Contraception
Contraception is provided free through the National Family Planning Programme at public health facilities, including condoms, oral pills, IUDs, injectables and sterilisation. Historically dominated by female sterilisation, the programme has expanded spacing methods, including the injectable Antara and the weekly pill Chhaya.
Key points
| Cost | Free in government facilities; incentives are paid for sterilisation |
|---|---|
| Methods | Condoms, oral pills, emergency pills, IUDs, injectables, implants in some states, and sterilisation |
| Emergency contraception | Available over the counter in pharmacies |
| Consent | Spousal consent is not legally required for contraception |
| ASHA workers | Community health workers deliver condoms and pills at village level |
| Adolescents | Served through adolescent-friendly health clinics, though access remains uneven |
| Sterilisation | Standards were tightened after the Supreme Court's ruling in Devika Biswas |
| National programme | Contraceptives are distributed free through public health facilities |
| Injectable | The three-monthly injectable has been added to the public basket |
In practice
- ASHA workers distribute contraceptives locally and can arrange clinic appointments discreetly.
- Ask for a long-acting method if repeated clinic visits are difficult.
Cost and coverage
Free in public facilities; low cost in the private sector and pharmacies.
Recent changes
Policy has shifted towards expanding the method mix and improving quality of care, after decades in which sterilisation dominated.
Where to go
- Government primary health centres and district hospitals.
- ASHA and ANM community health workers.
- Family Planning Association of India clinics.
Worth knowing
No law requires a husband's consent for contraception. If a provider asks for it, that is a practice, not a legal requirement — and worth raising with the facility in charge. Spousal consent is not a legal requirement for contraception, though facilities sometimes ask for it. You can refuse and ask for the request in writing.
The general article: Contraception · Compare with another country
Abortion
The Medical Termination of Pregnancy Act 1971, substantially amended in 2021, permits abortion up to 20 weeks on the opinion of one registered medical practitioner, and up to 24 weeks for categories prescribed by the rules — including survivors of sexual assault, minors, women whose marital status changed during pregnancy, and women with disabilities. Beyond 24 weeks, a medical board decides in cases of substantial fetal abnormality.
Key points
| Up to 20 weeks | One registered medical practitioner's opinion |
|---|---|
| 20 to 24 weeks | Two practitioners, for prescribed categories |
| Beyond 24 weeks | Medical board, for substantial fetal abnormality; courts also hear individual petitions |
| Consent | Spousal consent is not required; the Supreme Court held in 2022 that unmarried women have the same rights |
| Minors | Guardian's consent required under the Act, and the child protection law creates a reporting duty that sits uneasily with confidentiality |
| Confidentiality | Protected by the Act; disclosure is an offence |
| Sex determination | Strictly prohibited under separate legislation |
| MTP Amendment 2021 | Extended the limit to 24 weeks for defined categories of women |
| Medical Board | Beyond 24 weeks, only for substantial foetal abnormality, on a board's opinion |
| Marital status | The Supreme Court held in 2022 that unmarried women fall within the same categories |
In practice
- Go to a registered provider — government hospitals, approved private facilities, or accredited clinics.
- Medical abortion pills are widely sold but must be used under supervision; incomplete abortion is a common complication.
- For survivors of assault, hospitals must provide care and cannot refuse.
- Ask for written documentation of the gestational age; it matters if a board decision becomes necessary.
- Take identity and any medical records to the first appointment: the category you fall into must be documented.
- If refused, ask for the refusal in writing — providers registered under the Act must record their reasons.
Cost and coverage
Free in government facilities; variable in the private sector.
Recent changes
The Supreme Court's 2022 judgment extending the 24-week category to unmarried women was a significant expansion, and courts continue to authorise later terminations case by case.
Where to go
- Government district hospitals and approved facilities.
- Family Planning Association of India clinics.
- Women's helpline 181 and childline 1098 for support.
Worth knowing
For a minor, the doctor is not obliged to reveal identity to the police under the child protection law when the relationship was consensual, following the Supreme Court's ruling — a point many providers still get wrong. Sex determination is a separate criminal offence, and clinics may appear reluctant for that reason. State clearly that you are not asking for it.
The general article: Abortion · Compare with another country
Sexual orientation
Decriminalised in 2018, but the Supreme Court left marriage to Parliament in 2023 and no discrimination statute exists.
The Supreme Court read down the colonial provision criminalising same-sex relations in 2018, holding it unconstitutional as applied to consenting adults. In 2023 the Court declined to recognise same-sex marriage, holding that it was for Parliament to legislate, while directing government to address discrimination. Transgender people have statutory recognition following a 2014 ruling and a 2019 Act. There is no general statute prohibiting discrimination on grounds of sexual orientation.
The Supreme Court decriminalised consensual same-sex conduct in 2018, reading down the colonial provision. In 2023 the same court declined to extend marriage to same-sex couples, holding that this was for Parliament, while directing the government to consider practical protections through a committee. There is no statute prohibiting discrimination on grounds of sexual orientation, and transgender people have separate legislation with its own difficulties.
Key points
| Decriminalisation | Achieved by Supreme Court ruling in 2018 |
|---|---|
| Marriage | Not recognised; the Supreme Court left the question to Parliament in 2023 |
| Discrimination | No general statutory prohibition on grounds of sexual orientation |
| Transgender recognition | Established by a 2014 ruling and a 2019 statute |
| Conversion therapy | Treated as professional misconduct by the medical regulator |
| Adoption | Not open to same-sex couples jointly |
| Social climate | Varies enormously between metropolitan areas and elsewhere |
In practice
- Decriminalisation is settled law: police action premised on the old provision is unlawful.
- Complaints against a doctor offering conversion therapy can be made to the medical council.
- Legal aid clinics and organisations provide free advice in the major cities.
- A will is particularly important where a partner has no legal status: intestacy will not recognise them.
Cost and coverage
Court fees are modest and legal aid is available; documenting a will and nominations costs little.
Recent changes
The Supreme Court's 2023 marriage judgment left the question to Parliament while directing consideration of practical entitlements; a committee at central government level has been examining these.
Where to go
- National helplines run by non-governmental organisations.
- State human rights commissions, for official misconduct.
Worth knowing
Without marriage or partnership recognition, a partner has no automatic inheritance, hospital or decision-making rights.
Frequently asked questions
Can same-sex couples marry in India?
No. The Supreme Court held in October 2023 that creating such a right is for Parliament, not the courts, and declined to read marriage law as covering same-sex couples. A government committee was directed to examine practical entitlements such as joint bank accounts, hospital visiting and pensions.
Is there a law against discrimination?
Not for sexual orientation specifically. Constitutional equality guarantees apply against the state, and the 2018 judgment is authoritative on dignity, but there is no general statute covering employment or services. The Transgender Persons Act provides some protections for transgender people, with criticism of its recognition procedure.
The general article: Sexual orientation · Compare with another country
Drugs and controlled substances
A 1985 Act with mandatory minimums keyed to quantity, and a statutory route to treatment instead of punishment.
The Narcotic Drugs and Psychotropic Substances Act 1985 defines small, intermediate and commercial quantities for each substance. A small quantity carries up to one year or a fine; a commercial quantity carries a mandatory minimum of ten years, extendable to twenty, with bail severely restricted by section 37.
Section 27 punishes consumption itself, with up to one year for most drugs and up to six months for cannabis and some others.
Section 64A offers immunity from prosecution to an addict charged with consumption or a small quantity who volunteers for treatment at a recognised centre and completes it.
Bhang, made from cannabis leaves, is outside the Act's definition of cannabis and is sold legally in several states, while ganja and charas are not: the distinction surprises most visitors.
The death penalty is available for a repeat offence involving very large quantities, though it is rarely imposed.
Key points
| Main statute | Narcotic Drugs and Psychotropic Substances Act 1985 |
|---|---|
| Small quantity | Up to 1 year or a fine |
| Commercial quantity | Mandatory minimum 10 years, up to 20; bail restricted |
| Consumption | Section 27: up to 1 year; 6 months for cannabis |
| Treatment immunity | Section 64A, for volunteers who complete treatment |
| Bhang | Outside the statutory definition; legal in several states |
In practice
- Government de-addiction centres operate under the national programme and are free; private centres vary widely in quality.
- Section 64A immunity requires volunteering before or during proceedings and completing the treatment.
- A foreign national arrested under the Act should contact their embassy immediately: bail under section 37 is very difficult for commercial quantities.
Cost and coverage
Government de-addiction centres are free. Private residential treatment ranges from modest to very expensive with no reliable quality signal.
Recent changes
The national de-addiction programme has expanded outpatient opioid substitution, and buprenorphine treatment is available in a growing number of districts.
Where to go
- Government de-addiction centres under the Ministry of Social Justice.
- National Toll-free Drug De-addiction Helpline, 1800-11-0031.
- AIIMS National Drug Dependence Treatment Centre, Ghaziabad.
- Emergencies: 112.
Worth knowing
Quantity determines everything. The commercial-quantity thresholds are low for some substances, and the ten-year minimum with restricted bail applies regardless of personal circumstances.
Frequently asked questions
Is bhang legal in India?
Bhang is outside the Act's definition of cannabis and is sold legally in several states; ganja and charas are not.
Can treatment replace prosecution?
Section 64A gives immunity to an addict charged with consumption or a small quantity who volunteers for treatment and completes it.
The general article: Drugs and controlled substances · Compare with another country
Alcohol and tobacco
Chewing tobacco rather than cigarettes is the main problem, and several states prohibit alcohol entirely.
India's tobacco burden is unusual: smokeless products such as gutkha and khaini account for the majority of use and for a very high rate of oral cancer. Legislation restricts advertising, mandates large graphic warnings and bans smoking in public places, and many states have banned gutkha outright. Alcohol policy is a state matter, and several states prohibit sale and consumption entirely.
The Indian problem is not mainly cigarettes: smokeless tobacco — gutkha, khaini, betel quid with tobacco — accounts for the larger share of use and of oral cancer, which India reports in very high numbers. E-cigarettes have been banned outright since 2019, including possession for sale. Alcohol is a state subject, and several states, among them Gujarat, Bihar, Nagaland and Mizoram, prohibit it entirely.
Key points
| Legal age | 18 for tobacco; alcohol age varies by state, from 18 to 25 |
|---|---|
| Smokeless tobacco | The dominant form of use, with very high oral cancer rates |
| Gutkha bans | In place in many states |
| Graphic warnings | Among the largest in the world, covering most of the pack |
| Dry states | Several states prohibit alcohol sale and consumption entirely |
| Quitline | National toll-free quitline and mCessation text service |
| Public smoking | Prohibited, with designated areas in larger venues |
In practice
- The national quitline is free; the text-message cessation service works without a smartphone.
- Oral cancer screening is available at primary health centres — any non-healing mouth ulcer needs checking.
- Check the alcohol rules of the state you are in: they differ completely across borders.
- Tobacco cessation clinics operate in many district hospitals.
Cost and coverage
Quitline and public cessation services are free.
Recent changes
Enforcement against smokeless tobacco has been tightened through state-level bans on gutkha, renewed annually, and pictorial warnings now cover most of the pack. The e-cigarette prohibition of 2019 remains in force despite periodic challenges.
Where to go
- National tobacco quitline and mCessation service.
- Tobacco cessation centres in district hospitals.
- Primary health centres for oral cancer screening.
Worth knowing
A mouth ulcer or white patch that has not healed in three weeks should be examined. Oral cancer caught early is highly treatable; caught late it is not.
Frequently asked questions
Are e-cigarettes legal in India?
No. Production, import, sale, advertising and storage have been prohibited since 2019. Possession for personal use is not itself criminalised in the same way, but you cannot legally buy them, and bringing them in through customs is not permitted.
Which Indian states prohibit alcohol?
Gujarat, Bihar, Nagaland, Mizoram and the union territory of Lakshadweep, with partial restrictions elsewhere. Rules on permits for visitors differ; in Gujarat, for example, a visitor can apply for a temporary permit. Check before you travel rather than after you arrive.
The general article: Alcohol and tobacco · Compare with another country
General sources
- India.gov.in — national portal of India
- India Code — central and state legislation