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Indian abortion law reform gets nod from MPs

45352241 - court legal concept of abortion law, Copyright: kagenmi / 123RF Stock Photo. Several cases are provoking debate around India's abortion law - and whether it's time for change. Concept of Indian abortion law illustrated.Lawmakers in the Lok Sabha have approved reform to Indian abortion law proposed by the Centre, which could expand access to abortion in the country. 

Parliamentarians in the lower house of the Indian Parliament approved by voice vote the Medical Termination of Pregnancy (Amendment) Bill, 2020, which seeks to amend the Medical Termination of Pregnancy Act, 1971. This expands the timeframe within which a woman who falls into a “special category” can avail an abortion from the twenty week-mark of their gestation period to 24 weeks. 

Union Minister of Health and Family Welfare Dr Harsh Vardhan introduced the Medical Termination of Pregnancy (Amendment) Bill, 2020 to the Lok Sabha earlier this month. “When this original Bill [referring to the Medical Termination of Pregnancy Act, 1971] was brought in 1971,” Vardhan told lawmakers, “India was amongst one of the first few countries in the whole world to legalise abortion in order to provide legal and safe abortion services to women who required to terminate a pregnancy due to certain threptic, eugenics or humanitarian grounds.

“However, with the passage of time and advancements of medical technology for safe abortion, there is a scope for increasing upper gestational limit for terminating pregnancies, especially for vulnerable women, like survivors of rape, incest, minor girls or differently abled women and for pregnancies with substantial foetal abnormalities detected late in the pregnancy.” 

Provisions of the Medical Termination of Pregnancy (Amendment) Bill, 2020

The Bill includes a number of provisions which translates to reform to the abortion law. It enables abortions to be carried out after twenty weeks (but not after the 24th week) “if not less than two registered medical practitioners are, of the opinion, formed in good faith, that (i) the continuance of the pregnancy would involve a risk to the life of the pregnant woman or of grave injury to her physical or mental health; or (ii) there is a substantial risk that if the child were born, it would suffer from any serious physical or mental abnormality.” 

This includes if the woman alleges the pregnancy to have been conceived by rape, given that “the anguish caused by the pregnancy shall be presumed to constitute a grave injury to the mental health of the pregnant woman.” The reforms will also enable an abortion to be availed up to 24 weeks for those who have experienced incest, who are minors, or who are considered to be differently-abled. 

The Bill provides for the anonymity of women accessing an abortion, stating “no registered medical practitioner shall reveal the name and other particulars of a woman whose pregnancy has been terminated under this Act except to a person authorised by any law for the time being in force.” Violations of this provision renders the practitioner in question liable to be fined, imprisoned for a term of one year, or both. 

The Bill also mandates the convention of medical boards by each state and union territory government, to consist of a gynaecologist, radiologist or sonologist, paediatrician, and “such other number of members as may be notified in the Official Gazette by the State Government or Union territory, as the case may be.” This Board will serve “the purposes of this Act to exercise such powers and functions as may be prescribed by rules made under this Act.” 

The long path to reform

The Supreme Court, which is calling on state governments to ensure access to healthcare for sufferers of rare diseases.
The Union Government told the Supreme Court last year it would not seek to change the Indian abortion law and extend the timeframe – but has since changed course.

“The Bill is the first step towards the safety of women,” said Vardhan. “We have had extensive consultation with several stakeholders. There was also a Group of Ministers and the Bill was discussed in great detail.” He noted that “it is a very progressive legislation. Even the courts had said that the law should be reviewed.” 

Calls for reform to the Indian abortion law have been long-standing by activists. However, the path has been uneven. 

Last year, the Union Government told the Delhi High Court that it was contemplating amending the Medical Termination of Pregnancy Act, 1971. However, the Government subsequently told the Supreme Court it would not extend the timeframe in which an abortion could be accessed beyond twenty weeks. 

“Petitioners on their right to reproductive autonomy does not outweigh the interest of the state in protecting the life of [the] foetus in the womb, especially from the point of viability (i.e from the period of 20 weeks onwards),” the Government expressed in an affidavit. “It is a settled law that personal freedom of choice of an individual cannot curtail the freedom or choice of other individuals, [especially] the most vulnerable and persons who are defenceless.”

However, the Government went on to reverse course. The Union Cabinet in January approved the extension of the timeframe to 24 weeks, presaging the introduction of the Amendment Bill in the Lok Sabha and its eventual passage. 

The passage of the Bill comes at a time when unsafe, illicitly-provided abortions are a major driver of maternal mortality and result in thirteen deaths every day. The reform to the Indian abortion law could expand access to safe abortion for women who need it, in the process reducing maternal mortality and bolstering sexual and reproductive rights – especially for the most vulnerable demographics.

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