Samita, a 35-year-old mother of two, lives near Calcutta. Since the birth of her first son 10 years ago, she has taken extreme measures to self-induce abortions on three occasions: per her midwife’s instructions, she inserts a small grapevine stalk into her uterus, which causes heavy bleeding and intense pain. After her most recent attempt, Samita’s pain continued for more than 10 days. Her family took her to the nearest hospital, where doctors gave Samita blood transfusions and heavy doses of antibiotics. Samita’s doctor said that if she had delayed coming in by just one more day, she would have died.

India has one of Asia’s broadest abortion laws. Under the 1971 Medical Termination of Pregnancy (MTP) Act, abortions may be performed by a registered physician in a government-approved hospital or facility during the first 20 weeks of pregnancy. However, in this sprawling country of more than one billion people, progressive laws do not guarantee access to safe abortion services. Unsafe abortions still far outnumber legal procedures; an estimated 60 percent of abortions performed in India are unsafe.

Ipas works in India in partnership with the Ipas Development Foundation (IDF), operating a program that covers 14 states. Starting with training providers and promoting safe abortion technologies at the state and district levels, Ipas and IDF now work to implement the abortion law; advocate for increased commitment to women’s access to safe services; forge partnerships; and strengthen the public health system at all levels to create high-quality, comprehensive abortion care services.

IDF’s comprehensive abortion care (CAC) training system is now ISO-certified and ensures standardization and continuous quality improvement for trainings managed by the state health systems.

IDF’s efforts also include strengthening the provision of comprehensive contraception care (CCC) in the public health system. IDF works in partnership with the Government of India, and two state governments – Jharkhand and Madhya Pradesh – to train doctors, nurses and nurse-midwives to provide CCC and assist women in making informed contraceptive choices to limit and space births.