Mapping the Landscape of Abortion Inequity in India: Trends over Two Decades from National Family Health Survey

Isha Sharma, Indian Institute Of Technology Jodhpur
Alok Ranjan, Indian Institute of Technology Jodhpur
Atul Pandey, Indian Institute of Technology
Anindita Dey, Indian Institute of Technology Jodhpur

Background: Abortion remains a contentious issue worldwide. In India, where social norms, gender dynamics, and healthcare infrastructure intersect, the incidence of abortions reflects pervasive inequities in access to reproductive healthcare services. Method: The study uses four rounds of National Family Health Survey (NFHS-2; 1998-99 to NFHS-5; 2019-21) in order to present a temporal trend that examines the inequity in abortion over last 20 years. Results: The results suggest that primary reason of abortion is reported to be unintended pregnancy (70.6%). The results highlight a decreasing trend in the proportion of livebirth during 2015-16 (90.2%) and 2019-21 (88.9%). Only 48% of induced abortions in rural areas were performed by doctors according to the NFHS fourth round (2015-16), and there was no change in this trend in the NFHS fifth round (2019-21). The women belonging to the poor quintile were 1.26 times [95% CI: 1.10-1.50; p<0.001] more likely to have unsafe abortions than the richest quintile. Conclusion: A large proportion of women in India continue to utilize unsafe abortions and the prevalence varied significantly by socioeconomic and demographic characteristics. In order to achieve the aim of “leaving no one behind”, sexual and reproductive health (SRH) services needs considerable improvement.

Keywords: Sexual and Reproductive Health and Rights, Inequality, Disadvantage and Discrimination, Civil Registration and Vital Statistics

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