Young, Unmarried Women in India Face Obstacles to Obtaining Early Abortion Services

A new study by researchers at the Population Council, New Delhi, shows that many young, unmarried Indian women who received abortion services in 2007–2008 faced obstacles to obtaining the procedure early in their pregnancies. Shveta Kalyanwala and colleagues surveyed 549 women in the Indian states of Bihar and Jharkhand who had an abortion. Among these women, 84% decided before the end of the first trimester to have an abortion, but only 75% were able to obtain one during that time period. The authors believe that several factors contributed to women having an abortion later in pregnancy, including a delayed recognition of pregnancy, lack of awareness that abortion is legal for unmarried women and lack of support from partners and family.

While 83% of women surveyed realized they were pregnant within the first two months of their pregnancy and 91% within the first trimester, 9% did not realize it until the second trimester. Furthermore, only 22% of women had been aware prior to becoming pregnant that abortion services were legally available to unmarried women. Kalyanwala and colleagues also looked at the importance of confiding in someone about the pregnancy and receiving emotional or financial support for obtaining an abortion. The overwhelming majority of women surveyed said they had received support, with partners being the leading source. Overall, the young women surveyed were reluctant to confide in their father or other male relatives, and these family members were less likely to provide support than were partners, mothers, other female relatives or friends.

In addition, partner support was closely linked to early abortion provision: Women who reported having a supportive partner were more likely to have obtained a first-trimester abortion than were women who lacked their partner’s support; women in the latter group—who instead had to rely on their mother or others—were more likely to have had an abortion in their second trimester. According to the researchers, one in six women surveyed said their pregnancy had resulted from a nonconsensual sexual encounter. These women also had increased odds of having had a second-trimester abortion.

The authors believe the findings underscore the need for improved sex education programs for young women, whether they are in school or out of school, to ensure they understand the link between a missed period and pregnancy, the fact that both married and unmarried women are legally entitled to abortion services and the importance of obtaining an abortion early if the pregnancy is unwanted. These programs, they say, should also work to improve communication between young women and their parents. Finally, given the central role partners played in enabling women to obtain early abortion services, Kalyanwala and her colleagues strongly recommend that programs for young people foster more egalitarian gender attitudes and greater male responsibility regarding reproductive health.

The study, "Abortion Experiences of Unmarried Young Women in India: Evidence from a Facility-Based Study in Bihar and Jharkhand," appears in the June 2010 issue of International Perspectives on Sexual and Reproductive Health .

Also in this issue of International Perspectives on Sexual and Reproductive Health:

STI Treatment-Seeking Behaviors Among Youth in Nigeria: Are There Gender Differences? by Kristen Mmari of Johns Hopkins Bloomberg School of Public Health, et al.;

The Role of Abortion in the Last Stage of Fertility-Decline in Vietnam by Bussarawan Teerawichitchainan of Singapore Management University and Sajeda Amin of the Population Council;

Pelvic Pain and Associated Characteristics Among Women in Northern Mexico by Hilda García-Pérez of Arizona State University et al.;

Contraception Matters: Two Approaches to Analyzing Evidence of the Abortion Decline in Georgia by Florina Serbanescu of Centers for Disease Control and Prevention et al.