Medical Termination of Pregnancy (Amendment) Act, 2021

APR 6

Mains   > Social justice   >   Health   >   Women and Child issues

IN NEWS:

  • Rajya Sabha recently passed the Medical Termination of Pregnancy (Amendment) Bill 2021, which amends the Medical Termination of Pregnancy Act, 1971.

CONTEXT:

  • Under the Indian Penal Code, 1860, voluntarily terminating a pregnancy is a criminal offence.
  • The Medical Termination of Pregnancy Act, 1971 allows for aborting the pregnancy by medical doctors on certain grounds. 
  • A pregnancy maybe be terminated up to 12 weeks based on the opinion of one doctor, and up to 20 weeks based on the opinion of two doctors. 
  • Termination is permitted only when:
    • Continuance of pregnancy would involve a risk to the life of the pregnant woman, cause grave injury to her mental or physical health (including rape and failure of birth control measures); or
    • In the case of foetal abnormalities.
    • Termination is also allowed at any point during the pregnancy if there is an immediate necessity to save the woman’s life.

SALIENT FEATURES OF AMENDMENT:

  • Increase time limit: The amendment enhances the upper gestation limit from 20 to 24 weeks for special categories of women. These categories will include 'vulnerable women' including rape victims, differently-abled women, minors etc.
  • Relaxed norms: Opinion of only one doctor will be required up to 20 weeks of gestation and of two doctors for termination of pregnancy of 20-24 weeks of gestation.
  • ‘Specialists only’: The amendments require the termination to be performed only by doctors with a gynaecology or obstetrics specialisation.
  • State level boards: Upper gestation limit not to apply in cases of substantial foetal abnormalities diagnosed by Medical Board. The composition, functions and other details of Medical Board to be prescribed subsequently in Rules under the Act.
  • Extension of provisions: The ground of failure of contraceptive has been extended to women and her partner. The amendment has introduced a change in Section 3 of the Act to cover unmarried women.
  • Privacy of individuals: 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.
  • Punitive measures for violations: The Act penalises medical practitioners who fail to protect the privacy and confidentiality of women who wish to terminate their pregnancies.

SIGNIFICANCE OF THE AMENDMENT:

  • Rectify obsoleteness: The earlier MTP Act had failed to take into account the latest developments in the field of medical science. Current medical technology allows abortions at advanced stages of pregnancy.
  • Remove burden on the victim: The earlier act had provision that minors requiring abortions should get written consent from parents/guardians. This was regressive in some respects and the amendment has removed this requirement.
  • Prevent threat to life: The lacunae in the older enactments led to many unqualified persons running illegal abortion clinics endangering the lives of many women. It is expected that the new amendments will help tackle these issues and bring more abortions into the organized domain.
  • Promotes specialized care: The National Health and Family Survey 4 (2015-2016) data also showed that 47% of abortions in India are carried out by underqualified persons, like nurses, midwives or family members. The new amendment, which mandates a gynecologist, can help rectify this issue.
  • Assures privacy: The amendment enhances individual privacy. This can greatly help women access the facilities and also prevent the social stigma associated with abortions in Indian society.  

CRITICISM:

  • Deficit of specialists: The 2018 All India Rural Health Statistics show that there are only 1,351 gynecologists and obstetricians at community health clinics in rural areas. This shortage of qualified medical professionals will limit women’s access to safe abortion services.
  • Limited respite for rape victims: The amendment allows for termination of pregnancy after 24 weeks only in cases where a Medical Board diagnoses substantial foetal abnormality. This implies that for terminating pregnancies due to rape that have crossed the 24-week limit, there is no change in the process: the only recourse is to get permission through a Writ Petition.
  • Lack of autonomy for women: Most women in India have no control over the conditions in which they have sex and abortion is often the only form of birth control. The amendment does not address this issue.
  • Conflict with POSCO: On the one hand, the MTP Act’s confidentiality clause requires medical practitioners to protect the person’s identity, but the POCSO Act and the Code of Criminal Procedure mandate practitioners to report sexual offences against children.
  • No time limit for medical boards: For terminations after 24 weeks, the Act does not mention a time frame within which the medical boards will have to examine the pregnancy and share their opinions.
  • Ethical concerns: One opinion on abortion is that terminating a pregnancy is the choice of the pregnant woman, and a part of her reproductive rights. The other is that the state has an obligation to protect life, and hence should provide for the protection of the foetus. As long as the debate pertains, the abortion laws will always be subject to criticism.

CONCLUSION:

In Justice K.S. Puttaswamy v. Union of India and Others (2018), Justice Chandrachud stated that reproductive choice is a personal liberty guaranteed under Article 21 of the Indian Constitution. While specific changes like extending gestational limits and including unmarried women are laudable, the amendment does little to fundamentally shift power from the doctor to a woman seeking abortion. Abortion thus remains tied to state-sanctioned conditions and not a woman’s rights.

PRACTICE QUESTION:

Q. Does the Medical Termination of Pregnancy Act strike balance between the Right to life and the Right to choice? Substantiate your view?