This year in March, the Indian government passed the amended Medical Termination of Pregnancy (MTP) Act, 2021 in the parliament.

The new & amended rules that allow termination of pregnancies even up to 24 weeks of the gestation period stand out in sharp contrast to rules governing abortion in so-called developed countries like – the United States where getting abortions even after the sixth week is becoming a nightmare. Some of the more developed nations in Europe and other parts of the world that present themselves as champions of gender equality are still struggling over abortion rights or even pulling back from advances made earlier. In light of whatever is going on in the world over abortion rights, this amendment by GOI is undoubtedly applaudable & progressive.

But the condition was not the same even in India for the longest period of time, Back in 1971, India’s abortion laws were liberalized in response to high maternal mortality from unsafe abortions. this was when the doctors and government realize that decriminalizing abortion would encourage women to seek abortions in a legal and safe environment. 

The MTP Amendment Act 2021, which comes after 50 years of the historic MTP Act of 1971, is an evolutionary milestone.

Some of the key takeaways of the amendment in a nutshell are:

1. Raising the upper gestation limit from 20 to 24 weeks for particular groups of women, which is described in the MTPA 2021 as follows:

The government set up seven categories of women under the new amendment law, who would be eligible for termination of pregnancies between 20 and 24 weeks, under Section 3B of Rules

(a) survivors of sexual assault or rape ( also includes marital rape ) or incest;
(b) minors;
(c) change of marital status during the ongoing pregnancy (widowhood and divorce);
(d) women with physical disabilities (major disability as per criteria laid down under the Rights of Persons with Disabilities Act, 2016)
(e) mentally ill women including mental retardation
(f) the fetal malformation that has a substantial risk of being incompatible with life or if the child is born it may suffer from such physical or mental abnormalities to be seriously handicapped; and
(g) women with pregnancy in humanitarian settings or disaster or emergency situations as may be declared by the Government.”

2. The Amendment enables abortion on the recommendations of one doctor up to 20 weeks, and two doctors between 20 and 24 weeks for specific categories of women.

3. Failure of contraception as a ground for abortion until 20 weeks now available to a woman and “her partner”.

Under the 1971 law, failure of contraception as a ground for abortion was available only to a “married woman or her husband”. In a welcome step, the MTP Amendment Act expanded this to “any woman or her partner,” which means that unmarried women in relationships can now involve failure of contraception as a ground to seek an abortion. Allowing unmarried women to medically terminate pregnancies while also protecting the privacy of the person seeking an abortion will give women the reproductive rights they are entitled to.

Coming 50 years after the passage of the historic MTP Act of 1971, the MTP Amendment Bill 2020 is an evolutionary landmark addressing some of the challenges posed by the 15.6 million abortions we manage each year in India. It expands access to safe and legal abortion services on therapeutic, eugenic, humanitarian, and social grounds to ensure universal access to comprehensive care. This would positively lead to a significant reduction in maternal mortality rates in India.

Not only for the patients, but these progressive amendments also consider the advances in medical technology, simplify requirements of providers, increase the upper gestation limit for termination of pregnancy under specific conditions, and remove the gestation limit for cases that could burden the health system. it strengthens access to comprehensive abortion care without compromising dignity, autonomy, confidentiality, and justice for women who need safe and quality services. It also empowers healthcare providers to help women wanting abortions under various special circumstances.

Despite these positive changes in the country’s reproductive rights for women, abortion has always sparked heated moral, ethical, political, and legal disputes. Because abortion is a fulcrum of a much greater ideological conflict in which the fundamental meanings of family, the state, motherhood, and women’s sexuality are fought, it is not simply a medico-technical issue anymore. It is imperative now that the recent changes, rules, and regulations are adequately communicated and widely disseminated to not just service providers but also other stakeholders & beneficiaries.

About the Author:

Dr. Jagriti Varshney ( MBBS, MS Obs & Gyn ) is an obstetrician & gynecologist, working as a Senior Resident. She is actively involved in creating awareness about various women’s health-related issues -From puberty, menarche, breast development, and pregnancy to menopause. She runs an Instagram handle @theaccidentalgynaec to create content around women’s health. Views expressed here are personal.