Her right to choose | The Indian Express

Context: Cabinet has recently approved Medical Termination of Pregnancy (MTP) (Amendment) Bill, 2020 to amend the Medical Termination of Pregnancy Act (MTP), 1971.

Main provision of the bill:

• The bill proposes that the opinion of one registered medical practitioner or doctor will be required for termination of pregnancy until 20 weeks of gestation (pregnancy). But, the opinion of two registered medical practitioners will be needed for termination of pregnancy of more than 20 weeks and less than 24 weeks of gestation (pregnancy).
• As per the Medical Termination of Pregnancy (MTP) (Amendment) Bill, 2020, 24 weeks will be the upper limit for terminating certain kinds of pregnancies, including rape survivors, incest victims, differently-abled women, minors, etc.
• There will be no upper gestation limit for foetal abnormalities identified by Medical Board. The name and details of a woman with terminated pregnancy will not be revealed.

Positive aspects of bill:

The proposal to increase the maximum limit from 20 weeks to 24 weeks is welcome as physical and mental disabilities of foetus (child) developing inside the mother’s womb are identified after fifth months of pregnancy. When the upper limit was 20 weeks under the MTP act of 1971, vulnerable woman has only two options. They either gave birth to a disabled child or went through cumbersome legal process. As per the bill’s proposal, an unmarried woman will also be allowed medical termination of pregnancy. Thus, the bill ensures that single woman get the right to legal abortion.

Criticisms of bill: Medical Termination of Pregnancy (MTP) (Amendment) Bill, 2020, does not address following issues:

• Large number of abortions: Annual number of abortions in India is currently more than 15 million. This is equal to 33% of total annual pregnancies. Many women go for termination of unwanted pregnancies due to failure of contraception. Families in rural areas lack knowledge about and access to dependable and reversible methods of contraception like Intra-uterine devices (IUDs). Women rarely use condoms or pills that are provided by ASHAs to help them prevent unwanted pregnancy. In such cases, the unsafe abortion is only option before women. In the list of most important causes of maternal mortality, unsafe abortions come in third place. The bill does not have any provision to improve the availability and use of contraceptives.
• More dependence on medical termination through pills: women in rural and urban areas are dependent on medical termination through pills. They are less dependent on medical termination through surgical methods. A study published in The Lancet (a general medical journal) in 2015 showed that 81% women were dependent on medication for termination of pregnancy.
• Over the counter availability of medical termination kits: One can buy medical termination kits without prescriptions. This needs to be resolved by making advisory in simple language outside the medical stores mandatory.
• Women having no access to doctors: The bill’s provision to raise the upper limit will help only women having access to doctors. But, the bill does not address concerns of women having any access to doctors. Many women, including rape survivors, incest victims, go for unsafe abortions to protect secrecy. Many women choose unsafe abortion options for economic reasons. The costs of abortion in peri-urban areas is Rs 2,000. In cities, the cost increases to Rs 10,000.

Conclusion:

The Medical Termination of Pregnancy (MTP) (Amendment) Bill, 2020, scientifically raises the maximum limit from 20 weeks to 24 weeks and gives a single woman right to legal abortion. However, it does not contain any provisions to decrease the number of abortions in India, lower dependence on medical termination through pills, reduce over the counter availability of medical termination kits and increase low access of doctors to women.