Reproductive Health
Reproductive Health is a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health is a component of reproductive rights. These rights include the rights of men and women to be informed, have access to safe, effective, affordable and acceptable methods of family planning including methods for regulation of fertility; right access to appropriate health care services to enable women to have a safe pregnancy and childbirth and provide couples with the best chance of having a healthy infant.
Laqshya
- Labour Room Quality Improvement Initiative: A scheme to improve the quality of care to the pregnant mother in labour rooms and maternity operation theatres.
Janani Shishu Suraksha Yojana
- A centrally sponsored scheme launched in 2011 to eliminate high out-of-pocket expenditure for pregnant women and neonates.
- All pregnant women opting for institutional delivery in government institutions
PM Surakshit Matritva Abhiyan
- A fixed-day scheme to provide Ante-Natal Carefree of cost to all pregnant women on the 9th of every month
Objectives
- Provide healthy life to pregnant women.
- Lowering the Maternal Mortality Rate. (MMR)
- Making sure, of safe delivery & healthy life for the baby.
All pregnant women who are in the 2nd & 3rd trimesters of pregnancy can take benefit of the scheme
Mother’s Absolute Affection
National program for the promotion of breastfeeding
Goals
- Initiation of breastfeeding within one hour of birth.
- Exclusive Breastfeeding for the first 6 months
- Continued breastfeeding for 2 years.
- Safe & nutritious food on completion of Six months.
- +A lead development partners.
Menstrual Leave
Article 42 of the Constitution provides for Just and humane conditions of work and maternity relief. A private company Zomato became the first company to introduce a “period leave” policy for women.
Arguments in Support of Menstrual Leaves
- Menstrual cramps/pains experienced by some women can be as intense as a sickness, hence requiring rest for their fruitful engagement in economic activities.
- This will lead to the reduction of stigma associated with periods, create awareness and dilute the taboo.
- Safeguarding equal protection of law that calls for different to be treated differently.
- Global best practice: Many developed countries like Taiwan & Japan have institutionalized Period leaves.
Arguments against Menstrual leaves
- Reinforces gender stereotypes.
- Might be used as an excuse to justify lower salaries/opportunities to women.
- Infringes upon the right of privacy: Seeking leave would require female workers to inform the employee about it.
- Liable to be misused - As menstruation’s pain and intensity vary with individuals.
Yes, it is time to introduce menstrual leave in India by passing Menstruation Benefit Bill.
But apart from this, we need long-term measures to make our working spaces women-friendly by provisions of medicine, sick rooms and sanitary pads.
Termination of Pregnancy
The Medical Termination of Pregnancy Act, of 1971 allows for aborting pregnancy by medical doctors (with specified specialisation) on certain grounds.
- A pregnancy maybe be terminated up to 12 weeks based on the opinion of one doctor, and up to 20 weeks based on the opinion of two doctors.
- Termination is permitted only when the continuance of the pregnancy would involve a risk to the life of a pregnant woman, cause grave injury to her mental or physical health (including rape and failure of birth control measures), or in the case of foetal abnormalities.
- Termination is also allowed at any point during pregnancy if there is an immediate necessity to save the woman’s life.
Medical Termination of Pregnancy (Amendment) Act, 2020
Increases upper limit for termination from 20 to 24 weeks for certain categories of women, removes this limit in case of substantial foetal abnormalities, and constitutes Medical Boards at state-level.
| Time since conception | The advice of one doctor | |
| MTP Act, 1971 | MTP (Amendment) Bill, 2020 | |
| Up to 12 weeks | The advice of one doctor | The advice of two doctors |
| 12 to 20 weeks | The advice of one doctor | One doctor, if immediately necessary to save a pregnant woman's life |
| 20 to 24 weeks | Not allowed | Two doctors for some categories of pregnant women |
| More than 24 weeks | Not allowed | Medical Board in case of substantial foetal abnormality |
| Any time during the pregnancy | One doctor, if immediately necessary to save pregnant woman's life | |
Rationale
- With the advancement of medical technology for safe abortion, there is a scope for increasing the upper gestational limit for terminating pregnancies, especially for pregnancies with substantial foetal anomalies detected late in pregnancy.
- There is a need for increasing access of women to legal and safe abortion services to reduce maternal mortality and morbidity caused by unsafe abortion.
- Several Writ Petitions have been filed before Supreme Court and High Courts seeking permission for aborting pregnancies beyond the permissible limit on grounds of foetal abnormalities or pregnancies due to sexual violence.
Assisted reproductive technology (Regulation) Act, 2021
Parliament had passed the Act to regulate assisted reproductive technology services such as in-vitro fertilisation centres, sperm or egg banks and curb unethical practices such as sex selection.
Need for amendment
- India has become a significant centre of the global fertility industry due to revolutions in Assisted reproductive technologies. A reproductive segment of the Indian medical tourism market is valued at more than $450 million.
- Assisted Reproductive Technologies have given hope to many persons suffering from infertility but introduced a plethora of legal, ethical and social issues. Despite this, there were only guidelines, but no law exists to regulate ART in India.
- Select Committee on Surrogacy (Regulation) Bill, 2019, has recommended that the ART Bill should be brought before Surrogacy (Regulation) Bill, 2019, so that all highly technical and medical aspects could be addressed in Surrogacy (Regulation) Bill, 2019.
Major features of the Act
- Definition: Defines ART includes all techniques that seek to obtain a pregnancy by handling sperm or oocyte (immature egg cell) outside the human body and transferring gamete or embryo into a woman's reproductive system—ex: gamete donation, in-vitro-fertilisation and gestational surrogacy.
- Regulation of ART clinics and banks: Every ART clinic and bank must be registered under the National Registry of Banks and Clinics of India. Registration will be valid for 5 years, can be renewed for further five years and can be cancelled if the entity contravenes regulations.
- Conditions for offering ART services:
- Age requirement for gamete donor- for males (21 to 55 years) and for females (23-35 years)
- A woman can donate an egg only once in her lifetime and should be married having at least one alive child.
- Conditions for seeking ART services:
- Only infertile married couples or single women (Indian or foreign) can seek ART services.
- The party seeking ART services will be required to provide insurance coverage in favour of egg donor.
- Mandatory checking for genetic diseases before embryo implantation.
- Offences:
- Selling or purchasing of gametes
- Abandoning children born through ART
Concerns with the act
- Excludes same-sex couples, live-in couples and individuals belonging to the LGBTQ+ community from accessing ARTs.
- The eligibility criteria for egg donors are very restrictive.
- Requires ART clinics and banks to share information about commissioning parties and donors with National Registry. Sharing of this information may violate the right to privacy of parties.
- The acts, ART Act and surrogacy contain different provisions for regulating clinics based on whether they provide surrogacy or other ART procedures. This leads to overlap in regulating surrogacy services and other ART services.