Abortion services and ethico-legal considerations in India: The case for transitioning from provider-centered to women-centered care

摘要

Nearly a million Indian women lack access to safe and dignified abortion services from public healthcare facilities and instead opt to induce abortions by themselves or with the help from unskilled and unauthorized practitioners. Unsafe abortions account for an estimated 9% of all maternal deaths in India despite the legalization of abortion on all grounds since 1971 via the MTP Act. However, the Act technically does not make any provision for abortion based on a woman's request alone, subjecting her decision to the approval of her healthcare provider, limiting reproductive autonomy. Moreover, the problem of female feticide through sex-selective abortions has also contributed to a conflicting public agenda that prioritizes preventing the former over allowing women access to abortion services for other reasons. Women who are socio-economically, culturally, and educationally vulnerable and minors may experience further abortion related stigmatization. These ethico-legal considerations highlight the need for transition from a provider-centered to a woman-centered abortion service model.