A few months ago, I accompanied a young girl from a northern Indian city as she tried to access safe abortion care. She was a 15-year-old ninth grader who had been in a relationship with a boy five years older, without fully understanding the legal and social consequences under the Protection of Children from Sexual Offences Act (POCSO). She dreamed of becoming a cancer specialist and excelled in school. Yet, once she found out she was pregnant, instead of receiving support, she was asked to leave school because the institution believed she had brought shame and could set a “bad example” for other girls.AdvertisementLike many schools in India, this school had also failed to provide education on sexuality, safe sex, teenage pregnancy, and child protection laws. Such education could have helped her understand the risks and avoid what followed. Instead of protecting her, the school punished her; she lost friends and was treated like an outcast.Her parents did not support her either. With help from her caring brother and sister-in-law, her search for abortion services in her hometown, a state capital, began soon after. She was shunted from one facility to another. A couple of practitioners agreed to provide services, but without accountability and at an exorbitant cost. Although medical termination of pregnancy is permitted under the MTP Act, subject to specified conditions, unmarried women and pregnant minors continue to face serious barriers. POCSO’s mandatory reporting requirement means doctors must report pregnancy under 18 years to the police, which made doctors reluctant to help; many feared police harassment or legal proceedings. In X v Principal Secretary, Health and Family Welfare Department, Government of NCT of Delhi (2022), the Supreme Court of India recognised that mandatory reporting can deter adolescents from seeking safe abortion care and stressed the need to protect confidentiality. In practice, however, the process remained intimidating, expensive, and unclear. By then, she was already in her fourth month and was still eligible to seek termination from a registered medical practitioner, subject to the MTP Act.In the urgent search to terminate the pregnancy, her family reached out to friends and social networks, eventually connecting with a civil society network I am associated with that works on reproductive health and safe abortion care. This brought them to Delhi, where one clinic met them with suspicion. With support from activists, she was referred to another clinic run by an organisation known to provide non-judgmental care. New to the city, the girl and her sister-in-law struggled to navigate the clinical system. I helped coordinate appointments, travelled with them from one place to another, spoke to doctors, spoke to hospital staff beforehand to prevent the girl from facing moral scrutiny, signed documents as a witness, and supported them through check-ups.AdvertisementAlso Read | In murder of a musician from Manipur, many whys, one how and a collective failureEven getting a prescribed sonography was difficult. We visited three hospitals for an ultrasound and were met with hushed voices pointing to the girl’s age and character. One radiologist commented that social media had ruined young people, that girls from good families do not fall in love or engage sexually, and that although she looked innocent, “these days you never know”. He then refused to perform the sonography because he did not want to be drawn into POCSO-related police or legal processes. The fear was not isolated; the Supreme Court of India has recognised that providers’ fear of prosecution and mandatory reporting obligations can become barriers to safe and legal abortion access.At the clinic, however, the staff examined her with sensitivity and without judgment and ensured all legal provisions were followed. After three days of running from pillar to post in Delhi, the procedure was performed. Before it finally began, she broke down. Until then, she had held on to her dignity through humiliation, fear, and uncertainty. Finally, her ordeal came to an end.you may likeHer case ended with care only because she had a supportive relative, access to a feminist network, and eventually found a provider willing to help. But the scars she will carry may last a long time, and I hope this trauma does not dampen her spirit or her dreams. Many pregnant minors are not so fortunate. India’s abortion data shows why access matters: A Guttmacher Institute–Lancet Global Health national estimate found 15.6 million abortions in India in 2015, at a rate of 47 per 1,000 women aged 15-49. Only about 3.4 million abortions (22 per cent) took place in health facilities; 11.5 million (73 per cent) were medication abortions performed outside health facilities, with safety depending on supervision and access to correct medical guidance; and 0.8 million (5 per cent) used traditional or other methods outside facilities, often in unsafe conditions.The barriers are sharper for adolescents. The NFHS-5 provides nationally representative data for 2019-21, and a 2026 BMJ Public Health analysis of the same dataset estimated adolescent pregnancy prevalence at 6.68 per cent among girls aged 15-19 and linked it to early marriage or cohabitation before 18, lower education, socioeconomic disadvantage, and limited access to healthcare. Yet POCSO treats all sexual activity involving a person below 18 as an offence and requires mandatory reporting. When pregnancy itself triggers police involvement, adolescents and providers are pushed into an impossible choice: Seek lawful care and risk criminalisation or avoid the formal health system altogether.A law meant to protect children must not become a barrier to their health, dignity, privacy, and bodily autonomy. Protection must mean access to accurate sexuality education, confidential and non-judgmental health services, and legal processes that distinguish exploitation from consensual adolescent relationships. Without that shift, many young people will continue to be punished when what they need most is care.The writer is a public health professional