Running an obstacle-course: a qualitative study of women’s experiences with abortion-seeking in Tamil Nadu, India

Figures & data

Table 1. Participant’s profile and context

Name	Caste category	Age during study	Age at marriage	Education	Employment at time of abortion	Pregnancies (N)	Living children (N)	Negative pregnancy outcomes (N)	Induced abortions (N)	Brief description of the life context and vulnerability locating the participant
Bragadhi	General	31	23	12th class	None	3	2 (F)*	0	1	Lives in a joint family of orthodox Hindu- Brahmin priests. Family denies use of contraception/sterilisation. Has very rigid mother-in-law who is very judgemental about others. One daughter born prior to the unwanted pregnancy is speech impaired
Urmila	General	46	30	10^th class + vocational training	Permanent	2	1 (M)**	0	1	Comes from an upper-middle class family and is a VHN. Family denies sterilisation and she is concerned about childcare and job security of her husband.
Latha	General	33	27	8th class	None	4	1 (M)	1	2	Hails from an upper caste family, but had married a man from a lower caste. Therefore she is denied physical, emotional and financial support from her parental home during pregnancy, childbirth etc. She experienced a miscarriage followed by a D&C, during her first pregnancy at 4 months The lack of regular source of income from her husband also added to her everyday life burdens.
Maheswari	BC	30	27	10th class	None	3	2 (F)	0	1	She conceived due to the failure of the post-partum IUCD insertion. Extremely authoritative in-laws who had disapproved of the woman’s decision to abort. Sought abortion taking into confidence her husband and natal family members.
Preeti	BC	31	26	MBBS	Permanent + business	2	1 (M)	0	1	An MBBS, practicing doctor self-managed using medical abortion pills and taking into confidence her husband, also a doctor, but not her parents and in-laws.
Mohini	BC	34	25	12th class	None	6	2 (M)	0	4	Husband denied approval for sterilisation, but wanted to delay pregnancy with a desire to have a girl child. Her husband, although a weaver by tradition, has diversified to repair televisions as the mechanical loom has gained prominence. Given the sweeping changes in electronic technology he is no longer having job calls as before. However he denies her going for jobs due to childcare concerns.
Radha	BC	31	22	8th class	None	4	2 (F)	0	2	She chose to have an abortion without undergoing any sex determination, amidst the expectations and preference of the family for a son. Also husband being a sculptor at temples does not have permanent income and has jobs as and when work is available.
Saranya	MBC	23	19	12th class	None	5	2 (F)	0	3	She was forced into marriage with her mother’s step-brother and therefore had to discontinue her college education in computer science when she became pregnant. She resents the fact that she cannot postpone pregnancies and has to rely on her husband to get her the medical abortion pills. She feels trapped in a mesh of multiple responsibilities as daughter-in-law, wife and mother, amidst family's expectation.
Meenakshi	MBC	60	35	10th class	Permanent	2	0	0	2	A polio attack in her childhood left her disabled. Being a bank employee, she married her younger sister’s husband after taking partial consent from her sister. She had been financially supporting her sister’s family even before her marriage and she continued to support the family and raise her sister’s children. She decided not to have children both due to her disability and to avoid family inheritance issues.
Vanathi	Nomadic Tribe - MBC	25-30	18-22	No schooling	Seasonal tmporary business	6	3 (M)	1	1	Hails from a nomadic tribe. This particular community has been subjected to severe forms of historical stigmatisation and marginalisation. Her narratives depicted insecure and marginal livelihoods, poor economic conditions, inefficient health-provider relationships. Her husband gave away one son for adoption, as the community has daughter preference.
Sukanya	SC	25	19	8th class	None	5	2 (M)	2	1	Married to her maternal uncle (without siblings) who desires to have several children to share the family's burden in the future. She had experienced two miscarriages and one son was born with a deformity in the legs causing delay in walking. Being the only daughter, she decided to have an abortion as her mother was declared to be in the palliative stage of cancer.
Ponnarasi	SC	31	16	9th class	None	8	5 (3M, 2F)	2	1	The first three children she delivered at home. Her fourth pregnancy led to an early stillbirth, and she had a misccariage in between pregnancies. The seventh pregnancy was a high risk pregnancy that caused blurred vision, leg swelling in the third trimester and she therefore delivered in the hospital. She feels too weak and tired to go through another pregnancy and childbirth.
Kalaivani	SC	24	18	9th class	None	5	2 (1M, 1F)	2	1	First childbirth outcome was a stillbirth, and during the third pregnancy she had a miscarriage at seven months. She fears use of contraceptives and at the same time the possibility of getting pregnant, given her poor health.
Anandi	MBC	29	18	10^thclass + computer course	Seasonal	8	4 (3F, 1M)	0	1	She eloped and married a man from a lower caste (SC) who eventually turned out to be drunkard. She is also a victim of domestic and sexual violence. After fifth pregnancy, her husband sold the two newborns through unknown outsiders. One daughter was given away for adoption. She is the breadwinner of the houseold and the husband is irresponsible towards family needs.
Rajalakshmi	MBC	36	24	8th class	None	5	3 (2M, 1F)	0	2	Husband is not very supportive in managing the family needs with contractual and seasonal employment, in addition to being an alcoholic. One child was lately terminated due to severe fetal anomaly, not documented in detail, as it was not within the scope of the study.
Rajalatchmi	SC	24	16	3rd class	Contractual labourer	3	1 (F)	1	1	After a failed first marriage from which she had a daughter, and losing a son under the age of one due to unknown illness and poor health care, she was married to another man. She underwent both sexual and domestic violence. However, as soon as she got pregnant, her husband deserted her to marry another woman.

*F = female, **M = male

Figure 1. First experience seeking abortion among marginalised communities

Figure 2. First and subsequent experience seeking abortion among privileged communities