Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-27T14:54:37.111Z Has data issue: false hasContentIssue false
  • English
  • Français

Abortion among married young women: findings from a community-based study in Rajasthan and Uttar Pradesh, India

Published online by Cambridge University Press:  14 November 2019

A. J. Francis Zavier Open the ORCID record for A. J. Francis Zavier [Opens in a new window] ,
K. G. Santhya  and
Shireen J. Jejeebhoy
A. J. Francis Zavier*
Affiliation:
Population Council, New Delhi, India
K. G. Santhya
Affiliation:
Population Council, New Delhi, India
Shireen J. Jejeebhoy
Affiliation:
Aksha Centre for Equity and Wellbeing, Mumbai, India
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Abortion service provision has changed noticeably in the recent past and medication abortion currently accounts for four-fifths of all induced abortions taking place in India. How these changes have modified abortion experiences among young women – a group known to be more disadvantaged than adult women – remains unanswered. This paper fills this gap and examines the experiences of married young abortion seekers, including pre-abortion decision-making, abortion seeking and experiences of the procedure, and post-abortion complications. Data were drawn from a community-based survey of 4952 married young women aged 15–24 years conducted in Uttar Pradesh and Rajasthan in 2015. The study focused on 166 young women who had an induced abortion in the two years before the survey, and used descriptive statistics to describe their abortion experiences. Seventy-four per cent of abortion seekers had relied on medication abortion and 47% had obtained it over the counter without a physician’s prescription. Moreover, 90% accessed abortion services from private facilities, including drug sellers. A small proportion (4%) had undergone abortion in the second trimester of pregnancy. At the same time, 13% reported multiple abortion attempts; 17% underwent dilation and curettage; and 52% experienced self-reported complications, including 5% who experienced moderate to severe complications. The findings call for greater attention to providing contraceptive counselling and services to married young women, ensuring abortion services in public health facilities and exploring mechanisms to improve drug sellers’ knowledge and practices in providing medication abortion.

Keywords

AbortionReproductive healthYoung women
Type
Research Article
Information
Journal of Biosocial Science , Volume 52 , Issue 5 , September 2020 , pp. 650 - 663
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Banerjee, S and Clark, KA (2009) Exploring the Pathways of Unsafe Abortion: A Prospective Study of Abortion Clients in Selected Hospitals of Madhya Pradesh, India. Ipas India, New Delhi.Google Scholar
Bhilwar, M, Lal, P, Sharma, N, Bhalla, P and Kumar, A (2016) Prevalence of induced abortions and contraceptive use among married women in an urban slum of Delhi, India. International Journal of Gynecology & Obstetrics 136(1), 29–32.CrossRefGoogle Scholar
Elul, B, Barge, S, Verma, S, Kumar, N and Bracken, H (2004) Unwanted Pregnancy and Induced Abortion: Data from Men and Women in Rajasthan, India. Population Council, New Delhi.Google Scholar
Footman, K, Keenan, K, Reiss, K, Reichwein, B, Biswas, P and Church, K (2018) Medical abortion provision by pharmacies and drug sellers in low- and middle-income countries: a systematic review. Studies in Family Planning 49(1), 57–70.CrossRefGoogle ScholarPubMed
Ganatra, B (2000) Abortion research in India: what we know and what we need to know. In Ramasubban, R and Jejeebhoy, S (eds) Women’s Reproductive Health in India. Rawat Publications, Jaipur, pp. 186–235.Google Scholar
Ganatra, B and Hirve, S (2002) Induced abortions among adolescent women in rural Maharashtra, India. Reproductive Health Matters 10(19), 76–85.CrossRefGoogle ScholarPubMed
Ganatra, B, Manning, V and Pallipamulla, SP (2005) Availability of medical abortion pills and the role of chemists: a study from Bihar and Jharkhand, India. Reproductive Health Matters 13(26), 65–74.CrossRefGoogle ScholarPubMed
IIPS and ICF (2017a) National Family Health Survey (NFHS-4), 2015–16, India. International Institute for Population Sciences, Mumbai.Google Scholar
IIPS and ICF (2017b) National Family Health Survey (NFHS-4), 2015–16, India, Uttar Pradesh. International Institute for Population Sciences, Mumbai.Google Scholar
IIPS and ICF (2017c) National Family Health Survey (NFHS-4), 2015–16, India, Rajasthan. International Institute for Population Sciences, Mumbai.Google Scholar
Jejeebhoy, SJ, Kalyanwala, S, Zavier, AJF, Kumar, R and Jha, N (2010a) Experience seeking abortion among unmarried young women in Bihar and Jharkhand, India: delays and disadvantages. Reproductive Health Matters 18(35), 163–174.CrossRefGoogle ScholarPubMed
Jejeebhoy, SJ, Santhya, KG and Acharya, R (2010b) Health and Social Consequences of Marital Violence: A Synthesis of Evidence from India. Population Council and UNFPA, New Delhi.CrossRefGoogle Scholar
Jejeebhoy, SJ, Zavier, AJF and Kalyanwala, S (2010c) Assessing Abortion-related Experiences and Needs in Four Districts of Maharashtra and Rajasthan, 2006. Population Council, New Delhi.CrossRefGoogle Scholar
Jejeebhoy, SJ, Zavier, AJF, Acharya, R and Kalyanwala, S (2011a) Increasing Access to Safe Abortion in Rural Maharashtra: Outcomes of a Comprehensive Abortion Care Model. Population Council, New Delhi.Google Scholar
Jejeebhoy, SJ, Zavier, AJF, Acharya, R and Kalyanwala, S (2011b) Increasing Access to Safe Abortion in Rural Rajasthan: Outcomes of a Comprehensive Abortion Care Model. Population Council, New Delhi.Google Scholar
Kalyanwala, S, Zavier, AJF and Jejeebhoy, SJ (2010) Public Health Facilities and Women’s Access to Abortion: A Situation Analysis in Maharashtra and Rajasthan. Unpublished Report, Population Council, New Delhi.Google Scholar
Kapp, N, Blanchard, K, Coast, E, Ganatra, B, Harries, J, Footman, Ket al. (2018) Developing a forward-looking agenda and methodologies for research of self-use of medical abortion. Contraception 97(2), 184–188.CrossRefGoogle ScholarPubMed
Krishna, UR (1995) The status of women and safe motherhood. Journal of the Indian Medical Association 93(2), 34–35.Google ScholarPubMed
Kumar, R, Zavier, AJF, Kalyanwala, S and Jejeebhoy, SJ (2013) Unsuccessful prior attempts to terminate pregnancy among women seeking first trimester abortion at registered facilities in Bihar and Jharkhand, India. Journal of Biosocial Science 45(2), 205–215.CrossRefGoogle ScholarPubMed
Ministry of Health and Family Welfare (2010) Comprehensive Abortion Care: Training and Service Delivery Guidelines, Ministry of Health and Family Welfare, New Delhi.Google Scholar
Moore, AM, Stillman, M, Shekhar, C, Kalyanwala, S, Acharya, R, Singh, Set al. (2019) Provision of medical methods of abortion in facilities in India in 2015: a six state comparison. Global Public Health, https://doi.org/10.1080/17441692.2019.1642365CrossRefGoogle Scholar
Office of the Registrar General and Census Commissioner (2013) Primary Census Abstract, Data Highlights, India, Series 1. Office of the Registrar General and Census Commissioner, Government of India, New Delhi. URL: http://www.censusindia.gov.in/2011census/PCA/PCA_Highlights/pca_highlights_india.html.Google Scholar
Office of the Registrar General (2018) Special Bulletin on Maternal Mortality in India 2014–16, Sample Registration System. Office of the Registrar General, India; Government of India, New Delhi. URL: http://www.censusindia.gov.in/vital_statistics/SRS_Bulletins/MMR%20Bulletin-2014-16.pdfGoogle Scholar
Powell-Jackson, T, Acharya, R, Filippi, V and Ronsmans, C (2015) Delivering medical abortion at scale: a study of the retail market for medical abortion in Madhya Pradesh, India. PLoS One 10(3), e0120637.CrossRefGoogle ScholarPubMed
Ramachandar, L and Pelto, PJ (2004) Abortion providers and safety of abortion: a community-based study in a rural district of Tamil Nadu, India. Reproductive Health Matters 12(24 supplement), 138–146.CrossRefGoogle Scholar
Raushan, R (2019) Effect of domestic violence on unintended pregnancy among currently pregnant women: regional perspective in India. Paper presented at the dissemination meeting Maternal, Neonatal and Child Health, and Nutrition Situation in India: Insights from further analysis of National Family Health Surveys, 3rd July 2018, Magnolia Hall, India Habitat Centre, New Delhi.CrossRefGoogle Scholar
Santhya, KG, Acharya, R, Pandey, N, Gupta, AK, Rampal, S, Singh, SK and Zavier, AJF (2017a) Understanding the Lives of Adolescents and Young Adults (UDAYA) in Uttar Pradesh, India. Population Council, New Delhi.Google Scholar
Santhya, KG, Acharya, R, Pandey, N, Singh, SK, Rampal, S, Zavier, AJF and Gupta, AK (2017b) Understanding the Lives of Adolescents and Young Adults (UDAYA) in Bihar, India. Population Council, New Delhi.CrossRefGoogle Scholar
Santhya, KG and Jejeebhoy, SJ (2003) Sexual and reproductive health needs of married adolescent girls. Economic and Political Weekly 38(41), 4370–4377.Google Scholar
Santhya, KG and Jejeebhoy, SJ (2014) Adolescents and youth in India: challenges and opportunities. In Jejeebhoy, SJ, Kulkarni, PM, Santhya, KG, and Mehrotra, F (eds) Population and Reproductive Health in India: An Assessment of the Current Situation and Future Needs. Oxford University Press, New Delhi, pp. 175–246.CrossRefGoogle Scholar
Singh, S, Shekhar, C, Acharya, R, Moore, AM, Stillman, M, Pradhan, MRet al. (2018) The incidence of abortion and unintended pregnancy in India, 2015. The Lancet 6(1), e111–120.Google Scholar
Stillman, M, Jennifer, JF, Singh, S, Moore, AM and Kalyanwala, S (2014) Abortion in India: A Literature Review. Guttmacher Institute, New York.Google Scholar
WHO (2012) Safe Abortion: Technical and Policy Guidance for Health Systems. Second edition. WHO, Geneva.Google Scholar
Zavier, AJF, Jejeebhoy, SJ and Kalyanwala, S (2012) Factors associated with second trimester abortion in rural Maharashtra and Rajasthan, India. Global Public Health 7(8), 897–908.CrossRefGoogle ScholarPubMed
Zavier, AJF and Padmadas, SS (2012) Post abortion contraceptive use and method continuation in India. International Journal of Gynaecology & Obstetrics 118(1), 65–70.CrossRefGoogle Scholar