After almost 50 years of the principal act about Medical termination of pregnancy and a few changes in between, there has been another amendment in the medical termination of pregnancy bill or MTP bill. The changes made are positive and progressive. Changes have been made considering the past issues and recommendations from various sources. Everyone should be aware of abortion laws in India to know their rights and accessibility to legal services.
Highlights regarding the bill are:
- Confidentiality of the case is to be strictly maintained.
- Age of legal abortion has been increased from the previous 20 weeks to 24 weeks for special categories.
- Contraceptive failure clause now applies to all couples irrespective of their marital status.
- Only one registered medical professional opinion is sufficient for abortions till 20 weeks.
- There’s no upper gestational age limit for termination, in case there are substantial foetal abnormalities and if the same is approved by the medical board. Such pregnancies can be terminated at any time.
It’s a great step by the Indian government to amend the 50 year old bill keeping in mind today’s scenario and recommendations.
Abortion is still an important challenge to women’s health all across the globe. Although abortion services in India were liberalised more than five decades ago, awareness and access to safe services is still an important issue.
In India, abortions account for around 8% of all maternal deaths, because major chunk of it consists of illegal abortions. Even young, educated, independent urban couples fell prey to illegal centres due to lack of awareness of facilities and their rights. Here are few important points everyone should be aware of to get access to safe abortion services.
What’s medical termination of pregnancy?
Medical termination of pregnancy is the termination of ongoing pregnancy either medically or surgically. Pregnancy can be terminated both with medicines or aspiration/surgical method depending on the duration of pregnancy and associated conditions.
Pregnancy can be terminated legally with the opinion of one doctor upto 20 weeks under following categories:
- to save life of pregnant women
- to prevent grave injury to the physical and mental health of the pregnant women
- if there’s substantial risk to the physical and mental health of the foetus
- if the pregnancy is caused by contraceptive failure, used by any partner, irrespective of the marital status of couples.
MTP or medical termination of pregnancy can be performed for a special category of females upto 24 weeks with the opinion of two registered medical practitioners. This
Special category of females include
- Survivors of sexual assault or rape or incest
- minors
- Change in marital status during the ongoing pregnancy (widowhood or divorce)
- women with physical disabilities
- mentally ill women
- substantial foetal malformations
- women with pregnancy in humanitarian settings or disaster or emergency
Marital couple clause removed for contraceptive failure:
Until now failure of contraception was an indication for legal abortions only for married couples. But now it is changed. Though it should have been done long back, keeping in mind modern social culture and reproductive rights of individuals. Where in this country live-in relationships are already legal, contraceptive failure only for married couples was a regressive thing. But in this new amendment, all couples irrespective of their marital status are given the right for medical termination of pregnancy up to 20 weeks, if there’s contraceptive failure used by any of the partners. This clause can cater to most couples who want medical termination of pregnancy.
In case a female becomes a widow or there’s change in her marital status during an ongoing pregnancy, the female has the right to terminate her pregnancy till 24 weeks, with the opinion of two registered medical practitioners.
Confidentiality to be maintained strictly:
Doctor or the health service provider is legally bound to maintain the confidentiality of the female or couples undergoing abortion. Doctors can’t share the details of the female to anyone except legal authorities. Even in the report sent by the doctors, the name and address column is masked to maintain confidentiality. This may help provide confidence to the females who for some reason, don’t want to reveal their identity and avoid going to authorised abortion centres because of that. Doctors found guilty of confidentiality breach may have to face a fine and imprisonment of upto 1 year.
Abortion is legal at any time, if there are substantial foetal anomalies:
Previously abortions due to foetal anomalies were legal till 20 weeks and after that it was at the mercy of court to give permission or not. Most developmental anomalies can be detected in level 2 scan which is done around 18-20 weeks, but many times females don’t get scanned on time or they get to know the anomalies at a later scan. So now, females/ couples can undergo legal abortion at any stage, if there’s known foetal anomalies which can make survival of the foetus difficult post birth and if approved by the medical board.
For this, a medical board has to be constituted at state level. This board will comprise of a gynaecologist, a paediatrician and a radiologist or an ultrasonologist and other persons authorised by the state. If the gestational age is more than 24 weeks and there is substantial evidence of foetal anomalies making foetal survival difficult then the female or couple can approach this medical board for medical termination.
Who can perform legal abortion?
Legal abortion can be performed by registered medical practitioner, RMP, defined by government. Opinion of one RMP is required for terminations upto 20 weeks now, which was previously 12 weeks. And two RMPs opinion is needed for abortions from 20-24 weeks.These changes regarding the service provider would be beneficial for females in rural India, where it is difficult sometimes to find two RMPs.
Reproductive Rights:
Reproductive rights means that people can enjoy safe sex life and have the freedom and capabilities to decide when and how to reproduce. This also includes access to safe, effective, affordable and acceptable methods of family planning. Sexual and reproductive rights include
- Right to life and survival
- Right to liberty and security of a person which includes informed consent
- Privacy and confidentiality
- Right for correct information
- Choice to decide about marriage and having a family, decide about number or spacing of children
- Right to highest attainable standards of health
- Right to reproductive health services irrespective of age, marital status, gender or socioeconomic status.
The purpose of this bill is to decrease the maternal mortality by easy access of reliable services to the females/couples in need. Where many countries or states have banned legal abortions, these fresh changes indicate our country’s forward approach towards making a healthy future. There is room for improvement in the bill but still these latest amendments will prove beneficial for many. It’s our collective responsibility to develop a happy and healthy society. Spreading awareness about these health related issues is a small step towards achieving our goal of a healthy future.
