There are countries where gestational limits are higher or where there is no limit prescribed and abortion is a woman’s right. In India it is still a conditional right. In its current form, the MTP Amendment Bill, 2020 cannot be termed as progressive or women-centric

The Union Cabinet’s approval of the Medical Termination of Pregnancy (Amendment) Bill, 2020, in January set the stage for a small though belated step forward. Since this is only the second time that the MTP Act is being amended in its 49 years of existence, the news managed to create quite a buzz. Initial reports suggested that the gestational limit for abortion had been increased from 20 to 24 weeks, for all women, which was welcomed by many. However, the fine print reinforces the view that the increase in gestational limit is only for “special categories of women” (vulnerable women including survivors of rape, victims of incest, differently-abled, minors and so on). The move to remove the upper gestation limit in cases of substantial fetal abnormalities is indeed welcome, but it comes with a rider. Medical Boards — whose composition, functions and other details will be prescribed subsequently in Rules under the Act — will decide if women can have an abortion on this ground. It moves the decision-making from the woman and her doctor to a medical board comprising multiple members, thereby legitimising third-party authorisation, which was never the intention of the original MTP Act. Subjecting women to multiple medical checkups and assessment by an unfamiliar board in no way advances their rights and surely does not seem to keep their interests at the centre.  

The MTP Act guarantees women confidentiality, an aspect valued greatly by women who seek abortion care.  Under the Act, the name and other particulars of the women terminating a pregnancy can be shared only if ordered by the courts. The Cabinet-approved amendments include a clause, “the name and other particulars of a woman whose pregnancy has been terminated shall not be revealed, except to a person authorised in any law for the time being in force.” This could be problematic for many women, especially vulnerable ones.  Over the years, we have seen barriers to abortion care increase due to conflation of the MTP Act with Pre-Conception and Pre-Natal Diagnostic Techniques Act and Protection of Children from Sexual Offences (POCSO) Act. The proposed amendment could enable officials implementing these two Acts and even the Drugs and Cosmetics Act (which governs medical abortion drugs) to seek information on women seeking termination of pregnancy from doctors and chemists, compromising client confidentiality and putting them at risk.

For any legislation or policy to be hailed as landmark or progressive, it should benefit a vast majority of the target audience it is meant to serve or it should be expanding the boundaries on the issue it seeks to address. The proposed amendments fail this test miserably.  For the overwhelming majority of the estimated 15.6 million women (over 99 per cent) who seek to terminate their pregnancy every year, the amendment does not change anything.  Even for the small number of women who will benefit, the amendments do not go far enough. Many countries, both developed and underdeveloped, including some in the subcontinent already have a much liberal abortion law.

There are countries where gestational limits are higher or where there is no limit prescribed and  abortion is a woman’s right. In India it is still a conditional right. The proposal requiring the opinion of just one provider up to 20 weeks’ gestation is indeed useful for women who seek termination in the second trimester, as opposed to the current requirement of opinions of two providers.

To summarise, the proposed amendments addresses, to some extent, only the tip of the iceberg.  For the vast majority of women who need to terminate a pregnancy, the amendments will not make any difference. It is unlikely to make any dent in maternal mortality and morbidity due to unsafe abortions. Even when compared to the draft MTP Amendment Bill, 2014, developed after wide ranging consultation with a number of experts and stakeholders, the proposed amendments seem inadequate.

In its current form, the MTP Amendment Bill, 2020, cannot by any stretch of imagination be termed as progressive, women-centric or advancing women’s rights and agency.  The full draft of the Bill is yet to be circulated widely and hopefully there are no more nasty surprises in store. 

The intention of the Government seems to be right but the execution seems to fall short.  Hopefully some of the issues can be addressed when the Rules under the Act are framed.

Given the advances in medical technology, the current discourse on women’s rights and available evidence, it is an opportune time to make the MTP Act truly women-centric.  Women’s health and rights in general and abortion in particular, are increasingly under threat globally. A great opportunity exists for India to take a leadership role in setting the global agenda.

This would require the Government to review what is proposed and overhaul the amendments, so that a contemporary MTP Act, which serves the needs of women and advances their rights, is tabled in the Parliament. If this opportunity is not grabbed, we will be failing 50 per cent of our population. Will Indian women have to wait for another two decades to exercise full control over their bodies?

(The writer is CEO, Foundation for Reproductive Health Services India and CAG Member-Pratigya Campaign for Gender Equality and Safe Abortion)