By Sama Resource Group for Women and Health
In March 2020, the Government of India announced a sudden nation-wide lockdown in an attempt to curb the impact of COVID-19. This, and the following lockdowns, on top of the already crumbling healthcare system’s focus on COVID care at the cost of access to other equally critical health services, has had very serious implications for people’s health and lives.
This has had a particularly adverse impact on sexual and reproductive health (SRH) care, including access to abortion care.
“If COVID has come, does it mean that other illnesses or health problems have disappeared? Similarly, does it mean that women do not need abortion services?”
Woman activist in Sama workshop
An estimated 1.85 million women’s access to safe abortion services was curtailed during the COVID-19 lockdown in India.
While COVID lockdowns aggravated the existing barriers to abortion care, the right to abortion has in a sense been under perennial lockdown in many countries and regions across the world, including in India.
It is estimated that 6.4 million abortions performed each year in India are unsafe, contributing to 9 -13% of maternal mortality. Very few primary health care centres actually provide abortion services. This leads to a high unmet need for safe abortion care at primary level facilities. A shortage of trained doctors and the necessary infrastructure and equipment for providing safe abortions have consistently remained an issue.
And on the legal front, abortion is not considered the right of the person seeking it and is not available on request.
On the contrary, certain provisions pose serious barriers to access. In 2021, The Medical Termination of Pregnancy Act (1971) had been in place for 50 years. Amendments were brought about to the Act in the midst of the pandemic, disregarding public and consultative processes, ignoring the sustained demands and recommendations by women’s rights, human rights, queer and health rights organizations, informed by the gaps we saw in its 50 years of implementation. Unfortunately, an important opportunity for a transformative law that unequivocally recognizes the right to abortion and reproductive and sexual rights, has been missed.
Moreover, other policies continue to create delays and denials for access to safe and comprehensive abortion care. These have piggy-backed on discriminatory colonial laws and mindsets, in absolute violation of the right to bodily autonomy and integrity that pervades the health system.
At Sama we are working to better understand barriers to safe and comprehensive abortion services with an emphasis on Particularly Vulnerable Tribal Groups (PVTGs), some of the most marginalised communities in the country.
For example, the 1979 order restricting sterilization among these groups is being implemented in the state of Chhattisgarh. Although this order was revoked in December 2018, following a public interest litigation by some women from the Baiga tribal community with the support of local activists, in reality there are still barriers, denials and delays in accessing sterilization as well as abortion services for women and girls from PVTG communities. Sama’s meetings with women, girls and community health workers from PVTG/Baiga communities has supported building narratives and demands for better accessibility to State reproductive health services through facilitated discussions on reproductive rights and autonomy.
All women/persons – including those with marginalised identities, or coming from underprivileged contexts – must be enabled to exercise their right to bodily autonomy and decision making.
At Sama we are in the process of deepening understanding of abortion as an intersectional issue. We reiterate the need to foster feminist solidarity across regions, countries, and across the globe, to counter the politics of control over women’s bodies.
We call for the universal recognition of reproductive rights and the need for reproductive justice – locally and globally.
Sama is a SAAF grantee partner based in Delhi. You can read more about their work here.