India sees sharp rise in recorded abortions, driven by state-level disparities

In July 2025, the Health Ministry told Parliament that recorded medical terminations in India had risen from 5.34 lakh in 2020–21 to 8.93 lakh in 2024–25 — a 67 percent increase in five years, logged in the Health Management Information System from government and registered private facilities. The rise is uneven: Maharashtra reported more than 2.07 lakh procedures in the latest year, Tamil Nadu over a lakh, while Telangana’s numbers vaulted from under three thousand to more than twenty-eight thousand — a 917 percent jump that stands out even in a nationwide upward trend.

Both Maharashtra and Tamil Nadu have dense health infrastructure, high rates of facility births, and long-established reporting systems. Their curves are steep but steady. Telangana’s leap is newer. Health officials point to several converging factors: the registration of more private clinics, digitisation of rural primary health centres, and wider use of mifepristone–misoprostol combinations, which the law permits up to nine weeks’ gestation. Much of the surge may be a matter of capture — procedures that were happening before but are now entering the official record.

Other states show flatter lines, though not necessarily flatter realities. Uttar Pradesh, with nearly eight times Telangana’s population, has recorded a smaller percentage rise. Kerala’s growth has been modest, reflecting a baseline of steady provision. In low-reporting states, under-registration and the absence of formal providers in rural areas keep the official numbers low, but the absence of a number does not mean the absence of a case.

The 2021 amendment to the Medical Termination of Pregnancy Act reshaped the legal framework. It extended the upper limit to 24 weeks for certain categories, allowed unmarried women to terminate pregnancies on the same grounds as married women, and reduced the number of doctor approvals needed up to 20 weeks. These changes, combined with pandemic-era teleconsultation allowances, have brought more terminations into the formal health system — in places where that system is accessible.

Even so, the gap between recorded and actual incidence remains wide. A 2017 Lancet Global Health study estimated 1.5 crore abortions in India in 2015 — more than ten times the HMIS total for that year. Many medical abortions still go unreported when pills are bought over the counter, ordered online, or distributed informally in villages. In NFHS-4, 10.9 percent of abortions in Telangana occurred at home, nearly 70 percent in private facilities; NFHS-5 suggests the private share remains dominant.

Together, the data shows an India where access is expanding, but unevenly, where legality does not guarantee safety, where the numbers in the database are the visible edge of a much larger, more complex landscape.

Abortionhealthmaternal healthMedical Termination of Pregnancy ActTelangana