A study found that an estimated 5,80,100 abortions are performed in Assam every year. These include abortions taking place both in health facilities and in other settings.
The study on ‘Unintended Pregnancy, Abortion and Post-abortion Care in Assam—2015’ conducted jointly by Indian Institute for Population Sciences, Mumbai, Population Council, New Delhi and New York-based Guttmacher Institute, highlights the importance of access to and quality of safe abortion services in Assam.
The state’s abortion rate was found to be 66 terminations per 1,000 women in the reproductive age group.
“An estimated 90 percent of the abortions occurring in health facilities in the state are surgical, while about 10 percent are done using Medical Methods of Abortion (MMA). And 73 percent of all facility-based abortions take place in public facilities, and the rest in private facilities. Of all the states where the study was conducted (Bihar, Uttar Pradesh, Madhya Pradesh, Tamil Nadu, Gujarat and Assam), Assam is the only state which demonstrated better access to safe abortion services in public facilities than private facilities,” said a press statement.
Some of the barriers that were found to continue to persist in accessing facility-based abortions are — lack of trained staff, paucity of equipment and supplies, social or religious concerns and lack of registration/authorization to provide abortion.
It was found that 588 facilities in Assam provided abortion-related care as in 2015, 61 percent of which were in public facilities, while the rest were in private facilities. Further, the study revealed that though a majority of women in Assam live in rural areas, merely 45 percent of the facilities offering abortion-related services were located in these areas at the time of the study.
Reflecting on the findings of the study, Nozer Sheriar, board member Guttmacher Institute, New York and former Secretary General, Federation of Obstetrics and Gynaecological Societies of India (FOGSI) said, “This study fills an important evidence gap and provides insights to address the large gap between abortion legality and implementation of the law to ensure access to safe, quality abortion services for all women. The Assam results prove that women do seek abortion care at public sector facilities when services are made available closer to their communities. While no woman wants to turn to an unsafe provider, there are many factors that can lead a woman to seek an abortion outside of the formal health sector. Increasing the provision of abortion services in the public sector is critical to meeting demand for abortion services for rural and lower-income women”.
A majority of rural and poor women visit primary health centres (PHCs) to access health care. According to the Guttmacher study, Assam is the only state among the six states which registered 15 percent of all induced abortions in public facilities while Bihar, Gujarat and Uttar Pradesh fell behind at 2, 3 and 4 percent respectively.
Studies have shown that unsafe abortions are the third leading cause of maternal mortality in India. About eight women die from causes related to unsafe abortion in the country every day.
As per recommendations put forth in the report, there is an impending need to improve access to facility-based abortion services, especially in underserved rural areas of Assam, by ensuring that all public facilities are adequately stocked with equipment and supplies.