Objectives. To study the determinants of induced abortion among women in India and to examine the consequences of induced abortion on women’s reproductive health.
Methods. The analysis is based on 90,303 ever-married women of reproductive age, 15-49 years, included in India’s second National Family Health Survey, conducted in 1998-99. Covariates included in the study are sex composition of living children, sex preference, women’s age at effective marriage, urban/rural residence, religion, caste/tribe, couple’s education, couple’s working status, media exposure, wealth status, and women’s autonomy. Binary logistic regression methods were used to examine the association between induced abortion and possible determinants, as well as consequences of induced abortion on women’s reproductive health.
Results. At the national level, sex composition of living children, women’s autonomy, urban residence, couple’s education, and wealth status were found to be significantly associated with experience of induced abortion among women. However, the factors associated with induced abortion are found to be different in two distinct sociocultural set-ups in India. Although sex composition of living children and couple’s education were the major factors for induced abortion in the northern group of states, wealth status and caste/tribe status were the major factors for the southern group of states. The analysis also shows that, independent of other factors, the likelihood of experiencing any reproductive health problems was 1.5 times higher (odds ratio, 1.46; 95 percent confidence interval, 1.33-1.60; P < .001) among women who had one induced abortion and 1.9 times higher (odds ratio, 1.85; 95 percent confidence interval, 1.52-2.27; P < .001) among women who had two or more induced abortions compared with women with no history of induced abortion.
Conclusions. This study identifies women’s desire to limit family size with preferred sex composition of children as an important determinant of induced abortion in India. The study also suggests that induced abortions may have negative consequences for women’s reproductive health. There is a need for more in-depth qualitative studies at the regional level to better understand the determinants and consequences of this complex and sensitive issue in India. Programs should focus more on the availability and accessibility of contraceptives among women to elude the reproductive health consequences of induced abortion.
Keywords: Induced abortion, son preference, women’s autonomy, reproductive health, India