The access, availability and affordability of contraceptive and abortion services in India have been negatively impacted by the Covid-19 pandemic, exacerbating existing issues. Currently, the Government of India has considered these health services as essential during Covid-19.
Access to contraception and abortion services has been severely impacted by the COVID-19 pandemic, leading to an increase in unwanted pregnancies. This policy brief outlines the issues being faced by the system of contraceptives and safe abortion services and provides recommendations on actions the state and national governments can take to ensure universal coverage of services.
Methods for managing unwanted pregnancies
Safe contraception and abortion services are essential to the reproductive rights of women, as they address fertility control and reduce unwanted pregnancies. Access to contraception prevents pregnancies from occurring in the first place. However, as no method provides 100 percent protection, abortion services are required to ensure women who do fall pregnant have an option to terminate the pregnancy.
Why is access to contraceptives important?
Almost 137 million women in India use contraceptives each year. Contraceptive services are essential in avoiding the majority of unwanted pregnancies. Permanent contraception methods can prevent women from becoming pregnant long-term (with over 99 percent effectiveness using male and female sterilization). Temporary contraception methods such as condoms and oral contraceptive pills can be used to delay or space apart pregnancies. A range of contraceptives are available globally, which are listed in Appendix A.
Preventing unwanted pregnancies has important implications for both mother and child health. Spacing births using temporary methods by at least 4 years reduces infant mortality by up to 60 percent as families are better able to support the needs of each growing child . Ensuring a minimum of 2 years between births can reduce maternal mortality by up to 33 percent. In addition, large family sizes lead to a range of negative outcomes including strain on local resources, poorer economic outcomes for mothers, poorer educational outcomes for children, increased anxiety for parents, and financial stress . Ensuring families are able to have fewer children and increase the time between each child has family and society-level benefits.
The occurrence of early and child marriages also continues to be an issue in India, and access to contraceptive and abortion services is essential to protect these children. Children (girls under the age of 18) who get pregnant have a higher chance of experiencing complications during childbirth which lead to a range of life-long health problems. Early motherhood also prevents these girls from accessing education and sets them up for a life of vulnerability and dependence on others . Access to contraceptive and abortion services ensure these girls have some autonomy over their bodies and can delay pregnancy until they are older. In this brief, whenever we refer to women, we are also referring to young girl brides.
Why is access to safe abortion services important?
Contraceptive methods may fail and are not always available, and so safe abortion services ensure that women can terminate unwanted pregnancies. Under the Medical Termination of Pregnancy (MTP) Act, 1971, women may terminate a pregnancy with a referral from a doctor. Almost 16 million abortions are carried out in India each year .
There are two main methods of abortion:
– Medical abortion: This method uses pills to terminate pregnancies. The use of medical abortion pills is currently licensed up to 9 weeks in India, but can be used up to 32 weeks as per World health Organization (WHO) recommendations. In many countries, women can self-administer medical abortion pills with access to support on the correct use and post-abortion care. The…