The Changing Face of Reproductive Autonomy: Exploring Self-Managed Abortion Landscape in India through NFHS-5

Sushanta Banerjee, Ipas Development Foundation
Sumit Gulati, Ipas Development Foundation
Erin Pearson, Research Scientist

This study utilizes India's National Family Health Survey Round 5 (2019-2020) data from 724,115 women to estimate state-level self-managed abortion (SMA) rates following the World Health Organization's 2022 endorsement of medical abortion as a safe method. It examines SMA characteristics, trends over time, and associated complication rates in India using descriptive and multivariate analysis. This study finds that 29% of Indian women reporting induced abortions opted for self-managed abortion (SMA) using medical methods. It reveals significant regional disparities, with SMA rates higher in the eastern (45%), central (39%), and north-eastern (31%) regions. A rising trend in SMA increased from 19% in 2014 to 44% in 2020-2021. SMA prevalence was notably higher among economically disadvantaged, less educated, and employed women. The study found no increased risk of self-reported complications in SMA, indicating its safety and effectiveness, especially in early gestation. These findings underscore the importance of supporting reproductive choices, including access to quality drugs and information, while highlighting the continued relevance of provider-assisted care, particularly for surgical abortions and later gestational needs. This study offers crucial insights on self-managed abortion (SMA) for programmatic and policy advocacy while underscoring the need for more research in the SMA field.

Keywords: Sexual and Reproductive Health and Rights

See paper.