For the past three decades, several nations have modernized their abortion
legislation. After 1980, the global liberalization movement advanced. Currently,
just 8 percent of the global population resides in nations where abortion is
prohibited by legislation. While most nations have very restrictive abortion
legislation, 41% of females reside in nations where abortion is accessible at
the option of females.
In our country, the
Shantilal Shah Committee
(1964) proposed the liberalization of abortion legislation in 1966 to decrease
maternal morbidity and mortality owing to unlawful abortion. Based on this, a:
Medical termination bill was proposed in Rajya Sabha and Lok Sabha in 1969 and
enacted by the Parliament in August 1971. The MTP Act, 1971 was executed in
April 1972. Enacted laws were amended once more in 1975 to remove sluggish
method for the authorization of the location and to render facilities more
easily accessible.
The preamble of the MTP Act, 1971, reads An Act to allow for
the abortion of such pregnancies by approved medical professionals and for
events relevant therewith or subordinate thereto.
It is quite evident from the preamble that abortion will be allowed in certain
circumstances. The situations in which abortion is allowed are set out
within the Act. In addition, only a licensed medical professional who is
described in Section 2(d) of the Act as:
A professional who holds any
acknowledged medical training as specified in Clause (h) of section 2 of the
Medical Register
and who has similar experience or qualifications in
gynaecology and Obstetrics as may be provided by regulations issued under
the Act can be allowed to perform the abortion. Other issues relevant thereto
include, for instance, the issue of approval for abortion, the location
where abortion could be carried out, the right to set down legislation and rules
under this favor.
Important Provisions of the Act
- S. 2(d) of the MTP Act, 1971[i] describes Licensed Medical
Professionals. As per the Act, a Licensed Medical Professional implies any
medical professional who holds the necessary professional credentials as
specified in S. 2 of the Indian Medical Council Act, 1956 and whose identity
has been documented in the State Medical Register and who holds the necessary
medical expertise in obstetrics and gynecology as specified by the Act.
- Sec. 3 of the MTP Act, 1971[ii] indicates that when pregnancy may be
ended by licensed medical professionals.
- A licensed medical professional shall not be liable for any wrongdoing
that has been stated in the Indian Penal Code or any other legislation that
he/she has performed during abortion as per the requirements of the
legislation.
- Where the duration and period of pregnancy haven't surpassed more than
12 weeks.
- Where the period and duration of gestation have been more than 12 weeks,
but not more than 20 weeks, in this situation by the views of the two
medical professionals in good conscience.
- The prolongation of the pregnancy can pose a significant risk to a
female's health.
- When there is an apprehension that an infant born out of this pregnancy
would be vulnerable to adverse wellbeing and will be impaired.
- It is necessary to remember that the informed permission of the
relatives or parents is needed for abortion of any minor girl or girl who is
above eighteen years of age but who is of unsound mind.
Needs for Amending the Medical Termination of Pregnancy Act, 1971
Presently, women seeking to abort the baby after 20 weeks entail many legal
complexities, however this bill aims to change the legal
frameworks of abortion from 20- 24 weeks.
A lot of females suffer every day because of dangerous and unlawful abortions.
This bill aims to establish safeness and care for pregnant mothers in a simpler
and more accessible way.
One of the drawbacks of the Act is that it has struggled to catch up with new
technologies. As it was introduced in 1971 and that moment, the technology was
not so progressed and hence warranted an alteration.
It is specified in the Act that valid written permission of the parent is needed
in the situation that the female is a minor or under 18 years of age and over 18
years of age if of unsound mind. The proposed legislation aims to exclude this
clause, which is laid out in the MTP Act 1971.
This proposed legislation would ease the complex legislative requirements laid
out in the existing MTP, Act 1971. It would further facilitate the cautious
pregnancy termination for many females more appropriately and efficiently.
The Union Cabinet adopted the bill in January 2020 under the governance of PM Narendra
Modi.
Various other Laws related to Abortion in India
There are several other pregnancy terminations regulations in India. Abortion in
India is permitted in some cases. About 15.6 million abortions are reported to
happen in India annually.[iii] Although many of these dangerous and unlawful
abortions are taking place every day in India, which triggers the death of the
mothers. In addition to the MTP Act, 1971, the administration and the Family and
Health Ministry have separate plans and proposals for secured pregnancy
terminations.
Effective Abortion Supervision:
Aid Distribution and Preparation Standards
2010[iv]- These instructions deliver for all broad and thorough details on
pregnancy termination. It also includes legal problems linked to it. Both the
State Administrations and the Union Territories extend these rules towards
systematic abortion services for females in India.
CAC Training Programme:
The Health and Family Welfare Ministry has established a
structured training program and framework that offers suppliers, instructors,
and functional advice on systematic abortion treatment. It was carried out in
2014 after consulting with all medical professionals for the training of
practitioners in all States.
State Policy Development Strategies:
All States are supposed to put
forward their initiatives and objectives and guidelines as a segment of the
National Health Mission for the execution of health plans in
healthcare facilities. These are examined by the Health and Family Welfare
Ministry and then the funding is distributed appropriately.
Guaranteeing secure abortion procedures and preventing gender-based activities
and racism in gender classification- The Government adopted the Medical
Termination of Pregnancy Act, 1971 and the Preconception and Prenatal Diagnostic
Technique Act 1994[v], which renders the gender selection of the child unlawful.
Health Governance Information Structure:
This is an effort of the Family and
Health Welfare Ministry under the National Health Mission, which offers
in-depth knowledge of the health treatment facilities provided to the general
public. This Gateway is modified frequently.
National Mass Media Initiative:
The Health and Family Welfare Ministry initiated
it in 2014 to render the termination of pregnancies in a safe way. It was one of
the first mainstream initiatives of its type. It concentrated on normalizing
abortions and implementing better policies for pregnancy termination.
Section 312 of IPC, 1860[vi]. It is also associated with unlawful and
involuntary pregnancy termination. As per this Section, whoever willingly
induces a female to abort a baby, unless in good conscience, or if a female
is mentally and physically disabled, if she wants to have a baby, the
individual is punishable for the incarceration of up to three years and is also
subject to a penalty.
Medical Termination of Pregnancy (Amendment) Bill 2020
The Lok Sabha approved the MTP (Amendment) Bill 2020 (hereafter Bill) on 17
March 2020[vii]. This bill revised the Medical Termination of Pregnancy Act
1971. The main provisions of the proposed bill comprise: expanding the pregnancy
duration for abortion from 20 weeks to 24 weeks, creating a health board in
each State, and ensuring the seclusion of females whose pregnancy has been
ended.
Although this reform is a move in the proper path, there is yet a
considerable distance to reach in securing the sexual rights of females. The
Bill recommends that the upper limitation for abortion be extended from 20
weeks to 24 weeks. Nevertheless, in sub-section 2 (b) of the bill, it seems
that this expansion of the limitation would extend only to specific groups
of women.
Specific groups of women comprise rape victims, survivors of violence and minors, etc,
Minister of Health, Dr. Harsh Vardhan mentioned during the passing of the
bill[viii].
As per the clarification to sub-section 2, the higher pregnancy limitation would
not extend in situations where abortion is entailed due to the presence of some foetal
deformities recognized by the Health Board. This distinction is not fair, since
technical developments render it possible to detect some foetal defects even
after 20 weeks, which can convert the ideal pregnancy into an unwanted one.
To all appearances, the freedom to abort must be given to a female on request
as so much as the welfare of a female is not at stake. The capricious grouping
represents a decremental approach against female's freedom to their bodies to do
whatever they want with respect to the child. It further strengthens the
oppressive framework in which women do not have an institution to rule on issues
pertaining to their family offspring and their anatomy.
Refusing women the
freedom to abort is a breach of
Article 21 of
the Constitution of India. As the Apex Court mentioned in its Suchita Srivastava
verdict of 2009[ix]: There is no question that the freedom of a mother to make
a reproductive decision is indeed an aspect of individual freedom as described
in Article 21. It is necessary to understand that reproductive decisions may be
taken to reproduce as well as to withdraw from reproduction.
While one of the aspects of the Bill speaks regarding protecting the
right to
secrecy of females who have aborted, it drops short of fulfilling the main
elements of the privacy rights. Neglecting women to make
reproductive decisions is a breach of the
freedom to privacy concept. In the
2017 Puttaswamy decision, the Supreme Court ruled that privacy
protects
personal freedom and identifies the right of people to regulate
crucial facets of their lives. The achievement of satisfaction is centered on
the person's freedom and self-respect. If females do not get a voice in
determining what occurs to their bodies while they are pregnant, their dignity
would be abused.
The Apex Court's instance on pregnancy termination is focused on the opinion of
the Health Boards and not on the option of mothers.[x] There have been instances
where the actions made by the Health Boards are subjectively affected by social
and virtuous standards and not by medical considerations with reference to the
danger to the safety of mother or baby. Instead of making it easy for mothers to
take action, organizations are perceived as the main choice-makers. We thus
require more inclusive abortion legislation that encourages females to make
sound decisions over abortion up to 24 weeks without any special requirements.
Current Law and Policy: What is still missing?
Its brawny medical prejudice is a big censure of the Medical Termination of
Pregnancy Act. The rule of
doctors only for
providers eliminate intermediary health suppliers and professionals of
substitute structure of medicine. The need for another medical view for
a second-trimester pregnancy termination further limits access, particularly in
remote areas.
The Medical Termination of Pregnancy Act, 1971 requires the State to offer
abortion care at all healthcare facilities. Nevertheless, the absence of the
necessary authorization for public health centers excludes the general public
from the same compliance procedures that extend to the private sector. The
presumption that a public healthcare agency is responsible to the people and has
well-operational managerial mechanisms that don't need clarification in
legislation and practice is false.
Sometimes, any other legislation appears to
be inadequate or requires clarity. In the case of low condition abortion
treatment in the public sector, the same rigorous criteria should be implemented
as in the private sector and subjected to the same inspected processes as
required in the private one. Amusingly, though, the private sector in our
country remains relatively uncontrolled and frequently loses the
self-control required to conform with the quality requirements laid down in the
legislation.
The absence of clear legislation on effective medical practice and analysis is a
significant void in pergnancy termination strategy in India. The
National
Technical Guidelines released in 2001 do not comply with World Health Organisation's
directions and do not guarantee sound medical practice even in permitted
termination services. As a consequence, 39-79 percent of suppliers and the
continuing usage of anaesthesia in 8-15 percent of registered termination
centers are still widespread. India has not figured out a way to guarantee the
utilization of better and secured abortion procedures brought by study and
continually improving reproductive technologies.
Risk on Reproductive Health of Women
A female should have the freedom not only to pregnancy termination, but she
should have the privilege to deliver a healthy child. As an infant with severe
medical issues, not only the parents are burdened, but their relatives,
community, colleges, etc. overlook them and, in any situation, the mother of the
baby has struggled the most, resulting in extreme emotional trauma and other
medical issues Thus, women's sexual wellbeing must encompass all pre-and
post-pregnancy concepts.
Conclusion
Current Legislation and policy improvements, however not drastic, still mark a
move further in maintaining a female's access to secure abortion treatment. It
is only in past years that a number of governmental advisory initiatives
including decision-makers, specialist entities such as the Federation of
Obstetrics and Gynecology Societies of India (FOGSI) and the Indian Medical
Association (IMA), NGOs (notably Parivar Seva Sanstha, CEHAT, Health Watch and
Family Planning Association of India) and health campaigners have advocated
the enhancement of secured and lawful pregnancy termination aids in our
country. Most of their proposals are aligned with the goals and policies
described in the Action Strategy of
India's National Population
Development, 2000. They
include:
- Increased accessibility and adherence to cautious pregnancy
termination facilities,
- Creation of more skilled suppliers (comprising intermediary
providers) and services, particularly in remote areas
- Simplification of the approval procedure,
- Detaching clinic and supplier certification,
- Connecting strategy with technologies and analysis and effective
medical practice,
- The implementation of standardized practices for both the private
and public sectors and
- Maintaining the standard of treatment for termination of pregnancy.
Rising consciousness and eliminating myths regarding pregnancy
termination legislation among professionals and policymakers are only one move
forward. There is a demand to increase understanding of both birth control and
pregnancy termination services, particularly among teens, in the wider sense of
sexual and reproductive well-being, and to incorporate policies and approaches
into value structures and family and sex ties.
For these initiatives to be enforced successfully, they need to be supported by
governmental commitment and determination in terms of proper distribution of
funding, training, and funding for facilities, coupled with social feedback
focused on women's needs. Outreach and intervention at the national and state
levels are needed to implement the institutional policies applicable to
pregnancy termination, as set out in the National Population Strategy, 2000 into
outcome.
End-Notes:
- Section 2(d) of the Medical Termination of the Pregnancy Act 1971
https://tcw.nic.in/Acts/MTP-Act-1971.pdf
- Section 3 of the Medical Termination of the Pregnancy Act 1971 https://tcw.nic.in/Acts/MTP-Act-1971.pdf
- National Estimate of Abortion in India Released https://www.guttmacher.org/news-release/2017/national-estimate-abortion-india-released#
- Comprehensive Abortion Care-Service Delivery and Training Guidelines
2010 http://tripuranrhm.gov.in/Guidlines/Abortion_Care.pdf
- Preconception and Prenatal Diagnostic Technique Act 1994 https://pndt.gov.inwritereaddata/l892s/PC-PNDT%20ACT-1994.pdf
- Section 312 of the Indian Penal Code 1860 https://www.indiacode.nic.in/bitstream/123456789/4219/1/THE-INDIAN-PENAL-CODE-1860.pdf
- The Medical Termination of Pregnancy (Amendment) Bill 2020 https://clpr.org.in/blog/medical-termination-of-pregnancy-amendment-bill-2020/
- LS passes Bill to raise the limit for abortions till 24 weeks for
special categories https://www.thehindu.com/news/national/ls-passes-bill-to-raise-limit-for-abortions-till-24-weeks-for-special-categories/article31093261.ece
- Suchita Srivastava & Anr vs Chandigarh Administration (2009) 14 SCR 989
- Abortion jurisprudence in the Supreme Court of India: Is it the woman's
choice at all? https://clpr.org.in/blog/abortion-jurisprudence-in-the-supreme-court-of-india-is-it-the-womans-choice-at-all/
Award Winning Article Is Written By: Mr.Jay Gajbhiye
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