Half the pregnancies in 6 Indian states are unintended

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New Guttmacher study exposes how the world’s oldest family planning, dating back to 1951 programme fails Indian women

Exposing glaring loopholes in India’s family planning programme, the oldest in the world, a study by the Guttmacher Institute released earlier this week at the International Conference of Family Planning in Kigali shows that 50% pregnancies in six of the largest Indian states are unintended.

The state covered int he study are Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu and Uttar Pradesh. The findings echo the latest National Family Health Survey data which shows that just 53% couples in  India use contraception, use modern contraceptive methods. These states account for the largest proportion of India’s annual birth cohort of 26.4 crore.

The study found 55% pregnancies in Assam, 48% in Bihar, 53% in Gujarat, 50% in Madhya Pradesh, 43% in Tamil Nadu and 49% in Uttar Pradesh are unintended. It was done in association with the International Institute of Population Sciences in Mumbai.

“In both the public and private sectors, many facilities that offer abortion will not provide it beyond certain gestational ages that are well below the 20-week legal limit.”

Unintended pregnancies indicate not just the reach and depth of the family planning programme, they are also often a precursor to abortions, many of them in unsafe hands in the back alleys rather than in facilities.

In the 10 years between National Family Health Surveys III and IV, contraceptive use has actually gone down. In 2005-06 56.3% couples used any contraception but in 2015-16 just 53.5% did. Modern methods of contraception include condoms, intrauterine devices, sterilisation and pills.

According to a 2016 study published in The Lancet by the Guttmacher Institute and the World Health Organization, an estimated 56 million abortions took place globally each year between 2010 and 2014. In 2015, a study in The Lancet Global Health, also by Guttmacher Institute and IIPS, estimated that 15.6 million abortions were performed in India in 2015. This translates to an abortion rate of 47 per 1,000 women aged 15–49, which is similar to the abortion rate in neighboring countries.

The latest analysis by Guttmacher observed: “In both the public and private sectors, many facilities that offer abortion will not provide it beyond certain gestational ages that are well below the 20-week legal limit. Lower-level facilities may understandably need to refer later abortions to better-equipped facilities that are able to give more advanced care, but many higher-level facilities also do not offer second-trimester abortion. Among facilities that offerabortion in the six surveyed states, 29–63% of public hospitals and 22–75% of private hospitals provide pregnancy termination ninto the second trimester.”

                                   Assam  TN       UP        Bihar            Guj       MP

Abortions                    580000  70800  3152000     1251000    812000    1110000

Rate (per 1000)           66.2       32.8      61.1       49.4.             47.6.            57.3

% in health facilities    21            32         12         15.                 15                 26

% Unintended preg     55             43         49         48                   53               50