The numbers tell a stark tale of poverty, stigmatisation and patriarchy. Unsafe abortions are a leading cause of maternal mortality across China and India.

The global debate on anti-abortion legislation – with the abortion ban by the southeastern US state of Alabama earlier this year – shows no signs of settling down. The situation in Asia, particularly China and India, is truly worrisome, though.

According to Guttmacher Institute, a leading research organisation working on women’s reproductive health, 53.8 million unintended pregnancies occur each year in Asia. Of these, nearly 65 per cent end in abortions.

China has the highest number of abortions in the world. In 2018, about nine million abortions were recorded in the country, according to the data released by the National Health Commission, China. In India, nearly eight women die from causes related to unsafe abortions every day.

The numbers tell a stark tale of poverty, stigmatisation and patriarchy.

Table of Contents

Laws in place

The two most populous Asian countries, India and China, have legal provisions in place to facilitate safe termination of pregnancy. Still, unsafe abortions remain one of the top causes of maternal mortality in both countries.

The World Health Organization (WHO) defines ‘unsafe abortions’ as a pregnancy which is terminated either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards.

Data from the latest National Family and Health Survey (NFHS-4) in India shows that about 26 per cent of the abortions were reportedly performed by the women themselves at home. In many cases, the underlying reason is believed to be the preference for the male child. Improved technology for prenatal sex diagnosis have made unsafe abortions a common practice.

Both, in India and China, sex-selective abortions are illegal. However, the skewed sex ratios bear testament to the alarming ground realities. According to a global study published in the journal Proceedings of the National Academy of Sciences, on how selective abortions by women impact the sex ratio, the largest differences in gender ratios are from China and India.

China has the dubious distinction of having the world’s most skewed sex ratio at birth, with about 115 boys born for every 100 girls, according to the Global Gender Gap Report 2018, published by the World Economic Forum. The sex ratio in India, incidentally, has declined from 903 in 2007 to 898 in 2018, as per government data. Hong Kong, South Korea, Taiwan and Vietnam are the other Asian countries with poor sex ratios.

Social realities

Experts concur that abortions are common in China due to the country’s former population control policies. Though the country no longer has a strict population control policy, unsafe abortions still prevail. Lack of knowledge about contraception among Chinese youth is a major factor, say studies. According to a 2015 WHO report, a quarter of Chinese people in the 15-24 years age group had sex and at least a third of them refrained from using any form of contraception, leading to unplanned pregnancies.

The legalisation of abortions alone does not make them safe. Even in countries where abortion is legal, women fear stigmatisation due to religious or socio-cultural biases. Doctors too tend to deny termination of pregnancies in cases where women are unmarried. Fear of poverty, single motherhood, preference for the male child, or (in many cases) domestic violence compels women to undergo unsafe abortions.

The toll of unsafe abortions on women’s health is substantial. Socio-economic vulnerability and inadequate access to healthcare leave women at risk of abortion-related deaths. It’s a health threat that demands a comprehensive approach. Only laws on paper cannot save these women.