Few choices in life weigh heavier than ending a pregnancy. It is not just a medical procedure—it is a deeply personal moment where a woman holds two futures in her hands, knowing only one can continue. Sometimes it's about sparing a child from a life of suffering; sometimes it’s about saving her own. These decisions, often made in silence—through heartbreak, fear, or immense courage—are profoundly human, beyond the reach of any law or textbook.

I didn’t learn this truth from lectures or textbooks, but from a corridor—nearly a decade ago, during my third year of BSc Nursing. As part of our curriculum, I was assigned to deliver a health awareness talk at Government Lala Ded Hospital in Srinagar, one of the busiest maternity hospitals in the Valley.
The antenatal corridors were crowded. The air was thick with antiseptic and anticipation. Expectant mothers, many from remote villages, waited on benches with swollen bellies and weather-worn faces, some clinging to polythene-wrapped medical files. Most were illiterate. To many, words like antenatal care and balanced diet meant little.
My job was to bridge that gap—and speak in a language they understood. I used analogies from their own kitchens: “Think of vitamins like ingredients in a Wazwan—if even one dish is missing, the meal feels incomplete.” I explained folic acid as the gentle guard shaping their baby’s brain and spine, and calcium as what would one day make their child’s tiny feet strong enough to run toward them, calling them mummy.
Some women nodded. One elderly grandmother asked if eating meat once a month counted as a balanced diet—we all laughed. But behind that laughter, I felt a deep ache. So much of maternal health depends not just on care, but on knowledge. That day taught me that in healthcare, language is as important as medicine, and listening is as vital as speaking.

A Changing Landscape in J&K

Today, those same hospital corridors still bustle—but the numbers tell a shifting story. Over the last four years, medical terminations of pregnancy (MTPs) in Jammu & Kashmir have increased from about 3,500 to nearly 9,000.
On one hand, this could reflect improved access to safe, legal abortion. On the other, it raises pressing questions:
Are more women facing unplanned or crisis pregnancies?
Are congenital defects on the rise?
Are social and economic pressures quietly forcing women into difficult decisions?
Behind each statistic is a deeply personal story—like the women I once stood before in that hospital.

The Legal Framework

India’s Medical Termination of Pregnancy Act, 1971 (amended in 2021) allows termination:
Up to 20 weeks with the opinion of one doctor
Between 20–24 weeks with two doctors’ approval, for specific cases (rape survivors, minors, women with disabilities, fetal anomalies, etc.)
Beyond 24 weeks, only if a State Medical Board confirms serious fetal abnormalities.
These laws exist to protect women's health and autonomy while preventing unsafe, unregulated abortions.

Why Are Women Opting for MTP?

The reasons vary

Immediate threats to the mother’s life
Devastating prenatal diagnoses
Economic hardship, social pressure, domestic violence, sexual assault
Lack of support or access to contraception
Among the most difficult cases are those involving congenital anomalies—heart defects, cleft palate, severe brain or spine malformations. While some causes are genetic, many are preventable through proper nutrition and pre-conception care.

Risk factors include

Poor intake of folic acid and iodine
Maternal obesity and uncontrolled diabetes
Exposure to tobacco, alcohol, and environmental toxins
Advanced maternal age and poor antenatal care
Sedentary lifestyles and poor diets
Environmental degradation, processed food, and pollution—even in remote areas—have compounded these risks.

The Way Forward

If we want to reduce the number of MTPs, we must look beyond hospital walls:
Contraception must be stigma-free and accessible
Pre-conception counselling should be a routine part of health services
Nutrition awareness should start early—taught in schools and reinforced by ASHAs and Anganwadi workers
Environmental policies must protect mothers from toxins
Communication must be rooted in local language and culture—not just technical jargon

Government Support & The Need for Awareness

Government schemes like Janani Suraksha Yojana, Pradhan Mantri Matru Vandana Yojana, and Ayushman Bharat have made significant strides. Free supplements (iron, folic acid, calcium) and diagnostic tests are provided at government facilities.
However, a lack of awareness means many women still don’t benefit fully. Increasing knowledge about nutrition and regular antenatal care could prevent complications—and reduce the emotional and physical toll of MTPs.

Every Decision Deserves Dignity

Every termination isn’t just a procedure—it’s a story. A woman who once dreamed of naming her baby, watching their first steps, may find herself making an unthinkable choice—for love, for survival, or both.
Some decisions are made in pain. Others, in fear. Many, in love—the kind of love that chooses to protect even if it means letting go.
If we want to reduce the rising numbers, we must first replace judgement with empathy, and shame with support. Support begins with basics: good nutrition, timely care, safe environments, and the right to choose.
Behind every number is a heartbeat—whether it stays or fades, it deserves dignity. And every woman deserves to be heard.

Email:------------------------kaisarmalla94@gmail.com