Abortion in India

Ground Realities

Leela Visaria, Vimala Ramachandran

• Publisher: Routledge India
• Year: 2020
• ISBN:
  9781000084153
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

India was a pioneer in legalizing induced abortion, or Medical Termination of Pregnancy (MTP) in 1971. Yet, after three decades, morbidity and mortality due to unsafe abortion remain a serious problem. There is little public debate on the issue despite several national campaigns on safe motherhood. Instead, discussion on abortion has mainly centred around declining sex ratio, sex-selective abortion, and the proliferation of abortion clinics in urban areas. Adding to the problem is that abortion continues to be a sensitive, private matter, often with ethical/moral/religious connotations that sets it apart from other reproductive health-seeking behaviour.

This book fills a gap in our understanding of the ground realities with respect to induced abortion in India to create an evidence-based body of knowledge. Using both quantitative and qualitative research methods, the case studies show why and under what circumstances women seek abortion and the quality of services available to them. They also explore inter-generational differences in attitudes and practices, the perceptions and selection of providers, female-selective abortion, and informal abortion practitioners. Among other issues, the contributors show that strong preference for sons, availability of modern techniques for diagnostic tests, widespread acceptance of the small family norm, and heavy reliance on female sterilisation as the primary method of contraception lead women to abort unwanted pregnancies.

A book that goes beyond the smokescreen of data and regulations to unravel the human story behind elective abortion, it will be of interest to those studying health, public policy, and gender, apart from the general reader.

IX Pregnancy Wastage among the Poor in Coastal Karnataka

K. Susheela and K. Nagaraj

The main thrust of this study was twofold. One was to broadly estimate the extent and components of pregnancy wastage including abortion, which is an important reproductive health as well as rights issue, amongst two poor occupational groups, i.e., agricultural labourers and beedi workers in the Udipi district, a relatively advanced region in coastal Karnataka. The second was to understand the social, economic and cultural, as well as the medical underpinnings of this issue in these two groups. While some pregnancy wastage is inevitable, the right to induced abortion is not often a free choice for women but operates in the context of power relations.

ABOUT THE REGION

Udipi, in which this study was carried out, is a coastal district of Karnataka. The coastal part of the district is relatively more advanced than the interior parts or the ghat region lying to its east. Our survey village is located in the interior more backward part of the district. Along with high-value cash crops (like cashew and coconut), paddy cultivation, forest produce and fisheries are primary sources of livelihood for a majority of the population. In spite of abundant and assured rainfall, the topography of the region and the absence of agricultural modernisation has led to unemployment and underemployment, necessitating the adoption of alternative survival strategies like migration—permanent or seasonal—and non-agricultural activities, such as beedi-rolling.

The district’s tertiary sector, which comprises banking, trade and transportation, is well developed. The literacy level among both men and women is also quite high. The district has a large number of educational institutions, including many professional ones. There is also a fairly well-developed system of health care. A recent study on district-wise human development in the country (Geetha Rani 1999: 30) ranks the erstwhile (composite) Dakshina Kannada district, from which Udupi was carved out in 1998, first in the country. Nevertheless, access to health care and education is uneven, with the poor in the region not always able to access these facilities.

At the same time, the high level of infrastructure and social development, the ‘mobile’ character of the population and rural-urban linkages, the high level of rural non-farm employment and the exposure to mass media like the television and radio lead to a situation where the transference of urban lifestyles and values to the rural population, including the poor, is quite high. As a result, people’s aspiration levels are high. It is this disjunction, between poor living conditions on the one hand and high aspiration levels on the other, that underlies another basic phenomenon with important consequences for pregnancy wastage among the poor in the region—i.e., rapid fertility transition.

Fertility Decline

During the last decade, the district witnessed a rapid decline in fertility rate, which today, at 1.5, is below replacement level. In fact, it is one of the lowest among all districts in the country (Guilmoto and Irudaya Rajan 2002: 665-72).¹ While high female literacy may be a factor underlying the low fertility rate in the district, we believe that it constitutes only a par...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Contents
• List of Illustrations
• Glossary
• Preface
• I. Abortion Use and Practice: Evidence, Challenges and Emerging Issues
• II. Abortion Care in Urban Slums: The Case of Ahmedabad
• III. Women, Work and Abortion Practices in Tamil Nadu
• IV. Abortion among Married Women
• V. Sex-Selective Abortion in Gujarat and Haryana: Some Empirical Evidence
• VI. Community Perspectives on Abortion: An Ethnographic Exploration of Rural Pune
• VII. Post-Abortion Care in the Public Health System
• VIII. Induced Abortion: A Study of Rural Tamil Nadu
• IX. Pregnancy Wastage among the Poor in Coastal Karnataka
• X. Informal Providers of Abortion Services: An Exploration
• About the Editors
• Index