Laws related to Medical Termination of pregnancy in India

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Last year, the Delhi court allowed the medical termination of pregnancy of a lady who had completed 22 weeks of gestation because the foetus was tormented by multiple abnormalities.

Gestation is that the foetal development period from the time of conception until birth.

In India, the Medical Termination of Pregnancy (MTP) Act stipulates a ceiling of 20 weeks, for termination of pregnancy, beyond which abortion of a foetus is statutorily impermissible.

Initially, the MTP act said that abortion are often permitted up to twenty weeks of pregnancy. It also stipulated that the procedure are often dole out only by a registered caregiver. The abortion should occur at a hospital or at a clinic that's fully equipped to try to to so.

India, where the Medical Termination of Pregnancy Act was recently amended to permit abortion procedures until 24 weeks of gestation, and even later just in case of “substantial fetal abnormalities”, seems to occupy the alternative end of the spectrum of abortion regulation.

An adult female can also avail of abortion in India. 

About MTP Act:

The Medical Termination of Pregnancy Act, 1971 (“MTP Act”) was passed because of the progress made within the field of life science with relevance safer abortions.

In a historic move to supply universal access reproductive health services, India amended the MTP Act 1971 to further empower women by providing comprehensive abortion care to all or any.

The new Medical Termination of Pregnancy (Amendment) Act 2021 expands the access to safe and legal abortion services on therapeutic, eugenic, humanitarian and social grounds to confirm universal access to comprehensive care.

In case the lady is under 18, a case should be registered under the POCSO (Protection of kids from Sexual Offences) act. Registering the case is vital whether or not the sexual act has been consensual in order that those involved (the minors ) can undergo counselling.

Key Provisions of the MTP Amendment Act, 2021:

Termination thanks to Failure of birth control or Device:

Under the Act, a pregnancy could also be terminated up to twenty weeks by a married person within the case of failure of contraception or device. It allows unmarried women to also terminate a pregnancy for this reason.

In 1994, the PCPNDT (Pre-Conception and Pre-Natal Diagnostic Techniques) Act was enacted to stop misuse of the MTP Act and then that abortions “aren't administrated at the whims and fancies of a lady or a pair,” Dr Sunitha says. 

While consent of the spouse isn't required for a lady to undergo an abortion, a spouse cannot force a girl to undergo an abortion. “In such a case, a case for violence will be registered and under IPC 312/313, a case for causing miscarriage may be booked against the husband,” Gowda explains. 

A woman, whether a minor or not, cannot walk into a pharmacy to avail a pill for termination of pregnancy unless she encompasses a prescription from a trained health professional.

India’s abortion landscape today is found in long histories both of criminalising abortion care, and of controlling growth, which have shaped reproductive policies since the colonial era. Recognising this historical context can help understand the present contradictions between a seemingly liberal position in law and restrictions on abortion care in practice.

The Medical Termination of Pregnancy legislation failed to make these changes on the premise of women’s rights. Nor did it make a person’s decision to not have a baby the premise for a legal abortion. Instead, the govt. argued that legal reform was necessary on “humanitarian, health and eugenic grounds”.

In Lok Sabha debates about the bill, legislators noted that pregnancies resulting from rape caused great harm to women and required legal abortion as a humanitarian remedy for sexual violence. They expressed concern that ladies were risking their health, and sometimes dying, from unsafe abortions.

The act’s eugenic reasons for legalising abortion centered on disability. Legislators claimed that the new law would allow abortions when “foetal abnormality” was detected, and implied this might improve the health of youngsters, families, and therefore the national population itself.

Opinion Needed for Termination of Pregnancy:

Opinion of 1 Registered medical man (RMP) for termination of pregnancy up to twenty weeks of gestation.

Opinion of two RMPs for termination of pregnancy of 20-24 weeks of gestation.

Opinion of the State-level medical board is crucial for a pregnancy to be terminated after 24 weeks just in case of considerable foetal abnormalities.

Upper Gestation Limit for Special Categories:

Increases the upper gestation limit from 20 to 24 weeks for special categories of girls, including survivors of rape, victims of incest and other vulnerable women (differently abled women, minors, among others).

Confidentiality:

The “name and other particulars of a girl whose pregnancy has been terminated shall not be revealed”, except to someone authorised in any law that's currently operative.

Significance:

The new law will contribute towards ending preventable maternal mortality to assist meet the Sustainable Development Goals (SDGs) 3.1, 3.7 and 5.6

SDG 3.1 pertains to reducing maternal mortality ratio whereas SDGs 3.7 and 5.6 pertain to universal access to sexual and reproductive health and rights.

The amendments will increase the ambit and access of girls to safe abortion services and can ensure dignity, autonomy, confidentiality and justice for girls who have to terminate pregnancy.

Issues:

Different opinions on Termination:

One opinion is that terminating a pregnancy is that the choice of the pregnant woman and a component of her reproductive rights while the opposite is that the state has an obligation to shield life, and hence should provide for the protection of the foetus.

Across the planet, countries set varying conditions and cut-off dates for allowing abortions, supported foetal health, and risk to the pregnant woman.

Not allowed beyond 24-weeks:

The Act allows abortion after 24 weeks only in cases where a Medical Board diagnoses substantial foetal abnormalities.

This implies that for a case requiring abortion thanks to rape, that exceeds 24-weeks, the sole recourse remains through a Writ Petition.

Abortion to be performed by doctors:

The Act require abortion to be performed only by doctors with specialisation in gynaecology or obstetrics. 

As there's a 75% shortage of such doctors in community health centers in rural areas, pregnant women may still find it difficult to access facilities for safe abortions.

It is important to ask — in a very country where abortion is legal and funded by the govt, why do most ladies still go for unsafe abortions? in line with the UNFPA’s State of the globe Population Report 2022, 67% of all abortions that happened in India were unsafe.

Before the modified MTPA of 2021, the law stipulated that contraceptive failure was a suitable ground for abortion for married women. This led many unmarried women to the harmful path of quacks and illegal, unsafe pregnancy terminations.

Practitioners of different medicine were disallowed from performing abortions. The new Act was significant for other reasons too — the wording of the Act differed from its previous versions. The MTPA, 2021 didn't limit termination of pregnancy within the case of contraceptive failure only to married women. Unmarried women can even obtain legal, safe abortions now. The new act also expands on services like therapy, social care, rehabilitation, etc to make sure comprehensive care. Additionally, the new Act ensures confidentiality — a registered medical man can only disclose their patient’s name to someone authorised by law.

The fact remains that Indian women don't have complete autonomy over their reproductive rights. Even the improved MTPA, 2021 gives doctors, and not women the ultimate say over whether abortion should be disbursed. in an exceedingly country that's rife with stigma, vesting the decision-making prowess within the doctors takes away power from women who many need or want an abortion for private reasons.

While the new Act doesn't specify that girls must be married to get an abortion, it does specify the requirement for a partner – during this way, sex workers, already deeply stigmatised, are excluded even further. In many public and personal hospitals, medical practitioners enforce getting a husband’s approval to perform an abortion, although the law doesn't require it. A recent study interviewed 72 women and two children who were victims of rape and had sought abortions — it revealed that 77% of them couldn't obtain one as medical practitioners asked for a ‘husband’s approval’ to perform the abortion. 

It is commendable that the Central Government has taken such a bold stand while balancing the varied cultures, traditions and schools of thought that our country maintains, however the amendment still leaves women with various conditionalities, which in many cases become an impediment in access to safe abortion.

In Justice K.S. Puttaswamy (Retd.) vs. the Union Of India et al (2017), the court recognized the constitutional right of girls to create reproductive choices, as a component of private liberty under Article 21 of the Indian Constitution, which, despite laying a sturdy jurisprudence on reproductive rights and therefore the privacy of a girl, doesn't translate into a fundamental shift in power from the doctor to the girl seeking an abortion.

The government must make sure that all norms and standardised protocols in clinical practice to facilitate abortions are followed in health care institutions across the country.

Along with that, the question of abortion has to be selected the idea of human rights, the principles of solid science, and in step with advancements in technology. Since it's now become an act, one may be assured that the country is on the road to advancement, addressing women issues more fiercely than ever.