Factors associated with second trimester abortion in rural Maharashtra and Rajasthan, India.

Many married women in India experience abortion in their second trimester of pregnancy. While there is an impression that second trimester abortions are now overwhelmingly used for sex selection, little is known about the extent to which second trimester abortions are indeed associated with son preference and sex selection motives, relative to other factors. Using data from a community-based study in rural Maharashtra and Rajasthan, research highlights the role of limited access in explaining second trimester abortion. While women with a single child who was a daughter were indeed more likely than other women to have terminated a pregnancy carrying a female foetus in the second trimester, more strikingly, exclusion from abortion-related decision-making, unsuccessful prior attempts to terminate the pregnancy, and distance from the facility in which their abortion was performed, were significantly associated with second trimester abortion, even after controlling for confounding factors. The study calls for greater efficiency in implementing the PCPNDT Act and addressing deep-rooted son preference. At the same time, findings that poverty and limited access to facilities are as, if not more, important drivers of second trimester abortion, highlight the need to meet commitments to ensure accessible abortion facilities for poor rural women.