India’s Inverted Abortion Politics

In America, many state governments have tried to curb abortion by placing severe restrictions on providers and clinics, purportedly for women’s protection, despite opposition from the American Medical Association and other groups. If the limits are allowed to stand, self-induced abortions are expected to rise, leading to an escalation of health dangers to women, particularly those who can’t afford to travel for help.

In India, a curious inversion of this story is playing out: The government is trying to reduce the qualifications required of providers so that poor women will have easier access to abortions, while doctors are the ones opposing this relaxation of rules.

Abortion is allowed in India under relatively liberal conditions — for example, contraception failure. Although its legal status is uncontroversial, the topic itself, like all sexual matters, is nevertheless taboo in the religiously conservative country. Women must often deal with unwanted pregnancy in secret, a problem compounded by unmet contraception needs and widespread gender subjugation.

The lack of adequate medical facilities in rural areas and urban slums forces many women to try to terminate pregnancies themselves, or to seek the services of quacks and untrained midwives. Ipas, an international abortion care organization, estimates that about five million abortions were carried out in India in 2013, with more than half of them unsafe.

The primary reason advanced for this opposition — concern for women’s health — is just as specious in India as it is in America. Doctors are aware that abortion drug kits, like most prescription medicines in India, are available without authorization, and that their rampant self-administration is the cause of a large numbers of injuries and deaths.

Another objection is that given the pressure on Indian women to bear sons, the rule would promote more abortions of female fetuses. However, most gender determination (and resulting abortion) occurs during the second trimester, while the amendment expands the provider pool only for the first trimester.

But the real root of the tension is the government’s promotion of alternative medicine as a medically equivalent but cheaper alternative to allopathic (modern) medicine.

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