Filling gaps

India is closer to securing comprehensive reproductive health rights for women in India. The Union Cabinet approved the Medical Termination of Pregnancy (Amendment) Bill, 2020 that amends the parent act by focussing on improving the scope of MTP for a special category of women — rape survivors, victims of incest, single women and disabled women. Amidst the various talking points is the provision to increase the upper gestation limit of MTP or abortion from existing 20 to 24 weeks. The said provision has been a longstanding demand advocated by several medical professionals for years on account of medical complications that are only identifiable in the period of 20–24 weeks. For pregnancies diagnosed with substantial fetal abnormalities, the bill includes that no upper gestation limit would apply for termination. By inserting various clauses and sub-sections, the amendment to the Medical Termination of Pregnancy Act, 1971 will pave a safe and legal way for larger access to abortion. The proposed changes follow the due acknowledgement of barriers faced by women in getting a safe and sound abortion in the light of health and dignity above all. Accessibility to abortion has been limited on account of ambiguity over laws and medical professionals have been reported to desist from providing abortion facilities even when the law mandates so. In fact, India has passed several laws to safeguard the right to healthcare for survivors of sexual violence, mandating that hospitals — both public and private — provide immediate treatment to victims and carrying punitive action on account of failure in doing so. Yet, there have been several pleas filed in courts citing barriers faced by them in accessing abortion services. Those cases have naturally mustered the pressing need for the country to amend its abortion laws. Back in 1972, Parliament had passed the MTP Act to protect women’s right to life since abortion was criminalised under section 312 of IPC — intentionally causing miscarriage — before that. MTP was a landmark decision, a leap of faith and rightful acknowledgement of women’s right to reproductive health. Yet, while the act brought in provisions to ensure safe abortion under prescribed norms, the reality was very different. MTP Act

legalised abortion in India for up to 20 weeks of pregnancy on account of certain conditions and when provided by a registered medical practitioner at a registered medical facility. The 2020 amendment to the said act only strengthens the act, empowering it to allow for abortion from 20 to 24 weeks, and even beyond in certain complicated cases. It also seeks to relax the contraceptive-failure clause to “any woman or her partner” from the current “only married woman or her husband”, allowing unmarried women to medically terminate the pregnancy. The said provisions will breathe a new life in the MTP Act and consequently benefit women in terms of their reproductive health.

With the MTP (Amendment) Bill, 2020, instances of unsafe and illegal abortion will also come down. Misinterpretation and

lack of awareness vis-à-vis abortion law have inevitably given rise to procedural gaps and barriers, restricting women from maintaining their reproductive health. Both cases and reports have cited medical hesitancy in providing abortion services. With hospitals denying abortion on account of unscientific reasoning or misinformation, comprehensive dissemination of awareness regarding abortion is imperative. In their hesitance and due process, the situation for a pregnant woman seeking abortion often gets more complicated — as can be corroborated from Supreme Court ruling in 2017 which rejected an abortion plea due to the woman being 26 weeks pregnant and as a result of the recommendation it received from a courtappointed medical panel that indicated that an abortion at this stage of pregnancy posed a risk to the lives of the woman and the fetus. Even though the woman had requested an abortion at 17 weeks of her pregnancy, significant delays and denial by the government, the High Court and Supreme Court only turned a blind eye on women’s critical healthcare requirement. Women going to courts just to get required medical attention underscores the severity of the issue. The World Health Organisation and colleges of obstetricians and gynaecologists globally have recognised that second-trimester abortions are “an important component of comprehensive women’s health care” and affirmed that abortions past 20 weeks provided in accordance with medical guidelines are safer than the risks women face from unsafe abortions. Factually, unsafe abortion is the third-largest cause of maternal mortality and the Abortion Assessment Project–india estimated more than 6 million unsafe abortions in India. It is very unfortunate that unsafe abortion-related deaths occur despite abortion being

legalised 48 years ago. With new clauses in place, it is expected that women will be able to access abortion services without any hindrance, especially since the new provisions in the MTP (Amendment) Bill take into account the reasons due to which illicit abortion thrives in our society. While the Bill is yet to be tabled in Parliament, its expedited passage is expected considering the progressive object it holds — greater reproductive rights to women!