Why Is The Choice Of Abortion Not ‘Equal’ For All Women In India?

As a married woman when I went for an abortion & asked for a painkiller, the doctor said: “Some things should hurt.”

Pro-choice protest image used for representational purposes.

(Photo: iStock / Altered by Kamran Akhter / The Quint)

I bought the test only because I was out of other explanations. Due to a lifetime of gynaecological issues I had been on the pill since I was thirteen to regulate my periods – it seemed extremely unlikely that I was pregnant. Yet I could not deny that obnoxious second pink line that appeared on one home pregnancy test after another. An unwanted pregnancy is always shocking, but a little more so if every doctor you have been to has told you that you likely cannot bear children.

There I was, all of twenty-four years of age, and comprised mostly of caffeine, incidentally capable of bringing-forth life. I lived with the ‘father’, and while we intended to marry at some point, it was too early in our relationship for that. We didn’t want children, so we made an appointment at a private hospital and two hours later, we were sitting in front of a doctor explaining we needed to procure an abortion. She didn’t ask if we were married, and I neither confirmed nor denied it.

I didn’t do so because on the way to the hospital I had been reading up on the ‘Shah Committee’.

Little Clarity On Whether Unmarried Women Can Get An Abortion Outside Of ‘Guidelines’

Abortion was illegal, though widely unsafely practised in India till 1971, when the Medical Termination of Pregnancy (MTP) Act was passed (in all states except J&K) on the recommendation of the Shah Committee. The stipulations of the MTP Act allow medical abortions up to nine weeks and surgical abortions up to 20 weeks.

Abortions are allowed in cases of rape, incest, possibility of grave mental or physical harm to the mother as well as in case of married women who had experienced contraceptive failure.

There is little clarity on whether unmarried women can actually avail this service in circumstances outside of the guidelines or even under grounds of contraceptive failure, and I didn’t want to run the risk of being denied.

The doctor gave me an ultrasound and confirmed that I was five and a half weeks pregnant. She explained the process of a medical abortion which involves taking a single progesterone blocker called Mifepristone followed two days later by Misoprostol, which causes the contractions to expel the pregnancy tissue. She prescribed a painkiller for the contractions and guided me on its use. I was amazed at how professional and safe the environment felt; it was not at all what I had expected given the experience of buying tampons and condoms in this country.

‘I Felt Supported In My Choice To Decide For My Body’

“I understand that outside of marriage this is a very difficult situation to find yourself in,” the doctor said to me out the way out of her office, “But someday when you are married, you can do this the right way.”

I am sure she meant well, but suddenly it felt like the only reason the path to abortion felt so comfortable was because she knew we weren’t married.

It wasn’t about my right to choose, but their understanding that being out of wedlock this was the only choice. Still, because their treatment of the matter was so professional and medically thorough, my emotional experience of the process that followed was more comfortable than I had expected. It was more physically intense than emotional. Even if their support came from a misguided notion, I felt supported in my choice to decide for my body.

Trauma Of My Second Abortion & Moral Judgement By The Doctor

I felt much less supported four years later, when I was married and having this talk with a government-appointed doctor. I had not planned on finding myself in this situation ever again. I had spoken to my doctor about my lack of faith in oral birth control and discussed the possibility of my partner having a vasectomy. Even though it is one of the least invasive and safest methods of birth control, it was discouraged due to the possibility of being irreversible, as if a woman’s decision of not wanting children could not be serious enough to warrant permanent action. An IUD was discouraged because I had not given birth before. So I had stuck with the pills, changing them as and when they caused unwanted symptoms.

Birth control had become a mathematical nightmare, and a slight error in the arithmetic had led me right back to that situation. That time the doctor confirmed our marital status before anything else, he then immediately began to draw up a chart to map the course the pregnancy would take. I stopped him and explained that I did not want to bear a child.

He asked several questions about contraception and after I had answered them, he listed ‘failure of contraception’ as a cause for the pregnancy.

He then asked us if we were sure, and we confirmed to him that we didn’t want any children.

I gave him a detailed history of my prior termination, and responded by telling us that what we were doing was wrong. He explained that at 28, I would soon be too old to bear children and I was robbing myself of a healthy opportunity to do so. He questioned my husband about how he could ‘allow this’. He then refused to order an ultrasound because he deemed it unnecessary, since “I wasn’t going to keep it anyway.” He practically threw the medication at us without providing any guidelines for use. Due to rampant ‘misuse’ of the medication, it is now dispensed by doctors, and most pharmacists are not allowed to stock it.

When I asked the doctor if he was going to prescribe a painkiller, he said, “Some things should hurt.”

Abortion Is ‘Never About Choice’

I left the clinic in tears. The next few days I wrestled with the decision I had made; I had never considered a legal, on-term, medically-supervised abortion ‘immoral’ before, but the feedback I had received made me doubt my own conviction and choices. I also understood why so many of my friends who had been in this situation before had chosen to procure abortion kits from the pharmacist instead of doctors.

I understand the need for the ongoing reform to make abortion services more accessible through alternative medical practitioners. The truth is that in India, abortion is affordable – but the access is qualified by ‘prerequisites’.

We encourage a certain ‘type of woman’ to opt for it: an unmarried woman, a woman who has already borne children, a poor woman who is made to bear child after child for a son.

We tout our abortion laws as ‘liberal’, and they are certainly more ‘liberal’ than many other nations, but it’s not accurate when we say that is about ‘choice’ and not ‘population control’. The silence on this subject only confirms that.

This was never about choice – it was always about determining who was qualified to choose. Spoiler alert: it’s not the women.

(Aarushi Ahluwalia is a freelance journalist currently based in J&K. She recently launched her own women-centric news website, The Pamphleteer. She has worked extensively on the subject of gendered violence and women's issues for organisations such as Cobrapost, CNN and The Guardian. She loves her cats and is incredibly tired of being told to smile more. She tweets @the_pamphleteer. This is a personal blog, and the views expressed are the author’s own. The Quint neither endorses nor is responsible for them.)