Several states face shortage of medical abortion pills

The study conducted among 1,500 chemists in six states indicated shortage of medical abortion drugs in five out of the six states surveyed. The findings revealed an abysmal stocking in Madhya Pradesh (6.5%), Punjab (1.0%), Tamil Nadu (2.0%), Haryana (2.0%), and Delhi (34.0%). The only state that seems to be better is Assam (69.6%), the report said.

The surveyors found that about 79% of chemists no longer stock medical abortion (MA) drugs to avoid legal issues and excessive documentation requirements. 54.8% of chemists also report that these drugs are overregulated as compared to other schedule H drugs. Even in Assam, which has the highest stocking percentage, 58% chemists report overregulation of MA drugs. Statewise, regulatory or legal barriers continue to be the major reason for not stocking abortion drugs, with 63% chemists in Haryana, 40% in Madhya Pradesh, 74% in Punjab and 79% in Tamil Nadu reporting so.

“Medical abortion has increasingly become the preferred method to terminate a pregnancy in India and the non-availability of drugs is threatening women's access to safe abortion," said V.S. Chandrashekar, chief executive officer, FRHS India.

“Evidence shows MA drugs are a safe and effective means to terminate a pregnancy. Their non-availability can potentially reverse the gains made by the country in reducing unsafe abortions, maternal mortality and morbidity," Chandrashekar said.

While the purpose of the study was to verify the availability of MA drugs, the findings also revealed that emergency contraceptive pills (ECP) are not being stocked by chemists in the state of Tamil Nadu. Only 3% of the chemists surveyed in the state reported stocking ECPs and 90% not stocking shared that the pills are banned in the state. Emergency contraceptive pills are non-prescription drugs and are also stocked and distributed by Accredited Social Health Activists (ASHAs) under the National Family Planning Programme.

The study has recommended addressing misconceptions regarding MA and gender-biased sex selection; harmonizing Central Drugs Standard Control Organisation approvals/requirements and the Medical Termination of Pregnancy (MTP) Act; amending MTP rules to allow MBBS doctors to prescribe MA drugs, increasing investments in safe abortion communication by providing support to women who access MA drugs by setting up toll-free helpline numbers.

Health experts have said that medical abortion has reduced the cost of early abortion care considerably making it easily accessible for women.

“In covid-19 pandemic times, many providers have started asking for covid-19 test before carrying out a surgical abortion, which can further increase the cost of service for women. MA in comparison is cheaper as it does not require a clinical set up," said said Debanjana Choudhuri, senior manager-partnerships, FRHS India, adding that non availability of MA will push women to seek surgical abortion which can be cost intensive and can further widen the access gaps.