by Priyanka Yadav, Gajendra S. Meena1, Rajesh Kumar1, Nandini Sharma1
Community Medicine, AIIMS Nagpur, Maharashtra,1 Community Medicine, MAMC, New Delhi, India
SOURCE: Indian Journal of Community Medicine, 2025;50:147-53. Open access journal.
Abstract
Background: Abortions in India are increasing despite the laws to legalize them. Many abortions are conducted through unsafe practices and are underreported. To determine the prevalence of abortions in women of a reproductive age group in a rural area of Delhi and to determine associated factors.
Methodology: A cross‑sectional study was conducted among married women in the reproductive age group residing in Barwala village, Delhi/NCR. An interview schedule was used to interview 315 women, and information was obtained for socio‑demography, use of contraceptives, medical history, and history of abortions. Chi‑square and Fisher’s exact test were used for analyzing the association of abortions with other variables.
Results: Of all 315 women, 47% had a history of one or more abortions. Of all pregnancies (n = 953), 25.6% ended in abortions (n = 244). Of the total number of abortions reported, 60.7% (n = 148) were induced, while 39.3% (n = 96) were spontaneous.
Of induced abortions, only 35% were safe, while 65% were unsafe abortions. Age of mother, age at marriage, history of contraception use, and gender of first child were significantly associated with abortions. However, no significant association was found with socio‑economic status, education, and occupation of women and their spouses. Only 1.3% women knew that abortions are legal in India.
Conclusion: A high proportion of women are going for induced abortions, of which a greater proportion is that of unsafe abortions. There is also lack of knowledge about the legalisation of abortions in India.
Background: Globally, nearly 25% of all pregnancies end in abortions, both spontaneous and induced. It is estimated that 14.9% of all maternal deaths are caused by abortions. While the abortion rates have been declining in the developed countries, they are on the rise in developing countries. Spontaneous abortions which occur due to complications during the pregnancy are commonly termed as miscarriages, but when deliberate steps are taken to end a pregnancy, it is termed as induced abortion. According to WHO, every year in the world, there are an estimated 40–50 million induced abortions. (continues)
Association of abortions with other factors
Table 1 shows the association of socio‑demographic factors with history of abortions. Age group (30–39 years), age at marriage (>18 years), gender of first child (female), and history of use of contraceptives (never used) were significantly associated with history of abortions.
History of contraceptive use
Of all the study subjects, 68.6% (n = 216) reported to have never used any method of contraception. The most common reason for not using contraceptives was willingness to conceive in 26.4% (n = 57) of the women followed by lack of knowledge in 24.5% (n = 53). Nearly 13.4% (n = 29) said they had experienced discomfort and side effects on prior use and so preferred not using it, 12% (n = 26) said they had heard about various side effects from others and were apprehensive to use, and 11.1% (n = 24) were planning for tubal ligation once their family was complete. The rest 12.5% (n = 27) of the participants said that they did not feel the need to use contraception because they were having lactational amenorrhea or were abstaining from sex or were not living with their husbands. Of the women who wished to conceive, 33.3% (n = 19) clearly stated that they desired for a male child and would continue to conceive till they have a male child….
In the present study, the majority of induced abortions were by means of medications, while only a few had to go for surgical methods. A few women had used some indigenous method as home‑made remedy…. The greatest number of abortions in the current study took place at a gestational age of 8 weeks or less…. More than half of all induced abortions in the present study were unsafe as they were performed by unskilled personnel and/or in unskilled facility….
Most of the women who induced abortions by self were able to access the medicines from over the counter. Furthermore, history of first child being a female is also significantly associated with history of abortions, indicating a strong preference for male child.