Indians facing barriers to abortion access, privacy breaches due to requests to show Aadhaar
The reporting by Politico of documents that show United States Supreme Court judges voted to overturn abortion rights, striking down the Roe v. Wade decision, has reignited debate on abortion around the world. In India, a grey area around women seeking an abortion being asked to present their Aadhaar ID cards, errors with their cards, data breaches plus stigma are leaving women of all backgrounds, and, in particular, vulnerable groups such as transgender individuals, in desperate situations.
Extensive reporting by BehanBox, an outlet specializing in gender, equality and policy, uses interviews, studies and surveys to bring together the issues of stigma and how it affects decision-making, the law versus practice faced by those seeking abortion, and the impact the insistence for women to provide Aadhaar ID and consequent denials of service is having on health.
Although not available on request, abortion is legal in India in certain situations, but as BehanBox’s first article after the U.S. Supreme Court story explains, the law states that it is still the medical practitioners who make the final decision. It cites a 2021 study by the National Law School of India University which found that these practitioners are not impervious to shame, guilt and morality surrounding the procedure.
India’s Medical Termination of Pregnancy Act 1971 (MTP) has been subsequently amended in 2003 and 2021 to extend the situations in which an abortion is legal, such as all cases of contraceptive failure. Procedures are covered by India’s health insurance schemes.
Much of the coverage of requests to see Aadhaar by those seeking abortions services goes back to 2017 when a study was published in the BMJ (formerly British Medical Journal) of a 28-year-old domestic worker who sought a medical abortion for her sixth pregnancy.
The government hospital would not allow this without an ultrasonography (USG) report and would not allow this procedure without seeing her Aadhaar card. Even a private medical provider wanted to see valid ID. The woman turned to an unqualified provider, but the treatment led to complications resulting in her having to be admitted to hospital and receiving a blood transfusion.
The study resulted in 52 public health organizations and individuals issuing a statement demanding such linkages to be ended and the public informed of the situation, reported The Wire.
Parts of India require photographic and address identity for USGs, reports BehanBox, in its article on the impact of digital identity and Aadhaar requests.
“The denial of abortions because of the inability to submit the Aadhaar is a violation of the landmark Supreme Court judgement in Puttaswamy versus Union of India case as well as the Aadhaar Act, both of which hold that the lack of an Aadhaar should not be a reason for the denial of essential services,” states the article.
Registration errors or problems with biometrics can also lead to denials of service even when women have Aadhaar cards. Private providers can exploit those without cards by demand much higher fees. The date of birth can reveal someone seeking abortion to be a minor, who are prohibited from the procedures.
Beyond the risks to health are the risks to privacy when identity is required for healthcare, especially around reproductive health. The link to digitized identification information such as Aadhaar is preventing women from seeking safe abortions.
Data breaches of the Aadhaar system compound the risk and fear. The authorities’ use of the data is also highly problematic as different jurisdictions and agencies are using Aadhaar data against the people. The article gives the example of the Tamil Nadu government publishing list of people who had only had one vaccination rather than two in order to publicly shame them.
There have been multiple reports over the years such as states requiring Aadhaar to call an ambulance, receive HIV treatment, to track blood donations. The government is continuously attempting to link Aadhaar and state health insurance.
BehanBox quotes a study from 2007 to 2011 which found that 65 percent of abortions among women aged 15 to 58 in nine Indian states were unsafe.