What is MTP Act?

The Medical Termination of Pregnancy Act 1971 was enacted with the objective of providing women access to safe abortions during their pregnancy in certain cases. This Act was passed to stop illegal abortions, which were the reason for high maternal mortality. Since its introduction, many women have had access to affordable and safe abortions. In 2021, the Medical Termination of Pregnancy Act was amended to liberalise India’s stance on abortion and allow abortions up to 24 weeks (as opposed to 20 weeks earlier). The amendment simplifies the process of getting the required permissions in order to terminate a pregnancy. This Act has been a step in the right direction towards women empowerment. However, the courts have to still deal with cases where there is ambiguity in the law. Women have knocked on the court's door for permission to terminate the pregnancy beyond the time limit prescribed by the act. In such cases, the courts have to deliberate and balance the rights of a child and the rights of women.

According to United Nations Population Fund (UNFPA)’s State of the World Population Report 2022, globally 121 million unintended pregnancies occur every year. Out of the total unintended pregnancies, one in seven occur in India. Also, in India, a staggering 67% of the abortions were identified as unsafe for the period 2007-2011. Unsafe abortions are the major cause for maternal morbidity and mortality around the world. The report also found that around 60% of unintended pregnancies end in abortion. Hence, the Medical Termination of Pregnancy Act, 1971, and its subsequent amendment in 2021, which provides for safe abortions are progressive and liberal steps by the Government.

Medical Termination of Pregnancy Act of 1971: In India, voluntarily causing ‘miscarriage’ is a criminal offence under Indian Penal Code, Section 312. But, this Act allows termination of pregnancy by a medical professional (with specialisation) under some circumstances. In other words, the MTP Act is an exception to Section 312.

• It regulates the procedure and conditions under which abortion in India can be carried out under certain circumstances.
• It classifies cases where a pregnancy could be terminated as follows (after the 2021 amendment)
  • Up to 12 weeks of conception of pregnancy on advice of one doctor.
  • Between 12 and 20 weeks of conception of pregnancy on the advice of two doctors.
  • Between 20 and 24 weeks of conception of pregnancy, only in certain cases, on the advice of two doctors.

• This amendment was introduced in the Parent Act due to certain deficiencies in the Act and to address some specific requirements of current times. Following are the reasons for introducing an amendment to the act:
  • Advancement of Medical Sciences: Safe medical abortions are possible up to 24 weeks of the pregnancy. Also, foetal abnormalities could be identified beyond the 20 weeks.
  • Need of Vulnerable sections: To address the vulnerable sections such as sexual violence survivors, women with disabilities, minors, etc.
  • There was a need for increasing access to safe and legal abortion to women in order to reduce the maternal mortality or morbidity that is attributed to unsafe abortions or complications linked to it.

In the above table, doctor means a Registered Medical Practitioner as mentioned in the act

Other Provisions:
Privacy:The details of the women whose pregnancy has been terminated are not to be disclosed by the medical professional to anyone except to the person authorised by the law.

Medical Termination of Pregnancy (Amendment) Rules, 2021: notified by the Central Government in accordance with Section 6 of the Act.

• It defines the powers and duties of the state medical board.
• It mentions the eligibility criteria and experience required for a Registered Medical Practitioner under the act.
• Enumerates the following categories of women who could opt for termination of pregnancy (20 to 24 weeks) under clause (b) of subsection (2) of Section 3 of the Act:
  • Survivors of sexual assault or rape or incest;
  • Minors;
  • Women with physical disabilities (major disabilities as mentioned in the Rights of Persons with Disabilities Act, 2016);
  • Mentally ill women, including those with mental retardation;
  • Foetal malformation that has a substantial risk of being incompatible with life, or if the child is born, it may suffer from such physical or mental abnormalities as to be seriously handicapped; and
  • women with pregnancy in humanitarian settings or disaster or emergency situations as may be declared by the Government.

• Social Acceptance: Abortion has not been widely accepted in societies around the world for various historical and religious reasons. Therefore, a law made by Parliament legitimises safe abortion and increases its social acceptance. It gives back reproductive rights to a woman and provides her a choice.
• Safe abortion: Unsafe abortion has been the leading cause of maternal mortality. This law ensures that abortions are carried out by medical professionals in government hospitals or hospitals approved by the government for this purpose. Therefore, women have increased access to safe and affordable abortions.
• In coherence with medical science: Foetal abnormalities were often found or developed after a 20 weeks period. Because of this, before the amendment, women had to approach the court in cases where substantial foetal abnormalities were found. This Act has increased the upper limit for termination on the advice of the medical board.
• Ensures equality of rights: Before the amendment, only married women could opt for abortion, but now unmarried women also have the same right.
• Benefits vulnerable section: The Act allows certain categories of vulnerable women who are allowed to terminate pregnancies up to 24 weeks. The rules have specified these women, and they include sexual assault survivors, rape victims, etc. Hence, these vulnerable women do not have to approach court in such cases.

• Shortage of medical professionals: Under the act, the opinion of doctors with specified specialisations is sought for abortion. But there is a severe shortage of such medical professionals, i.e., gynaecologists and obstetricians in India, particularly in rural areas.
  • According to the Rural Health Statistics 2020-21, there is a shortfall of 4066 obstetricians and gynaecologists (as against the requirement of 5481). This is a shortfall of 74%.
• No time boundation for the medical board: There is no time limit under which the medical board should decide on a case. Any unwarranted delay in decision making by the board may put women's health at risk.
• Lack of awareness: Women are not aware of their legal rights under the act. This may lead to an increase in unsafe abortions.
• Societal norms: The societal view on abortion has not undergone any significant change, and it is still viewed as an unwanted practice. Also, due to the stigma attached to pregnancies among unmarried women, there is an increased chance of unsafe abortions as families try to keep the case under secrecy.

In June 2022, the US Supreme Court overturned the landmark judgement of Roe v. Wade that protected the right of a woman to have an abortion. In contrast, in India, the regulation of abortions has been liberalised through the Medical Termination of Pregnancy (Amendment) Act, 2021. Thus, women in India can have safe abortions. It gives the woman autonomy and privacy she needs in the event of the termination of her pregnancy. However, some experts have complained that there are still gaps in legislation that are forcing women to approach courts for relief. Hence, there is a need to plug those gaps to unburden courts and provide relief to affected women. Moreover, there has to be a wider debate and discussion on the rights of women and the rights of an unborn child, with the aim of striking a balance between the two.