Women and Reproductive Control: The Nexus between Abortion and Contraceptive Use in India

Anju Malhotra, International Center for Research on Women (ICRW)
Laura Nyblade, International Center for Research on Women (ICRW)
Sulabha Parasuraman, International Institute for Population Sciences (IIPS)
Kerry MacQuarrie, International Center for Research on Women (ICRW)
Namita N. Kashyap, International Institute for Population Sciences (IIPS)
Sunayana Walia, International Center for Research on Women (ICRW)

We examine women’s options to exercise reproductive control by focusing on contraception and abortion as two main proximate determinants of fertility outcomes. We examine how domestic and provider-related constraints are reflected in the occurrence and resolution of unwanted pregnancies. We utilize high-quality data from a methodologically innovative study that captures the full reproductive histories—including abortion—of 2500 married women (15-39) in Madhya Pradesh, India. Our data show that 23% of women have attempted at least one abortion. Although abortion is legal in India, most abortions for rural women (56%) were through unsafe means. Women’s effective access to contraception is extremely limited: spacing methods were used only 6.4% of the time that women wanted to space childbearing. Our results suggest that, to achieve continued fertility decline and reproductive health and rights, policy efforts must make the effective provision of spacing methods a priority and improve access to safe abortion.