Abortion stigma is a powerful deterrent to accessing abortion services. It can arise from lack of information or awareness about abortion being a relatively simple medical procedure, cultural superstitions and myths, and patriarchal beliefs that feel the need to control what women do with their bodies and reproductive choices.
For a woman or a trans person to access abortion services therefore, can be a huge hurdle. For many, it is a secret endeavour, away from the prying eyes of their family or partner. The Indian law too, grants adult women the agency to make decisions about their abortion rights (to a certain extent) by decreeing that a woman’s parents’ or spouse do not have to grant consent in order to avail an abortion. However, the final decision to get an abortion does not lie with the pregnant woman.
The Medical Termination of Pregnancy Act states that the pregnant woman has to get the consent of one medical practitioner if the pregnancy is less than 12 weeks old, and two medical practitioners if the pregnancy is between 12-20 weeks old. Therefore, medical service providers make the final decision on abortion in their hands.
Now, what if doctors themselves hold regressive views on abortion? When a woman is denied an abortion service by her doctor, it is extremely likely that she will perform the abortion anyway – using unsafe methods. Despite the legality of abortion in India, a survey that studied abortion services in 9 of its biggest states found that 67% of abortions performed in these states were unsafe and illegal abortions.
The quotes below were taken from a study conducted by Asia Safe Abortion Partnership and a local partner as a follow up to a previous study that was published in the journal Reproductive Health Matters.
It is imperative that medical service providers are told to provide non judgmental and stigma free healthcare, especially for an issue that holds so much social taboo as abortion.
In India, another problem arises because abortion, which is legalised through the Medical Termination of Pregnancy Act, is frequently conflated with sex determination, which is penalised through the Pre-Conception and Pre-Natal Diagnostic Techniques Act. Therefore, abortion is often conflated with sex determination, even though they are two completely different procedures. The pressure to stop gender biased sex selection leads to many medical practitioners often denying life-saving abortion services to women.
Dr Suchitra Dalvie from Asia Safe Abortion Partnership writes, “In many places, pharmacists now refuse to stock or sell morning-after pills for fear of harassment. Doctors turn detectives and refuse women who seek 2nd trimester abortions – suspicious that the abortion follows the results of prenatal sex determination – and civil society turns vigilante, undertaking sting operations that use pregnant women as decoys to flush out suspects. As a result, it has become even more difficult to get a “regular” abortion from a qualified and registered doctor, thus turning women towards more-unsafe options.”
The quotes below were taken from doctors in a study conducted by SAMYAK, an NGO. In these, doctors provide justifications for not providing legal abortion services to women, citing the fear of getting caught for performing sex selective abortions. In order to curb sex determination, government authorities often target abortion services, leading to safe abortion services for women being denied to them. When this happens, the gap is filled by unqualified persons and quacks that offer illegal and unsafe abortions that put women’s health at risk.
It is in this climate that we must wonder whether it is right for doctors to deny treatment to women in need of abortion services, due to personal prejudices, stigma or for the mythical goal of “saving the girl child”.