India’s Medical Termination of Pregnancy (MTP) Act, 1971, allows a woman to get an abortion based on certain conditions up to 20 weeks of the pregnancy. Prior to the MTP Act, abortion under any circumstances, except danger to a woman’s life, was illegal in India.
Currently, abortions are conditional on reasons such as physical or mental health of the woman, abnormalities in the foetus, rape, and failure of contraception for married women.
However, abortion is not available on request in India and is, thus, not a right. Additionally, a woman needs the consent of one medical provider if she is seeking an abortion up to the 12th week, and of two medical providers if her pregnancy is between 12-20 weeks.
Due to this, one could argue that the MTP Act does not fully recognise the autonomy of women over their own bodies. This becomes highly problematic in the light of the fact that the right to bodily autonomy is intrinsic to safeguarding the health and well-being of our women and young girls.
Across the world, abortion is a normal medical procedure which is performed under safe conditions by trained healthcare workers. It helps protect the sexual and reproductive health and rights of women and young girls, gives them the freedom to start a family at the right time, and allows them to make informed decisions in case of pregnancy-related complications such as foetal abnormalities.
With newer medical technologies available to us today, we can now detect many more foetal abnormalities which we could not detect earlier. However, due to various technological and human resource constraints, many of these abnormalities cannot be identified within the MTP Act’s mandated time-limit of 20 weeks.
As Dr Devi Shetty, the renowned cardiac surgeon, points out, currently, 26 million pregnant women are screened annually in India. However, with fewer than 15,000 experienced radiologists in the entire country, it is near impossible to screen all these 26 million women within 20 weeks.
This leads to many women discovering these abnormalities beyond the 20th week of the pregnancy. Consequently, many of them either end up taking the difficult decision to carry their pregnancies through to the full term, or end up seeking the permission of the courts for an abortion. However, experience shows that the courts do not always rule in their favour. This, in turn, puts these women in a difficult situation.
As if such situations are not tragic enough, we often hear of heart-breaking cases of young, pregnant rape survivors. Suffering from the trauma of rape and trying to avoid the stigma related to it, many of these young girls discover and/or report their pregnancies after 20weeks.
In such cases, the survivors and their well-wishers often end up going to courts for permission to end their pregnancies. Perhaps one of the more tragic recent cases was that of the 10-year-old girl who was raped by two of her maternal uncles. Her parents discovered her pregnancy at 26 weeks and then went from court to court for weeks desperately seeking permission for her to abort the pregnancy. However, in the end, as we all know, she was denied an abortion by the courts.
While some women and young girls find themselves able to take recourse to the law, many Indian women when denied a safe abortion turn to illegal and unsafe means, risking their lives and long-term health. Staggeringly, over 3.6 million unsafe abortions take place each year in our country, leading to two women losing their lives every hour.
These above-mentioned arguments raise important questions about the feasibility of the 20-week limit for accessing abortion under the MTP Act and shine a spotlight on the urgent need for making urgent legislative changes to increase this limit to up to 24 weeks.
In fact, in 2014, the Ministry of Health and Family Welfare (MoHFW) put together a draft MTP Amendment Bill which was sent to the Prime Minister’s Office (PMO). As a forward-looking step, it proposed increasing the ceiling-limit for getting an abortion from 20 to 24 weeks. It also introduced the concept of “substantial foetal abnormalities” — in which case a pregnancy can be terminated at any point during the pregnancy. However, this draft Bill is yet to come up for legislative consideration.
Recently, there have been extremely positive developments in the country around the issue of access to safe abortion. According to the Supreme Court’s recent Right to Privacy judgment, “A woman’s freedom of choice whether to bear a child or abort her pregnancy are areas which fall in the realm of privacy.” Delivering its judgment in the case of the recent 10-year-old rape survivor, the Supreme Court further recommended establishing medical boards in each State to expedite decision-making related to granting abortion in exceptional cases. In step, the Central Government has now directed all States to establish these medical boards.
While these judicial decisions and the step taken by the Indian Government provide hope, it is imperative that our parliamentarians from across party lines come together to incorporate progressive changes into our already liberal MTP Act– such as increasing the MTP Act’s gestation-limit for accessing abortion from 20 to 24 weeks. This can help women and young girls access safe abortion more easily and significantly reduce India’s burden of maternal mortality due to unsafe abortions.
I firmly believe that no woman or girl should be denied the care she needs. She must be empowered to make decisions about her own health, body and, ultimately, her life.
(The writer is a Member of Parliament from Paschim Champaran, Bihar, and a member of the Parliamentary Standing Committee on Health and Family Welfare. He is also a qualified medical practitioner)