The bill amending the 2020 Medical Termination of Pregnancy (MTP) bill is to be discussed at an upcoming Rajya Sabha session. This is the second time, in 49 years of existence, that the MTP law will be amended. While introducing the bill in the Lok Sabha, the Minister of Health stressed the government’s intention to improve access to safe, affordable and legal abortion services for women without compromising safety, quality of care and, more importantly, ensuring dignity, autonomy, confidentiality and justice for women. women who have to terminate their pregnancy.
The amending bill proposes a few welcome changes – it replaces the expression “married woman and her husband” with “wife and her partner”; increases the upper limit of gestation to 20-24 weeks for “certain categories of women”; reduces the opinion required for termination of pregnancy between the 12th and the 20th week of gestation from two providers to one and removes the upper limit of gestation for fetal abnormalities’ necessitated by the diagnosis of medical advice.
The question is: does the proposed amendment live up to its intention? The answer, unfortunately, is not entirely. A critical review of the proposed changes shows that with a few changes the legislation can meet the needs of those seeking abortions. Despite the existence of liberal legislation for 49 years, many abortion seekers in India find it difficult to access safe and legal services to terminate their pregnancy for a variety of reasons. The MTP (amendment) bill offers parliamentarians the opportunity to draft progressive and innovative law.
The changes suggested by medical and legal experts and civil society can be categorized into three broad areas: advancing rights-based legislation, synchronizing the bill with recent laws and judgments, and operational convenience of implementation. artwork.
The exercise of the right to abortion in India is conditional and can only be allowed on the basis of the doctor’s opinion. Making abortions in the first trimester (up to 12 weeks) a right or available on request would be a welcome step as around 90% of abortion seekers terminate their pregnancy within 12 weeks. Sixty-six countries around the world already allow abortion as a right up to 12 weeks or more after the onset of gestation. As the world’s largest democracy, should we deny our citizens this right?
The “no upper gestational limit” clause is limited to fetal abnormalities and should be extended to survivors of sexual abuse. Having to continue a pregnancy resulting from sexual abuse can cause untold mental and physical anguish and negatively impact survivors’ ability to exercise their rights to life and liberty. Often, survivors of sexual abuse take longer to seek help, given the trauma and associated stigma, which is only higher in the case of minors. Recognizing this, in the past, courts have allowed dismissals beyond 24 weeks in such cases. Enshrining this in law would avoid the need to seek judicial intervention and ensure that an incident does not define the life and autonomy of the survivor.
The Transgender People (Protection of Rights) Act 2019 and the 2014 National Legal Services Authority vs Union of India judgment upheld the right to gender self-identification. Not only women, but also transgender, intersex and different-sex people may also need access to abortion care. Changing the terminology of the bill from “pregnant woman” to “pregnant person” would make abortions more accessible to those who need them. This would likely make India the first country in the world to have gender-neutral abortion laws. The word “abnormalities” implies that disabilities are “abnormal” and that non-disabled people are “normal”, and therefore more valued and sought after. Replacing the term “anomalies” with “anomalies” would make the MTP law inclusive and sensitive.
Confidentiality is highly valued by those seeking an abortion and it must be protected by law. The provision of the proposed amendment that requires the personal details of abortion seekers to be disclosed to anyone authorized under the law may prove problematic for both applicants and providers. This could compromise the privacy and interests of the abortion seeker, could lead to harassment of the provider, and could result in providers being reluctant or unwilling to provide services. Rewording the clause to say that “the contact details of the person requesting the services of the MTP should not be disclosed to anyone unless the courts order it” would protect both overzealous officials.
Extending the upper gestation limit to 24 weeks for all pregnant people and not just for certain categories of women would keep the law simple and non-discriminatory, thus avoiding the need to categorize those who are eligible and those who are not. Given the shortage of specialists capable of providing second trimester and late abortion, provider advice should be sufficient for abortions within the 20-24 week period. Also, when only one supplier is required for the service, what is the need for advice from two suppliers? The establishment of medical boards with a gynecologist, pediatrician, radiologist or sonologist and other members by the state government can pose a major operational problem as many districts do not have enough specialists. Also, with only one board in a state, pregnant people would have to travel long distances to be diagnosed, which would mean increased costs and delayed decision making. These changes would help facilitate the implementation of the law, improve access and reduce the burden on health systems.
The changes suggested above would make the MTP law more progressive, rights-based, and ensure that anyone seeking to terminate their pregnancy can do so legally without compromising their safety, autonomy, privacy or dignity. At a time when sexual and reproductive health and rights are under threat globally, this would strengthen India’s leadership on this critical issue. We fervently hope that Parliament and the government will rise and be counted.
(The author is CEO, FRHS India and a member of the Campaign Advisory Group, Pratigya
Campaign for Gender Equality and Safe Abortion)