Background: Rural India experienced a high frequency of unsafe abortions; therefore more research is needed to understand the regional patterns and socio-demographic factors of unsafe abortion by place of residence. The present study aims to explore the predisposing, enabling, and need factors of unsafe abortion in India.
Methods: In the National Family Health Survey, 2015-16, women aged 15–49 who had their last pregnancy terminated by induced abortion during the five years prior to the survey (N = 9113) were included in the study. The present study computed the rural-urban divide in percentage of unsafe abortions by respondents’ background characteristics. Predisposing, enabling, and need factors for unsafe abortion in India by place of residence were investigated using multivariate logistic regression models.
Results: In India, 27.3% of responders performed unsafe abortions out of 9113 induced abortions in 2015-16. Furthermore, the rural-urban divide was found to be considerable (7.2%), particularly among women aged 35-39 (15%). In terms of predisposing factors, there was a substantial difference in adjusted odds of unsafe abortions across the regions, with the risk of unsafe abortions being much higher in the urban eastern region (aOR:5.90, 95% CI:3.96,8.80) compared to the urban south region. In India, the likelihood of unsafe abortions increased with decreasing age, regardless of where the woman lived. In rural settings, women with an uneducated spouse are more likely to have unsafe abortions (aOR:1.92 CI:1.27,2.90). In India, poor households were more likely to undergo unsafe abortions, whereas it was found more likely in rural settings (aOR:1.26 95% CI:1.10,1.50). Similarly, SCs/STs more likely performed unsafe abortion in rural settings. In both rural and India, unmet need for family planning was revealed to be a significant need factor for unsafe abortion.
Conclusion: Despite the fact that abortion is legal, India's high estimated frequency of unsafe abortion reveals a serious public health issue. Large numbers of women are at risk of unsafe abortion due to socioeconomic vulnerability, unmet family planning needs, and a lack of awareness.