Getting an abortion in India is not just about finding the right doctor who can perform the procedure in a safe manner and through legal methods, it’s also about dealing with the stigma and navigating the laws around it. Though we may be living in 2020, if an Indian woman seeks termination of pregnancy even today, she can not do so openly without judgment and people trying to change her mind.
Says 26-year-old Mithila (name changed), “When I got pregnant, my boyfriend and I couldn’t talk to our friends or family about it. So, we looked up a gynaecologist online. As expected, we got lectured about having sex before marriage and got asked the dreaded question – do your parents know?” The doctor refused to perform the termination and as luck would have it, they found a different doctor who turned out to be very supportive.
But not everyone has good fortune. Uncomfortable questions and unsolicited advice often leads to many women becoming wary of going to a doctor. They usually opt for unsafe abortion options or self-medicate with pills at home. Reports suggest that 10 women in India die every day from unsafe abortions. In fact, it is the third leading cause of maternal deaths in the country.
The law of the land
In India, almost 15 million pregnancies are terminated every year. This was a criminal offence according to Section 312 of the Indian Penal Code (for intentional miscarriage) till it was finally legalised in 1971 with the Medical Termination of Pregnancy (MTP) Act.
The law said that termination of pregnancy is allowed only up to 20 weeks of gestation for certain circumstances such as risk to the child’s life, the risk to the mother’s life, pregnancy by rape, or pregnancy by the failure of contraceptives (only for married women). The legal age to get an abortion was stated as 18 years, whereas minors and women with social or psychological disabilities need written consent from guardians. It was a law considered a step ahead of its times.
However, it aimed at dealing with the increase in population and mortality rates instead of empowering women. Today, societal progressions and advancements in the medical field made it necessary to make a few changes in the law. The Parliament recently brought in some long-pending modifications with the approval of the MTP (Amendment) Bill, 2020. It legally raised the limit for an abortion to 24 weeks and made contraceptive failure a valid reason even for unmarried women.
Dr Aruna Muralidhar, Senior Obstetrician and gynaecologist, Fortis La Femme Hospital, was quoted as saying, “Many only realise that they are pregnant after the 20th week as this is when the tummy starts showing. Also, one only gets to know that the baby has abnormalities in the 20-week scan. The amendment proposed that not only doctors but also other nursing and medical professionals would be able to perform abortions. This would help increase the number of healthcare workers.”
Change is coming
According to a government statement, “The Medical Termination of Pregnancy (Amendment) Bill, 2020 is for expanding access of women to safe and legal abortion services on therapeutic, eugenic, humanitarian or social grounds… It is a step towards the safety and well-being of the women and many women will be benefited from this. The proposed increase in gestational age will ensure dignity, autonomy, confidentiality, and justice for women who need to terminate the pregnancy.”
The new amendments to the MTP Act, 1971 are mainly as follows:
Increases the upper limit for abortion from 20 weeks to 24 weeks for certain categories of women, with opinions required from two doctors only for cases where pregnancy is over 20 weeks.
Allows unmarried women to seek safe termination of pregnancy on the grounds of contraceptive failure.
While this is a huge jump in the abortion laws, there is still the problem of it being only a conditional right – i.e., one can get an abortion only based on a doctor’s opinion.
“First trimester abortions should be allowed as per request/decision of the pregnant person and it should become a legal right. Moreover, constituting medical boards at all levels would be an operational nightmare. Medical boards will further add to delays and complicate access to abortion, apart from putting an unnecessary burden on an already weak healthcare system. The number of specialist doctors to constitute such boards is limited in many districts and smaller towns,” said Anubha Rastogi, lawyer and member of Pratigya Campaign Advisory Group.
(Edited by Kanishk)