By Dr. Jaydeep Tank
Secretary General, Federation of Obstetric and Gynecological Societies of India
In 1971, India became one of the first few countries to recognize the right of women to safe and legal abortion with specifics like who, when, where and for whom abortion can be performed up to 20 weeks. The MTP Act for the times was a progressive law under a wide range of therapeutic, eugenic and humanitarian grounds.
In order to keep pace with the evolving need of women and advances in medical technology, recently amendments have been proposed to the MTP Act. At a time when abortion and reproductive rights are under threat many countries in the world (including USA), the timing and scope of the amendments to the Indian law is especially laudable. The Indian Government has sought these changes in the MTP Act to give Indian women and girls greater autonomy and control over their lives and reproductive choices. While we await Parliament’s approval of the MTP (Amendment) Bill 2020 due anytime now, let us demystify the proposed amendments─ what it entails, what it means for the women of the country and what is needed to ensure its swift translation into action.
The MTP Act amendments are proposed by the Ministry of Health and Family Welfare after extensive consultations and deliberations with various stakeholders including the civil society and FOGSI. These are drafted in response to the growing barriers and struggles, in various settings and at various levels, women face in accessing safe abortion services. The guiding principal of drafting the amendments was to make changes that are women centric and rooted in the Indian field realities.
Once the amendments become law, women will require opinion of only one provider for termination of pregnancy up to 20 weeks. This is a welcome move from the current law which mandates one doctor approval for pregnancy termination up to 12 weeks and two doctors for termination up to 20 weeks. It will provide respite to the women who choose to terminate second trimester pregnancies as majority secondary level facilities (that can offer abortion services) in rural and peri urban areas may have only one abortion service provider. This amendment will prevent women from opting unsafe pathways because of the barriers of need for two-doctor opinion.
To overcome the impediment faced by vulnerable women in accessing abortion services, the amended abortion law when passed will enhance the upper gestation limit from 20 to 24 weeks for special categories of women including survivors of rape, victims of incest, differently abled women and minors. However, opinion of two providers will be required in such cases (20 to 24 weeks). This will provide extended time to this group of girls and women, who encounter far more barriers of stigma, access and agency preventing them to avail abortion services within the current period.
Last September, a pregnant woman was diagnosed with a serious fetal heart abnormality at 22 weeks of pregnancy. As the existing law did not permit it, she had to undergo tedious court proceedings, multiple examinations and investigations by doctors. It took more than 45 days before she was permitted to undergo the abortion.
This is not an isolated case. Fetal abnormalities in some medical conditions are detected only beyond 20 weeks. Under the proposed amendments, abortion will be allowed at any time for cases with substantial fetal abnormalities post diagnosis, by the medical board. This feature considers the field reality which the current law overlooks. This amendment is aimed at saving women from the trauma, huge expenses and a delay in abortion caused due to filing petitions in courts and awaiting a judgement.
Enforcing the amended abortion law into action will require concerted efforts of multiple stakeholders including the federal government, state governments, FOGSI and the civil society. We hope these concerted efforts will enable effective roll out of the law and trickle down of relevant information on the amended abortion law till the last point in the field, while keeping the spirit of the amendments intact.