Report: 67% abortions in India unsafe, cause nearly 8 deaths every day

UNFPA has called the staggering number of unintended pregnancies in the world “a global failure to uphold a basic human right”.

“Globally, an estimated 257 million women who want to avoid pregnancy are not using safe, modern methods of contraception, and of them, 172
million women are using no method at all,” it says, adding that the current rate of 64 unintended pregnancies per 1,000 women means that roughly 6 per cent of the world’s women experience an unintended pregnancy each year.

“In many respects, unintended pregnancy can be seen as a cause and result of gender discrimination. It often occurs because of gaps in gender equality and agency,” it finds.

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More than 60 per cent of unintended pregnancies end in abortion, and more often than not, these abortions are unsafe – they make up one of the leading causes of maternal deaths and hospitalisation of women.

“An estimated 45 per cent of all abortions remain unsafe; they are also a public health emergency, hospitalising about seven million women a year globally, costing an estimated $553 million per year in treatment costs alone, and contributing to a significant share of all maternal morbidity and 4.7–13.2 per cent of all maternal deaths,” states the report.

Studies from India indicate unintended pregnancies are associated with lower maternal healthcare utilisation and poorer infant and maternal health outcomes.

Women between the ages of 15–19 are at the highest risk of dying from an abortion-related complication, the report adds.

The report also states 13 per cent of all young women (adolescents) in developing countries begin childbearing. Three-quarters of girls with a first birth at age 14 and younger had a second birth before turning 20, and 40 per cent of those with two births went on to have a third birth before turning 20. Half of the girls with a first birth between ages 15-17 had a second birth before turning 20.

For adolescent fertility in India, women in the 15-19 age group have 43 births per 1,000 women (NFHS-5, 2019-21), which declined from 51 during NFHS-4 (2015-16). A total of 23.3 per cent women aged 20-24 were married before age 18 (NFHS-5), with a decline of only 3.5 points from NFHS-4. The median age at first birth is 21 years, and 9.3 per cent of women aged 20-24 have given birth before 18 years.

The report points out that while teenage pregnancies in India have declined by 1 per cent, there is more that needs to be done.

The report states that both the Medical Termination of Pregnancy Act of 1971, and the Medical Termination of Pregnancy (Amendment) Act 2021, which expands the scope of the Act and provides impetus for safer abortions, are progressive and encouraging.

The NFHS 5 findings of increased contraception use across the country have been encouraging, with a 9 per cent jump in use of modern contraception methods between NFHS 4 and 5, the report says. However, it points out that female sterilisation as a method of contraception is at 37 per cent, and “is too high”.

The UNFPA has propounded that increasing access and use of modern contraceptive methods in India, as well as creating awareness especially among adolescent girls through sex education, is the only way to curb unintended pregnancies and unsafe abortions.

“If comprehensive sexuality education is not offered in her school, she may lack accurate information. Pregnancy may be her default option because she has few opportunities and choices in her life. Without a chance to finish her education, for instance, she may not see a reason to postpone childbearing,” says UNFPA.