Abortion is the deliberate elimination of an unwanted pregnancy. Medical termination of pregnancy (MTP) is the abortion service offered through medication or surgery to women who do not want to continue with their pregnancy. In India, abortions are governed by the Medical Termination of Pregnancy Act, 1971, wherein it is stated that pregnancy can be medically terminated only by a “registered medical practitioner” (RMP) at a medical facility that is registered as medical termination of pregnancy (MTP) center. If a woman may suspect being pregnant or has confirmed pregnancy through a test and if she desires to terminate the pregnancy, it is best to approach the pregnancy abortion clinic in Chennai registered under the MTP Act immediately.
Abortion economy in India
Though India has seen early legalization of abortion, the problem of illegal providers and unsafe abortion is rampant. Unqualified and unregistered practitioners exploit the vulnerability of women seeking an abortion, creating a political economy controlled by them and contributing to widespread post-abortion problems and mortality. There are specific peculiarities associated with the abortion economy in India. Registration, monitoring, and inspection of MTP centers in India are carried out by local civic bodies but there is no way that they can regulate the abortion economy because the cost of abortion for unwanted pregnancy in India is influenced by several factors as described below.
Abortion cost depends on the duration of pregnancy
If a pregnancy needs to be eliminated, it is best to do it during the early stages of pregnancy in order to reduce the risks associated with late abortion. There is considerable variation in abortion costs depending on the number of weeks of pregnancy. Second-trimester abortions cost up to 3 to 4 times more than the first trimester. It is better to discuss all the options with the RMP. The first trimester of pregnancy is the safest period for abortion because it can be managed by prescription medication available at a reasonable cost with no risks or side effects. A review of Indian studies in the international journal on sexual and reproductive health and rights indicates that abortions in the first trimester cost an amount that averages Rs.500 to Rs.1000 and second-trimester abortion from Rs.2000 to Rs.3000. After the first trimester, abortion charges are higher as the procedure may involve higher technical skills and associated risks.
Abortion cost varies with an abortion procedure
Each pregnancy state is different. There are different abortion procedures for different cases of pregnancy. Abortion procedures vary in pricing. The abortion pill may have a different cost than an in-clinic abortion or an abortion for an ectopic pregnancy. In cases requiring anesthesia, the cost maybe two to three times higher for general anaesthesia than for local anaesthesia.
- Early non-surgical abortion is performed during 2-10 weeks of pregnancy and is based on the medical process where drugs are prescribed at specific intervals to stop the process of pregnancy and eliminate the contents of pregnancy. The law governing medical abortions in India allows abortion doctors in Chennai the final authority to prescribe abortion pills that can be taken only under their supervision. Though medicines can be bought from retailers with a valid prescription, medicines may be dispensed at the clinic itself. Thus, the cost of the abortion pill varies from clinic to clinic.
- Vacuum aspiration is performed in 2-12 weeks of pregnancy where the foetus and the placenta are sucked out through a vacuum tube inserted in through the cervix. At times, the walls of the uterus are scraped to make sure that the content is washed out completely. The further along with the pregnancy, the more the procedure is expected to cost.
- Dilation and evacuation is a process performed between 13 to 22 weeks of pregnancy. In this, the cervix is slowly opened with medication under general anaesthesia after which, with the help of suction curettage and forceps, the content is removed from the womb. Sometimes, the procedure may require dismembering the foetus. The price usually depends on where the procedure is done and how far along the pregnancy is.
- Induction abortion is a procedure performed in 13 to 21/22 weeks of pregnancy and beyond in special cases. In a hospital, the mother is given drugs in order to terminate the pregnancy thus beginning the process of labor in 2 to 4 hours. A suction curettage may be performed along if the placenta is not completely expelled through labour. Because this procedure is performed in late pregnancy, it can cost more.
Abortion cost may involve acceptance of contraception
The state provides abortions within the family planning context by subsidizing to select private abortion providers if they offer abortion services based on acceptance of sterilization or an IUD. NGOs and other organizations like the Family Planning Association of India (FPAI) get grants for conducting sterilizations and inserting IUDs, also offering money as incentives to women. All these are often linked to abortion services, which are provided free to acceptors of contraception.
Abortion costs may vary with the woman’s marital status
Studies suggest that the experiences of unmarried young women seeking abortion in India differ from those of married women. It might be thought that it is exploitation on the pretext of abortion charges confined to unmarried women seeking abortions but it is not so. The study revealed that 25% of unmarried young women, compared to just 9% of married young women, had had a second-trimester abortion. Unmarried women reported non-consensual sexual relations leading to pregnancy and also enlisted reasons that were obstacles to avail timely abortion. Failure to recognize early pregnancy, exclusion from abortion-related decision-making, lack of confidentiality in selecting the abortion facility, unsuccessful previous attempts of abortion, and lack of partner support are some of the paramount obstacles.
Abortion centers in Chennai offer quality care, including post-abortion contraception, playing a great role in abortion service provision. Timely interventions to expand access to safe abortion services at reasonable cost are best offered through better-equipped facilities, ensuring adequate and continuous supply of abortion medication and by increased and continued training for abortion providers.