Nirdhāra: a multi-method study of women’s abortion trajectories in Karnataka, India

Overview

My doctoral research examined how abortion is navigated, experienced, and made possible in everyday life in rural South India. Embedded in feminist and reproductive justice approaches, I centred women’s lived realities [1] to analyse abortion not as a discrete event, but as part of ongoing reproductive trajectories [2] shaped by social relationships, structural conditions, and systems of governance. 

Using a multi-method research design, I conducted qualitative interviews with women who had abortions (including self-management), alongside questionnaire and interview data with community health intermediaries (CHIs). Data collection took place over eleven months in Bagalkot and Belgaum districts in Karnataka, India. 

Empirically, I generated new data on women’s abortion experiences and management, including self-managed abortion, and on the role of CHIs in shaping abortion knowledge, access, and care. I show how abortion is mediated through trust-based relationships and community-level infrastructures, rather than occurring solely within formal health systems. By recruiting participants outside clinical settings, I was able to capture abortion experiences that do not come to the attention of formal health systems, including self-managed abortions that were successfully completed without facility-based care alongside those who sought post-abortion care. This addresses a significant gap in the literature, which has largely relied on facility-based samples and therefore disproportionately captures “failed” self-managed abortion, leaving successful self-management empirically under-documented. 

Conceptually, I challenge linear and individualised framings of abortion. I demonstrate that women’s abortion trajectories are non-linear, involving multiple, simultaneous strategies to enable care, and shaped by ongoing negotiations with norms surrounding fertility, sexuality, and womanhood. This work contributes to rethinking abortion safety, foregrounding how experiences of risk and care are produced through social and structural conditions rather than clinical or legal criteria alone. Within this, I begin to reconceptualise self-managed abortion not simply as an individual act, but as one shaped through relationships, informal networks, and community-based forms of care.

Drawing on the concept of reproductive governance [3], I analyse how abortion laws intersect with population and health policies in India. I demonstrate how normative constructions of sexuality and womanhood, alongside longstanding population control logics, shape who is able to access abortion and under what conditions. In doing so, I position abortion self-management as a key site of policy contestation. 

I successfully defended my thesis (November 2019) and was awarded (with no corrections) my PhD in January 2020.

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[1] Pregnant persons- trans men, non binary persons, and cis-gender women, amongst others- all want, seek, and receive abortion care. I use women here to specifically refer to cis-gender women as this is the population I captured in my data collection. I do not wish to misrepresent these data or make invisible the additional barriers and forms of violence that trans men and non-binary folks may encounter over the course of their trajectories.

[2] Abortion trajectories are complex, non-linear processes embedded within larger social and structural relationships and interactions (Coast et al., 2018).

[3] Reproductive Governance, developed by Morgan and Roberts (2012), is an analytical tool to trace the shifting political rationalities of population and reproduction.