Assessing socio-cultural barriers related to induced abortion and reproductive health among married women in Rural Uttar Pradesh, India

Abstract

In the Global South, a disproportionate number of young married women who have unwanted and mistimed pregnancies, undergo unsafe abortion practices, leading to a heightened burden of maternal and infant deaths in developing countries. Unsafe abortion practices are frequently associated with limited contraceptive methods with a skewed focus on female sterilisation, a high unmet need for contraception, poor quality of sexual and reproductive health care services, low male involvement in reproductive health matters, and widespread gender discrimination against girls and women, which limit their access to quality health care services. The present qualitative study attempts to examine the practice of induce abortion at the village as well as assess the socio-structural barriers lead to the poor sexual and reproductive health in rural Uttar Pradesh, India. The study underlines the lived experience and process of decision-making related to induced abortion, and the intertwined family, social and healthcare-associated challenges faced by young married women in rural Uttar Pradesh, India. Evidence from the study suggests that inability to use safe contraception methods, unsupportive behaviour of the spouse towards childcare, financial hardship, lack of accessibility and affordability of contraception methods, lesser decision-making power, and social norms and customs appeared to pose critical barriers to safe abortion practices among young married women. Findings from the study also highlight an abysmal dearth of access to safe, affordable and quality abortion care services in rural Uttar Pradesh. The study emphasized individual and community-level perspectives on young married women’s or married couples’ decisions regarding induced abortion in rural Uttar Pradesh, besides highlighting various forms of social stigma, discrimination and health-related complications faced by them. This calls for program managers and policy makers to increase investments in high-quality comprehensive sexual and reproductive health services, and to revitalize efforts for greater male involvement in reproductive health matters, so as to ensure safe pregnancy and child health experiences in the Indian context.