Original Articles

Induced Abortion Practices in an Urban Indian Slum: Exploring Reasons, Pathways and Experiences


Objective:To explore the context, experiences and pathways of seeking abortion care among married women in a minority dominated urban slum community in Mumbai city of India.
Materials and methods:A mixed-method study was conducted using a systematic random sampling method to select 282 respondents from the slum community. One fifth of these womenreported undergoing at least one induced abortion over past five years. A quantitative survey was conducted among these women (n=57) using structured face-to-face interviews. Additionally, in-depths interviews involving 11 respondents, 2 community health workers and 2 key informants from the community were conducted for further exploration of qualitative data.
Results:The rate of induced abortion was 115.6 per 1000 pregnancies in the study area with an abortion ratio of 162.79 per 1000 live births. Frequent pregnancies with low birth spacing and abortions were reported among the women due to restricted contraception use based on religious beliefs. Limited supportfrom husband and family compelled the women to seek abortion services, mostly secretly, from private, unskilled providers and unregistered health facilities. Friends and neighbors were main sources of advice and link to abortion services. Lack of safe abortion facilities within accessible distance furtherintensifies the risk of unsafe abortions.
Conclusion:Low contraception usage based on rigid cultural beliefs and scarcely accessible abortion services were the root causes of extensive unsafe abortions.Contraception awareness and counseling with involvement of influential community leaders as well as safe abortion services need to be strengthened to protect these deprived women from risks of unwanted pregnancies and unsafe abortions.

Duggal R, Ramachandran V. The Abortion Assessment Project – India: Key Findings and Recommendations. Reproductive Health Matters 2004; 12 (24 Supplement): 122-9.

Registrar General of India. Maternal Mortality in India, 1997–2003: Trends, Causes and Risk Factors. New Delhi: Registrar General, India 2006.

Faundes A. Unsafe abortion – the current global scenario. Best Practice & Research Clinical Obstetrics and Gynaecology 2010; 24: 467-77.

Singh S, Wulf D, Hussain R,Bankole A, Sedgh G. Abortion Worldwide: A Decade of Uneven Progess. Guttmacher Institute. New York: USA, 2009.

Sedgh G, Hussain R, Bankole A, Singh S. Women with an unmet need for contraception in developing countries and their reasons for not using a method.Occasional Report No 37. New York: Guttmacher Institute, 2007.

International Institute for Population Sciences (IIPS) and Macro International.National Family Health Survey (NFHS-3), 2005–06: India: Mumbai: IIPS, 2007.

Ravindran TKS. Gender Gaps in Research on Abortion in India: A Critical Review of Selected Studies (1990- 2000). the Gender and Reproductive Health Research Initiative. CREA. New Delhi, 2002.

World Health Organization, Department of Reproductive Health and Research. Safe Abortion: technical and policy guidance for health systems. 2nd ed. Geneva: WHO 2012.

Duggal R, Barge S. Abortion Services in India Report

of a Multicentric Enquiry. 2004. Available from: http://www.cehat.org/go/uploads/AapIndia/national.pdf (Accessed on 24 September 2014) 10.World Health Organization. Unmet Need for Family Planning. 2013. Available from:

http://www.who.int/reproductivehealth/topics/family_p lanning/unmet_need_fp/en/(Accessed on 09 October 2014)

Agarwal S, Sangar K. Need for Dedicated Focus on Urban Health within National Rural Health Mission. Indian Journal of Public Health 2005; 49: 141-51.

Gupta M, Thakur JS, Kumar R. Reproductive and Child Health Inequities in Chandigarh Union Territory of India. journal of Urban Health: Bulletin of the New York Academy of Medicine. 2008; 85: 291-9.

Tragler A. A study on Sex Ratio at Birth in Suburban Slums of Mumbai. Indian Journal of Public Health 2011; 55: 128-31.

ReichweinB.Vaid M. What obstacles do rural Indian women face when attempting to end an unwanted pregnancy? Research Brief Series. Marie Stopes International, 2013.

Banerjee SK, Andersen KL,Warvadekar J. Pathways and consequences of unsafe abortion: A comparison among women with complications after induced and spontaneous abortions in Madhya Pradesh, India. International Journal of Gynaecology and Obstetrics 2012; 118 (Supplement 2): S113-20.

Zavier AJ, Padmadas SS. Postabortion contraceptive use and method continuation in India. International Journal of Gynaecology and Obstetrics 2012; 118: 65-70.

Saha S, Duggal R, Mishra M. Abortion in Maharashtra

Incidence, Care and Cost. Centre for Enquiry Into Health and Allied Themes. Mumbai, India, 2004.

APNALAYA. Annual Report 2011-12. Mumbai, India. 19.Behera D, Mote B. Community Profile Report of Indira Nagar Slum. Submitted to Tata Institute of Social Sciences (TISS), Mumbai, India 2012.

Malhotra A, Nyblade L,Parasuraman S, MacQuarrie K, Kashyap N, Walia S. Realizing Reproductive Choices and Rights:Abortion and Contraception in India. International Centre for Research on Women (ICRW) 2003.

Ganatra B. Abortion research in India: What we know, and what we need to know. In Ramasubban, R. &Jejeebhoy, S. J. (eds), Women’sReproductive Health in India. Jaipur: Rawat Publications 2000: 186-235.

Gupte M, Bandewar S, Pisal H. Women’s Perspectives on Quality of General and Reproductive Health Care: Evidence from Rural Maharashtra, in Koenig, M. & Khan, M. E. (eds), Improving Quality Care in India’s Family Welfare Programme, Population Council, New York 1999: 117-39.

Ganatra B, Hirve S, Rao VN. Sex-Selective Abortion: Evidence from a Community-based Study in Western India. Asia-Pacific Population Journal 2001; 16: 109-24.

Ramachandar L. Linking the community and the provider: Village health nurses in Tamil Nadu. Paper presented at the Population Council Workshop on ‘Abortion in India: How Can Research Help Us Move Forward?’ Goa, 2002.

ChhabraR. Nuna SC. Abortion in India: An Overview. New Delhi: VeeremdraPrinters. 1994.

Sinha R, Khan ME, Patel BC, Lakhanpal S, Khanna P. Decision Making in Acceptance and Seeking Abortion of Unwanted Pregnancies. Centre for Operational Research and Training. New Delhi, India 1998: 10- 3.

Jejeebhoy SJ, Kalyanwala S, Mundle S, Tank J, Zavier AJ, Kumar R, et al. Feasibility of Expanding the Medication Abortion Provider Base in India to Include Ayurvedic Physicians and Nurses. International Perspectives in Sexual and Reproductive Health 2012;38: 133-42.

Andersen K, Singh A, Shrestha MK, Shah M, Pearson E, Hessini L. Early pregnancy detection by female community health volunteers in Nepal facilitated referral for appropriate reproductive health services. Global Health: Science and Practice 2013; 1: 372-81.

Jejeebhoy SJ, Kalyanwala S, Zavier AJ, Kumar R, Mundle S, Tank J, et al . Can nurses perform manual vacuum aspiration (MVA) as safely and effectively as physicians? Evidence from India. Contraception 2011; 84: 615-21.

Berer M. Provision of abortion by mid-level providers: international policy, practice and perspectives. Bulletin of World Health Organization. 2009; 87: 58-63.

IssueVol 9, No 3 (September 2015) QRcode
SectionOriginal Articles
Induced abortion Urban slum Contraception Religious beliefs India

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How to Cite
Behera D, Bharat S, Gawde N. Induced Abortion Practices in an Urban Indian Slum: Exploring Reasons, Pathways and Experiences. J Family Reprod Health. 2015;9(3):129-135.