Context: The Delhi High Court permitted a depressed widow to terminate her 29-week pregnancy, citing the risk of mental harm. Despite the Medical Termination of Pregnancy (Amendment) Act's 24-week limit, special considerations apply to specific groups, including survivors of rape and vulnerable individuals.
About Medical Termination of Pregnancy (Amendment) Act, 2021:
- The Medical Termination of Pregnancy (Amendment) Act, 2021 alters the MTPA 1971.
- The amendments increase the ambit and access of women to safe abortion services and will ensure dignity, autonomy, confidentiality and justice for women who need to terminate pregnancy.
Features of the amendment act:
- The Amendment raises the upper gestation limit from 20 to 24 weeks for particular groups of women, include rape survivors, incest victims, and other vulnerable women (such as differently-abled women, minors), among others.
- It replaces the terms “married woman and her husband” with the terms “woman and her partner”. As a result, an unmarried woman can also terminate pregnancies within the time limit prescribed under the Act.
- Upper gestation limit not to apply in cases of substantial foetal abnormalities diagnosed by Medical Board.
- The ground of failure of contraceptive has been extended to women and her partner up to 20 weeks
- For safeguarding the privacy and confidentiality of women, section 5A of the Act penalise medical practitioners who fail to protect the privacy and confidentiality of women who desire to terminate their pregnancy.
Limitations of the Amendment Act:
- Time frame for Medical Board’s decision not specified: The amended Act does not stipulate the time limit within which the medical board must make its decision, result in further complications for pregnant women.
- Since the amended Act exclusively allows for the termination of pregnancies in the case of women, it is unclear if transgenders will be included under the amended Act.
- Unavailability of qualified medical professionals to terminate pregnancies: The All-India Rural Health Statistics (2018-19) reveal a severe shortage of gynecologists in rural India. With only 1,351 serving at community health clinics, there's a substantial 75% shortfall (4,002 doctors), posing a significant obstacle to ensuring safe abortions.
- Judicial inconsistency: Lower courts sometimes making flawed decisions that higher courts later correct on appeal. However, pregnant women experiencing physical hardships may not have sufficient financial resources for filing an appeal against an unjustifiable judgement resultantly becoming a victim of the tedious judicial system.
- There is no provision for ensuring the accountability when death of the mother is caused due to the denial to abort.
- Section 3 of the MTP Act, which rests the decision of undergoing a medical termination solely on the doctor’s opinion, also points to lack of autonomy for women.
- Frontline healthcare workers (around 95%), the first points of contact for women—are also unfamiliar with the amendment to the MTP Act, 1971.
Suggested measures:
- Need law on comprehensive abortion care is essential to ensure access to safe services, health and safety standards, financial accessibility, and protection from harassment (Shantilal Shah committee).
- Social media emerged as one of the key sources of information for women. This should be used by the respective state health authorities to share messages on different clauses/sub-clauses of the MTP (Amendment) Act, 2021 in simple languages among women.
- Provide a reasonable time frame within which the medical board must make its decision.
- Advocate for the establishment of a fast-track appeal process, particularly in cases involving maternal health risks or physical hardships.
- Propose the inclusion of provisions that hold healthcare providers accountable for maternal deaths resulting from the denial of abortion when it is legally permissible. This can act as a deterrent and ensure that medical decisions prioritize maternal health.
- Need a mechanism for regular review and updates of the MTP Act to address emerging issues and ensure that the legislation remains relevant and effective.