Amendments to the Medical Termination of Pregnancy Act extends gestation period for abortion but continues to deny agency to women
THE INDIAN Parliament passed the Medical Termination of Pregnancy (MTP) Amendment bill, 2021 on March 18.
The law increases the gestation limit for abortions from the earlier ceiling of 20 weeks to 24 weeks but only for special categories of pregnant women such as rape or incest survivors. This termination would need the approval of two registered doctors.’
“The risk of women dying during an abortion in 24th week is similar to 20th week and hence there’s no harm in extending the time period,” said Lt Col. Dr Lily Swain Sahoo, a gynaecologist at Military Hospital, Secunderabad. “The difference is that in 24th week the abortion is like a mini delivery and takes more time. It is not riskier for doctors to perform the operation in the 24th week.”
It also makes the requirement for approval of one doctor for all pregnancies up to 20 weeks. The earlier law, the MTP Act 1971, required one doctor's approval for pregnancies upto 12 weeks and two doctors' for pregnancies between 12 and 20 weeks.
Women can now terminate unwanted pregnancies caused by contraceptive failure regardless of their marital status as compared to earlier law that allowed only a married woman and her husband to do this. The new law also removes the upper gestation limit for abortion in case of foetal disability if so decided by a medical board of specialist doctors to be set up by states and union territories.
The law, however, still falls short of giving full autonomy to women. "To me, the provisions (of MTP Amendment Act 2021) are progressive in a paternalistic, victimhood kind of way," Suchitra Dalvie, gynaecologist and coordinator for Asia Safe Abortion Partnership (ASAP), a pan-Asia network for safe abortion advocacy, told IndiaSpend.
Women can now terminate unwanted pregnancies caused by contraceptive failure regardless of their marital status as compared to earlier law that allowed only a married woman and her husband to do this
A 2016 Bombay High Court judgement in a suo motu public interest litigation on the condition of a prison inmate had emphasised the right of a woman to control her body and fertility--"the right to autonomy and to decide what to do with their own bodies, including whether or not to get pregnant and stay pregnant.”
The MTP Act 2021 also contradicts the Supreme Court's 2017 privacy judgement (Justice K.S. Puttaswamy versus Union of India and others), which ruled that a woman's right to make reproductive choices is a dimension of personal liberty as understood under Article 21 of the Constitution. Any law that restricts a person's privacy must be "just, reasonable, and fair.”
Member of Parliament Priyanka Chaturvedi had also raised the issue of woman’s right over her pregnancy during discussion on the bill in the Parliament. “Making a woman who is pregnant with a disabled foetus run to medical boards where doctors and officials will decide for her is extremely demeaning to her, is invasion of her privacy, invasion of her choice and also, creating more bureaucratic hurdles than needed at a time when she needs to take that decision,” she had said seeking changes in the text, The bill was, however, passed without any major amendments.
Far from Health Facilities
India legalised abortion with the historic Medical Termination of Pregnancy Act of 1971 that created a framework to protect women from the grave risks of unsafe abortion. Despite legislative protection, however, unsafe abortion remains the third leading cause of maternal mortality and close to eight women die from causes related to unsafe abortion each day.
In 2015, 15.6 million abortions were accessed annually in India, according to a study in The Lancet. Of these, 78 percent or 12.3 million were conducted outside health facilities.
In Uttar Pradesh, 83 percent of the abortions were https://www.guttmacher.org/report/abortion-unintended-pregnancy-six-stat... performed out of health facilities while the proportion was 80 percent in Gujarat.
“Lack of trained staff and equipment supplies besides religious and social concerns play a major role in making it difficult for women to access medical facilities,” said Dr Sahoo.
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