The growing literature on abortions in the developing countries tend to focus on the health consequences of unsafe abortions and the limited access to abortion services, but does not look at the real and often crippling economic cost of abortion. A woman undergoing an abortion has to incur expenditure in various forms, both direct and indirect. So far no all India household survey on abortion related expenditure has been conducted. However there are micro level surveys, which had been carried out in a specific state or a district, specially focussing on abortion. These surveys do throw some light on the expenditure incurred by women on abortion, although the sample size of abortion seekers covered by some of these studies is fairly small. These studies show that women have to incur some expenditure to get MTP services even from public clinics, which are expected to provide free services. However, by and large the government providers seem somewhat cheaper and are probably safer than the others, especially the illegal providers. Unfortunately, none of these studies have tried to look into the sources of financing the abortion expenses by the women. Also, the surveys included only women who had undergone an abortion from the approved MTP centres ; none of the surveys made an attempt to include the abortion seekers from illegal providers. Another limitation of these survey data on abortion cost is that it does include the cost of follow up care and this cost can be very high in case there is a complication after the MTP. A visit to different types of MTP providers in Delhi reveals that there are a wide range of services available across the city. The type of providers include government hospitals, family welfare centres, clinics run by NGOs like the Family Planning Association of India and Marie Stopes, government approved as well as not approved qualified private doctors and illegal providers like dais and quacks. These providers cater to different segments of the city’s population and the quality of services offered and the charges for abortion services also vary accordingly. The safety and the cost of abortion, to a large extent would depend upon the method of abortion used. The dilation and curettage (D&C), is still the most commonly used method of abortion in India. The alternative method for early abortion, manual vacuum aspiration (MVA) is not widely available in the country even in the government run MTP clinics. As a result the average cost of abortions becomes very high. Finally as far as abortion services are concerned, the option of insurance schemes is almost non- existent in the country. In fact in India health insurance is yet to pick up in a big way. Of the various schemes meant for the employees of the organized sector the ESIS, CGHS and the Railway Health Scheme provide MTP services for the women covered under their schemes in the hospitals run by them. Other insurance schemes as yet do not cover abortions . A review of the available literature
the first step is to increase the research in this critical area of financing for abortion care. We need to know not only about the abortion charges at the various types of MTP centres, but also the household dynamics like the source of financing the abortion etc. It is evident that even in the government facilities, the abortion seekers had incurred substantial expenditure .