Global Perspectives on Abortion Access: Challenges in India and the United States
The Current State of Abortion in India
75% abortions in India happen in homes, according to a study led by researchers from the Mumbai-based International Institute of Population Sciences. The study, published in the reputed journal The Lancet Global Health, has found that in 2015, half of the 48·1 million pregnancies in India were unintended. Of these, 15·6 million pregnancies ended in abortions. Most abortions were found to occur outside health facilities using drugs, whereas 64% of all facility-based abortions were surgical.
Most of these abortions were by women obtaining medical abortion drugs from chemists and informal vendors without prescriptions. Even where trained providers exist, most do not give women a choice of options, whereas data from studies have shown that women overwhelmingly prefer medical abortion.
Barriers to Formal Healthcare Services
Social taboo, lack of abortion facilities and trained manpower are some of the reasons that limit access to abortion services in India. The barriers that continue to impede women’s access to safe abortion services within the formal health-care system include:
- A shortage of number of trained providers.
- Legal impediments.
- Lack of privacy and confidentiality.
- Insistence on specific contraception as a precondition for providing abortion services.
Furthermore, over-medicalised service delivery protocols are in use for medical abortion, which is approved for use only up to 9 gestational weeks in India.
India Pregnancy and Abortion Data (2015)
| Category | Statistics |
|---|---|
| Total Pregnancies | 48.1 million |
| Unintended Pregnancies | ~24 million (Half of total) |
| Total Abortions | 15.6 million |
| Abortions Occurring in Homes | 75% |
Understanding Six-Week Abortion Bans in the United States
In the United States, some states are moving forward with even tighter restrictions. A six-week ban on abortion would be much more restrictive than it sounds, acting as a de facto ban for many. For many people, six weeks is early enough that they haven’t actually realized they are pregnant. To call it a six-week ban — it’s really a two-week window at best.
The pregnancy clock starts by counting back to the person’s last menstrual period. A typical menstrual cycle is 28 days, but many people have irregular periods. Those factors mean someone might not realize they are pregnant until 30 or 40 days, which is just shy of the six-week deadline.
Timing and Regulatory Frameworks
In 2018, the most recent year for which the Centers for Disease Control and Prevention has data, more than 92 percent of abortions took place at or by the 13th week. Almost 78 percent took place at or before nine weeks of pregnancy. According to these numbers, a six-week ban would prohibit the procedure at a point when almost two-thirds of people who would have sought an abortion haven’t yet terminated their pregnancy.
These laws don’t operate in isolation; they operate within a web of other restrictions. States that have passed six-week bans all have other restrictions in place, such as:
- Waiting periods: In Missouri, people must wait 72 hours, while Ohio, Kentucky, Texas, South Carolina and Louisiana enforce 24-hour waiting periods.
- Provider regulations: Requirements that the procedure only be performed by physicians who have admitting privileges at a nearby hospital.
- Financial barriers: Prohibiting insurance from covering abortion, which can cost upward of $400.
The regulatory burden has historically driven almost half of some states’ clinics to close, making it even harder to meet early deadlines.