Effects of Indian Healthcare Policies on Contraception, Pregnancy, and Pregnancy Termination Rates

Authors: Akanksha Gupta, Shalini Singh, Neha Sahu, Dr Rinki Kumari

DOI: 10.18231/j.ijogr.10632.1762255301

Keywords: Indian healthcare policies, contraception utilization, pregnancy rates, abortion rates, socioeconomic disparities, urban-rural gap, reproductive health, policy impact.

Abstract: Background: India has implemented several healthcare policies over the past two decades to improve reproductive health outcomes, including access to contraception and safe pregnancy termination services. However, the extent to which these policies have influenced contraception use, fertility rates, and abortion rates across different regions remains underexplored. This study aims to evaluate these policy impacts using a mixed-methods approach. Methods: A retrospective, descriptive study was conducted using secondary data from NFHS (3, 4, 5), DLHS, and SRS reports spanning 2001-2021. Policy documents including the National Population Policy (2000), National Health Policy (2002, 2017), RCH Program, NHM, and the MTP Act were reviewed. Quantitative data were analyzed using SPSS for trends and regional comparisons, while qualitative insights were obtained through semi-structured interviews with healthcare professionals, policymakers, and community health workers, analyzed using content analysis. Results: The study found a steady increase in modern contraceptive prevalence from 47% (NFHS-3) to 56.5% (NFHS-5), alongside a decline in total fertility rate from 2.7 to 2.0 during the same period. However, pregnancy termination rates saw a slight increase, indicating persistent challenges in preventing unintended pregnancies. Regional disparities were evident, with Kerala showing better performance in contraceptive use and fertility reduction, while states like Bihar and Uttar Pradesh lagged. Qualitative data highlighted barriers such as cultural resistance, limited awareness, logistical challenges faced by ASHAs, and strong abortion stigma in rural areas. Policy initiatives improved access to services but struggled with implementation in socio-economically weaker regions. Conclusion: While India’s healthcare policies have made measurable progress in improving reproductive health outcomes, socio-cultural barriers, regional disparities, and gaps in service quality continue to hinder equitable progress. Strengthening community-level interventions, improving awareness campaigns, enhancing ASHA training, and addressing cultural stigma are essential for achieving comprehensive reproductive health improvements across the country.