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‘Unsafe abortions are a critical reproductive-health issue in Rajasthan,’ warns expert

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This scenario becomes even more complicated due to the lack of requisite healthcare and limited access to safe abortion services

Divya Santhanam flags that an increase in child marriages could lead to unplanned pregnancies and unsafe abortions in the state

In Rajasthan, 35% of women aged 20-24 years reported getting married before 18 years of age, which is quite high compared to the national average of 26%. This brings us to the critical issue of solid linkages between early marriages and unplanned pregnancies. This scenario becomes even more complicated due to the lack of requisite healthcare and limited access to safe abortion services.

Nearly 15 of every 1,000 girls in Rajasthan in the age group 15-19 years undergo induced abortions annually. Only 40 percent of these abortions occur with assistance from healthcare providers, indicating that the rest 60 percent of the abortions in the age group are ‘unsafe’ and without any trained assistance.

According to WHO, abortions are safe when they are carried out with a recommended method appropriate to the pregnancy duration. The person carrying out the abortion must have the necessary expertise. However, such specifications often remain on paper, especially in developing countries. Based on data from 2010–2014, approximately 45% of abortions worldwide were unsafe, and almost all occurred in developing countries.

Divya Santhanam, Senior State Program Manager, Population Foundation of India, says, “In Rajasthan, the use of modern contraceptives is low at 11 percent among married adolescents as compared to 47 and 68 percent usage among the 25–29 and 30–39 years age group, respectively. This unmet need for contraception among adolescents in the state results in unintended pregnancies and induced abortions. During the pandemic, with healthcare workers diverted towards the management of COVID-19, a spike in unplanned pregnancies is being estimated.  One can only imagine how abortions were carried out during this time in environments that possibly did not conform to even minimal medical standards.”

Unsafe abortions can have immediate ramifications and lead to severe health risks – including loss of life, not to mention long-term complications that can compromise the health and well-being of women or girls. In rural Rajasthan, where basic reproduction information and health infrastructure are often amiss and young girls are married off before their minds and bodies have matured, unplanned pregnancies and unsafe abortions are inevitable.

Availability of contraceptives and comprehensive abortion care (CAC) services are crucial for adolescents’ well-being and for better social and economic outcomes. Based on Population Foundation of India’s study ‘Returns on Investment in Adolescents’ Sexual and Reproductive Health in Rajasthan’, the returns to investment in provisioning of contraceptives and Comprehensive Abortion Care (CAC) to adolescents  or the benefit-cost ratio (BCR) for Rajasthan is 2.97. This implies that for every INR 100 invested to provide contraceptives and abortion care, there could be a return of approximately INR 300 in terms of healthcare costs saved.”

This underscores the importance of adequate investment in adolescent health and infrastructure that supports them with information and necessary medical care. Reducing teenage pregnancy is the biggest challenge in addressing adolescents’ reproductive health needs. Demographic dividend in terms of increased economic output, growth, and social development will remain a distant dream if we do not address the unmet needs of our adolescents, women and girls.

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