ectopic pregnancy / undiagnosed adnexal mass
- coagulopathy or women on anticoagulant therapy
- chronic adrenal failure or current use of systemic corticosteroids
- uncontrolled hypertension with BP >160/100mmHg
- cardio-vascular diseases such as angina, valvular disease, arrhythmia
- severe renal, liver or respiratory diseases
- glaucoma
- uncontrolled seizure disorder
- allergy or intolerance to mifepristone / misoprostol or other prostaglandins
- lack of access to 24-hours emergency services.
[edit] Psycho-social situations
This include the cases when
- women unable to take responsibility
- anxious women wanting quick abortion
- language or comprehension barrier
- not willing for surgical abortion in case of failure
[edit] References
- ^ Historical abortion statistics, India Historical abortion statistics, India
- ^ Guidelines for Medical Abortion in India
Katz , Neil S. Abortion in India: Selecting by Gender. 20 May 2006. 1 Jan. <http://www.washingtonpost.com/wp-dyn/content/article/2006/05/19/AR2006051901219.html>. Abortion, Femal Infanticide.. 3 Jan. 2003. 1 Jan. <http://www.indianchild.com/abortion_infanticide_foeticide_india.htm>.
