An Analysis of Trend, Pattern, and Determinants of Abortion, Miscarriage, and Stillbirths in Odisha, India

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Prafulla Kumar Swain
Anmol Jena
Subhadra Priyadarshini


The study aimed at examining the prevalence of pregnancy termination by Abortion, Miscarriage, and Stillbirths (AMS) and its determinants in the state of Odisha, India. The NFHS-IV data have been used for this analysis. GIS mapping has been used for the spatial distribution of outcome variables at the district level. Univariate analysis (chi-square) and a multivariable logistic model have been used to identify the potential factors associated with AMS. Out of 8,484 pregnancy cases registered, 969 (11.4%) cases had met with pregnancy termination by AMS. Jagatsinghpur, Jajapur, Subarnapur, Kendrapara, Nayagarh, and Puri have been identified as high prevalent districts. The age group of 30-34 years is more likely of pregnancy termination than the age group 15-19 years (OR=1.254). Women who have completed secondary education have 1.568 times higher odds of pregnancy termination by AMS than those who are illiterate. Pregnancy complications show significantly higher odds (OR=1.091) of pregnancy termination. Among the trio of reasons for pregnancy termination, miscarriage cases are the most prevalent, followed by abortion and stillbirths. Potential factors like age, education, wealth index, place of delivery, and anemia are significant for AMS (p value<0.05). Hence, a robust program must be developed to reduce adverse pregnancy outcomes.



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Swain, P. K., Jena, A., & Priyadarshini, S. (2021). An Analysis of Trend, Pattern, and Determinants of Abortion, Miscarriage, and Stillbirths in Odisha, India. Journal of Population and Social Studies [JPSS], 29(-), 223 - 234. Retrieved from
Author Biography

Anmol Jena, Department of Statistics, Utkal University, India

Corresponding author


• Abdoli, A. (2016). Salt and miscarriage: Is there a link? Medical Hypotheses, 89, 58–62.
• Ahmed, M. K., Rahman, M., & van Ginneken, J. (1998). Induced abortion in Matlab, Bangladesh: Trends and determinants. International Family Planning Perspectives, 24(3), 128–132.
• Altijani, N., Carson, C., Choudhury, S. S., Rani, A., Sarma, U. C., Knight, M., & Nair, M. (2018). Stillbirth among women in nine states in India: rate and risk factors in study of 886,505 women from the annual health survey. BMJ Open, 8(11), Article e022583.
• American College of Obstetricians and Gynecologists (ACOG). (2015). Practice bulletin No. 150. Obstetrics & Gynecology, 125(5), 1258–1267.
• Babu, D. N. P., Nidhi, D., & Verma, D. R. K. (1998). Abortion in India: What does the national family health survey tell us? The Journal of Family Welfare., 44(4), 45–54.
• Bhati, D. K. (2013). Stillbirths: A high magnitude public health issue in India. South East Asia Journal of Public Health, 3(1), 3–9.
• Blencowe, H., Cousens, S., Jassir, F. B., Say, L., Chou, D., Mathers, C., Hogan, D., Shiekh, S., Qureshi, Z. U., You, D., & Lawn, J. E. (2016). National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: A systematic analysis. The Lancet Global Health, 4(2), e98–e108.
• Cousens, S., Blencowe, H., Stanton, C., Chou, D., Ahmed, S., Steinhardt, L., Creanga, A. A., Tunçalp, Ö., Balsara, Z. P., Gupta, S., Say, L., & Lawn, J. E. (2011). National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995: A systematic analysis. The Lancet, 377(9774), 1319–1330.
• Dandona, R., Kumar, G. A., Kumar, A., Singh, P., George, S., Akbar, M., & Dandona, L. (2017). Identification of factors associated with stillbirth in the Indian state of Bihar using verbal autopsy: A population-based study. PLoS Medicine, 14(8), Article e1002363.
• de Bernis, L., Kinney, M. V, Stones, W., ten Hoope-Bender, P., Vivio, D., Leisher, S. H., Bhutta, Z. B., Gülmezoglu, M., Mathai, M., Belizán, J. M., Franco, L., McDougall, L., Zeitlin, J., Malata, A., Dickson, K. E., & Lawn, J. E. (2016). Stillbirths: Ending preventable deaths by 2030. The Lancet, 387(10019), 703–716.
• de La Rochebrochard, E., & Thonneau, P. (2002). Paternal age and maternal age are risk factors for miscarriage; results of a multicentre European study. Human Reproduction, 17(6), 1649–1656.
• Duggal, R. (2004). The political economy of abortion in India: Cost and expenditure patterns. Reproductive Health Matters, 12(sup24), 130–137.
• Duley, L., Henderson-Smart, D. J., & Meher, S. (2005). Altered dietary salt for preventing pre-eclampsia, and its complications. Cochrane Database of Systematic Reviews, (4), Article CD005548.
• Feodor Nilsson, S., Andersen, P., Strandberg-Larsen, K., & Nybo Andersen, A.-M. (2014). Risk factors for miscarriage from a prevention perspective: a nationwide follow-up study. BJOG: An International Journal of Obstetrics & Gynaecology, 121(11), 1375–1385.
• Flenady, V., Wojcieszek, A. M., Middleton, P., Ellwood, D., Erwich, J. J., Coory, M., Khong, T. Y., Silver, R. M., Smith, G. C. S., Boyle, F. M., Lawn, J. E., Blencowe, H., Leisher, S. H., Gross, M. M., Horey, D., Farrales, L., Bloomfield, F., McCowan, L., Brown, S. J… Goldenberg, R. L. (2016). Stillbirths: Recall to action in high-income countries. The Lancet, 387(10019), 691–702.
• Fukuta, K., Yoneda, S., Yoneda, N., Shiozaki, A., Nakashima, A., Minamisaka, T., Imura, J., & Saito, S. (2020). Risk factors for spontaneous miscarriage above 12 weeks or premature delivery in patients undergoing cervical polypectomy during pregnancy. BMC Pregnancy and Childbirth, 20, Article 27.
• Hirve, S. S. (2004). Abortion law, policy and services in India: A critical review. Reproductive Health Matters, 12(sup24), 114–121.
• Hossain, M. B., Kanti Mistry, S., Mohsin, M., & Rahaman Khan, M. H. (2019). Trends and determinants of perinatal mortality in Bangladesh. PLoS ONE, 14(8), Article e0221503.
• Hossain, S. (2020). Salinity and miscarriage: Is there a link? Impact of climate change in coastal areas of Bangladesh - A systematic review. European Journal of Environment and Public Health, 4(1), Article em0036.
• International Institute for Population Sciences. (2017). National Family Health Survey (NFHS-4) 2015-16. Ministry of Health and Family Welfare, Government of India.
• International Institute for Population Sciences. (2007). National Family Health Survey (NFHS-3) 2005-06. Ministry of Health and Family Welfare, Government of India.
• Kaushalya, K., Rana, A. K., & Saini, S. K. (2005). A descriptive study on fertility pattern, prevalence of “pregnancy wastage,” and their relationship with health of woman in a rural community, UT Chandigarh, 2005. Nursing and Midwifery Research Journal, 1(3), 144–150.
• Keeping, J. D., Najman, J. M., Morrison, J., Western, J. S., Andersen, M. J., & Williams, G. M. (1989). A prospective longitudinal study of social, psychological and obstetric factors in pregnancy: Response rates and demographic characteristics of the 8556 respondents. BJOG: An International Journal of Obstetrics and Gynaecology, 96(3), 289–297.
• Kochar, P. S., Dandona, R., Kumar, G. A., & Dandona, L. (2014). Population-based estimates of still birth, induced abortion and miscarriage in the Indian state of Bihar. BMC Pregnancy and Childbirth, 14, Article 413.
• Lakew, D., Tesfaye, D., & Mekonnen, H. (2017). Determinants of stillbirth among women deliveries at Amhara region, Ethiopia. BMC Pregnancy and Childbirth, 17, Article 375.
• Lavelanet, A. F., Schlitt, S., Johnson, B. R., & Ganatra, B. (2018). Global abortion policies database: A descriptive analysis of the legal categories of lawful abortion. BMC International Health and Human Rights, 18, Article 44.
• Lawn, J. E., Blencowe, H., Waiswa, P., Amouzou, A., Mathers, C., Hogan, D., Hogan, D., Flenady, V., Frøen, J. F., Qureshi, Z. U., Calderwood, C., Shiekh, S., Jassir, F. B., You, D., McClure, E. M., Mathai, M., & Cousens, S. (2016). Stillbirths: Rates, risk factors, and acceleration towards 2030. The Lancet, 387(10018), 587–603.
• Levy, A., Fraser, D., Katz, M., Mazor, M., & Sheiner, E. (2005). Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. European Journal of Obstetrics & Gynecology and Reproductive Biology, 122(2), 182–186.
• Magnus, M. C., Wilcox, A. J., Morken, N., Weinberg, C. R., & Håberg, S. E. (2019). Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. BMJ, 364, Article l869.
• NITI Aayog. (2019). The success of our schools: School education quality index.
• Newtonraj, A., Kaur, M., Gupta, M., & Kumar, R. (2017). Level, causes, and risk factors of stillbirth: A population-based case control study from Chandigarh, India. BMC Pregnancy and Childbirth, 17, Article 371.
• NITI Aayog. (2019). Healthy states progressive India: Report on the ranks of states and union territories.
• Rai, R., & Regan, L. (2006). Recurrent miscarriage. The Lancet, 368(9535), 601–611.
• Santos, A., Coelho, E., Gusmão, M., Silva, D., Marques, P., & Almeida, M. (2016). Factors associated with abortion in women of reproductive age. Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 38(06), 273–279.
• Vora, K. S., Mavalankar, D. V., Ramani, K. V., Upadhyaya, M., Sharma, B., Iyengar, S., Gupta, V., & Iyengar, K. (2009). Maternal health situation in India: A case study. Journal of Health, Population and Nutrition, 27(2), 184–201.
• World Health Organization (WHO). (2016). Sexual and reproductive health: The neglected tragedy of stillbirths.
• Yi, S., Tuot, S., Chhoun, P., Pal, K., Tith, K., & Brody, C. (2015). Factors associated with induced abortion among female entertainment workers: A cross-sectional study in Cambodia. BMJ Open, 5(7), Article e007947.
• Yogi, A., K.C, P., & Neupane, S. (2018). Prevalence and factors associated with abortion and unsafe abortion in Nepal: A nationwide cross-sectional study. BMC Pregnancy and Childbirth, 18, Article 376.