Commissionerate System

Medical Termination of Pregnancy

News Excerpt

The Union Cabinet has approved the amendments to the Medical Termination of Pregnancy (MTP) Act, 1971, which will help strengthen women’s reproductive rights and prevent unsafe abortions along with giving its nod to extend the upper gestation limit for abortion from the existing 20 weeks to 24 weeks.

 

Need for Amendment

  • The MTP Act, 1971 was replete with unclear language, which resulted in doctors refusing to perform abortions even within the stipulated 20 week gestation limit.
  • Women had to seek the approval of the judiciary, which, by most accounts, did not always come in time.
  • MTP Act, 1971 failed to keep pace with advances in medical technology that allow for the removal of a foetus at a relatively advanced state of pregnancy.
  • A number of foetus abnormalities are detected after the 20th week, often turning a wanted pregnancy into an unwanted one.

Pre-Connect

  • India will soon have one of the world’s most liberal abortion legislations.
  • The MTP Bill raises the legally permissible limit for an abortion to 24 weeks from the current 20 weeks.
  • For pregnancies that are between 20-24 weeks opinions will be required from two doctors rather than one.
  • This has been specially done keeping in mind “vulnerable women including survivors of rape, victims of incest and others like differently-abled women, Minors etc.
  • The upper gestation limit will not apply in cases of substantial foetal abnormalities diagnosed by a Medical Board.
  • The composition, functions and other details of the Medical Board are to be prescribed subsequently in Rules under the Act.
  • It also has a provision to protect the privacy of the person seeking an abortion.

Analytica

Merits

  • The changes in the act are for expanding access of women to safe and legal abortion services on therapeutic, eugenic, humanitarian or social grounds.
  • It is a step towards the safety and well-being of the women and many women will be benefited by this.
  • This will increase access of women to safe medico-legal services and will thus reduce maternal mortality and morbidity arising out of unsafe abortions.
  • The change accepts failure of contraception as a valid reason for abortion not just in married but also in unmarried women.
  • The proposed increase in gestational age will ensure dignity, autonomy, confidentiality and justice for women who need to terminate pregnancy.
  • Most foetal abnormalities are diagnosed before 20 weeks but abnormalities in the heart, brain and genetic abnormalities get detected only after 20 weeks.
  • The 20-week deadline caused a phobia which often led to abortions on suspicion of anomalies. The Cabinet’s decision will not only reduce unsafe abortions but it will also save many normal foetuses from being aborted on such suspicion.
  • The extension will particularly help women from low socio-economic strata who cannot access healthcare services in a specific time frame and end up in a Catch-22 situation when there is a seriously malformed foetus that is past 20 weeks.
  • In the times when countries, including many states in the US, are restricting abortion, it is heartening to see a trend of liberalization of abortion laws, which in today’s day and age, is not a privilege but an absolute right of every woman.
  • The current amendment will also ensure clarity amongst medical practitioners, who have in the past shown inhibition towards pregnancy termination procedures especially in cases of survivors of rape and incest – where survivors were subsequently forced to approach the courts for judicial sanction.

Concerns

  • The new piece of legislation should be worded in a manner that obviates frequent appeals to the judiciary. Such fine print would — more significantly — be essential to accomplishing one of Bill’s main goals: “Giving reproductive rights to women”.
  • There are concerns that a more liberal abortion law can aggravate the situation where ante-diluvian preference for a male child keeps sex determination centres in business in spite of their illegal status. The litmus test of the proposed MTP law’s claims to being women-centric lies in addressing all such concerns.
  • All women are not included in the law, as in, the bill includes some conditionality that could result in a denial of reproductive rights of women, especially those with limited resources and poor access to services.
  • Much like the 1971 MTP Act, which required a physician's permission for abortion to happen, this amendment suggests anyone seeking abortion between 20-24 weeks will need the approval of two physicians to go through the process, which makes this process far less accessible for many women, especially women from the marginalised sections and rural communities, who may not have access to any medical practitioners.
  • Also, if a pregnancy has to be terminated between the 5th (20 weeks) and 6th month (24 weeks) due to foetal abnormalities, the permission of a medical board is required, which again may be hard for many to access, and for those who can, it might be a long bureaucratic process, making the abortion a very cumbersome process.
  • Although the law and the proposed amendment that has been backed by the Centre sound great on paper, their implementation remains tough given that abortion is still widely stigmatised in India, and there is very little awareness about the laws.

Conclusion

India will now stand amongst nations with a highly progressive law which allows legal abortions on a broad range of therapeutic, humanitarian and social grounds. The new MTP (Amendment) Bill, 2020, is a milestone which will further empower women, especially those who are vulnerable and victims of rape.