India: A country of contrasts when it comes to abortion

A recent paper by Kirti Iyengar, Sharad D Iyengar and Kristina Gemzell Danielsson in the Lancet, entitled “Can India transition from informal abortion provision to safe and formal services?”, discusses the fact that although abortion was legalised in India in 1972, several barriers continue to prevent women from accessing safe services, especially in rural areas. These range from skewed distribution of facilities, mainly found in urban areas, the high cost of services, provider-related barriers such as denying women the choice between medical and surgical abortion, and insistence on husband’s consent even though the law does not require it. Moreover, Indian women have shown an overwhelming preference for medical abortion, but providers may refuse to offer it.This paper argues there is evidence that women are increasingly seeking abortion services from informal providers or chemists as a result of these barriers. The annual sales of mifepristone and misoprostol in India are estimated at 11 million doses, while reported abortions number only 700,000. This difference may be due to under-reporting of medical abortion by formal providers, and widespread provision of the pills by informal providers. Of 577 chemists surveyed in 2008, 80% admitted providing mifepristone and misoprostol, but they had little information on accurate dosage, eligibility, or side effects.Sweeping amendments have been proposed to the abortion law in India, including certification of awider range of providers, in line with the new WHO guidelines, but doctors’ professional associations have been vehemently opposed so far. The authors argue that even within the confines of existing law, practice needs to change to make medical abortion widely available to meet demand, which means overcoming senior provider resistance to change, addressing cost issues, and much more.SOURCE: Lancet, June 2016, Open AccessHowever, if you are from countries like UAE, Dubai, Qatar, where abortion is illegal, you have a lot of money and you need an abortion, there are private clinics inviting you to come to India!! A quick website search for “abortion clinics India” turned up (among others) a website topped with a photo of a white Western couple asleep, offering abortion help at the Vibha Family Hospital in Mumbai, with a video about “Mary” who appears to be in the second trimester, found the hospital advertisement online, booked and chose the “VIP Package”, which included visa arrangements, flight to India with her partner, being collected at the airport, a “cosy double deluxe room” in the hospital, surgical abortion with general anaesthesia the next day, overnight stay and travel home.SOURCE/VISUAL/VIDEO: Abortion in Mumbai India, accessed 1 July 2016