Dev World Bioeth. 2021 Jun;21(2):74-77. doi: 10.1111/dewb.12296. Epub 2020 Oct 5.
Nearly a million Indian women lack access to safe and dignified abortion services from public healthcare facilities and instead opt to induce abortions by themselves or with the help from unskilled and unauthorized practitioners. Unsafe abortions account for an estimated 9% of all maternal deaths in India despite the legalization of abortion on all grounds since 1971 via the MTP Act. However, the Act technically does not make any provision for abortion based on a woman's request alone, subjecting her decision to the approval of her healthcare provider, limiting reproductive autonomy. Moreover, the problem of female feticide through sex-selective abortions has also contributed to a conflicting public agenda that prioritizes preventing the former over allowing women access to abortion services for other reasons. Women who are socio-economically, culturally, and educationally vulnerable and minors may experience further abortion related stigmatization. These ethico-legal considerations highlight the need for transition from a provider-centered to a woman-centered abortion service model.
近百万印度女性无法在公共医疗设施获得安全和有尊严的堕胎服务，而是选择自行或在非专业和未经授权的从业者的帮助下进行堕胎。尽管自 1971 年以来，通过《医疗终止妊娠法案》（MTP 法案）将所有理由的堕胎合法化，但不安全堕胎仍占印度所有产妇死亡的约 9%。然而，该法案实际上并没有仅根据妇女的请求提供任何堕胎规定，而是将其决定置于医疗保健提供者的批准之下，限制了生殖自主权。此外，通过性别选择性堕胎进行的女性胎儿选择性堕胎问题也导致了一个相互冲突的公共议程，该议程优先重视防止前者而不是允许妇女出于其他原因获得堕胎服务。在社会经济、文化和教育方面处于弱势地位的妇女和未成年人可能会经历进一步的与堕胎相关的污名化。这些伦理法律考虑因素突出表明需要从以提供者为中心的堕胎服务模式向以妇女为中心的堕胎服务模式转变。
