Duggal Ravi
Centre for Enquiry into Health and Allied Themes, Mumbai, India.
Reprod Health Matters. 2004 Nov;12(24 Suppl):130-7. doi: 10.1016/s0968-8080(04)24012-5.
Access to abortion services is not difficult in India, even in remote areas. Providers of abortion range from traditional birth attendants to auxiliary nurse midwives and pharmacists, unqualified and qualified private doctors, to gynaecologists. Despite a well-defined law, there is a lack of regulation of abortion services or providers, and the cost to women is determined by supply side economics. The state is not a leading provider of abortions; services remain predominantly in the private sector. Abortions in the public sector are free only if the woman accepts some form of contraception; other fees may also be charged. The cost of abortion varies considerably, depending on the number of weeks of pregnancy, the woman's marital status, the method used, type of anaesthesia, whether it is a sex-selective abortion, whether diagnostic tests are carried out, whether the provider is registered and whether hospitalisation is required. A review of existing studies indicates that abortions cost a substantial amount--first trimester abortion averages Rs.500- 1000 and second trimester abortion Rs.2000-3000. Given the number of unqualified providers and with 15-20% of maternal deaths due to unsafe abortions, the costs of unsafe abortions must also be counted. It is imperative for the state to regulate the abortion economy in India, both to rationalise costs and assure safe abortions for women.
在印度，获取堕胎服务并不困难，即使是在偏远地区。提供堕胎服务的人员范围广泛，从传统接生员到辅助护士助产士、药剂师，从不合格和合格的私人医生到妇科医生。尽管有明确的法律，但堕胎服务或服务提供者缺乏监管，女性所承担的费用由供给侧经济因素决定。政府并非堕胎服务的主要提供者；服务主要集中在私营部门。在公共部门，只有当女性接受某种形式的避孕措施时堕胎才是免费的；可能还会收取其他费用。堕胎的费用差异很大，这取决于怀孕周数、女性的婚姻状况、所采用的方法、麻醉类型、是否是性别选择性堕胎、是否进行诊断测试、服务提供者是否注册以及是否需要住院。对现有研究的综述表明，堕胎费用相当高——孕早期堕胎平均费用为500至1,000卢比，孕中期堕胎为2,000至3,000卢比。鉴于不合格服务提供者的数量以及15%至20%的孕产妇死亡是由不安全堕胎导致这一情况，不安全堕胎的成本也必须计算在内。印度政府必须对堕胎经济进行监管，既要使成本合理化，又要确保女性能够安全堕胎。
