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RSTV: LAWS IN THE MAKING- MEDICAL TERMINATION OF PREGNANCY (AMENDMENT) BILL, 2020

Law_Making

Introduction:

The law in India provides a time period of 12 weeks in which pregnancies can be terminated. This period can be extended to 20 weeks in certain cases. This has resulted in women resorting to unsafe abortions, which can lead to complications and sometimes, even death. With advances in medical technology for safe abortions the Bill amends the 1971 abortion to increase the upper limit for terminating pregnancies

The Medical Termination of Pregnancy (Amendment) Bill, 2020 was introduced in Lok Sabha by the Minister of Health and Family Welfare, Dr. Harsh Vardhan on March 2, 2020. The Bill amends the Medical Termination of Pregnancy Act, 1971 which provides for the termination of certain pregnancies by registered medical practitioners. The Bill adds the definition of termination of pregnancy to mean a procedure undertaken to terminate a pregnancy by using medical or surgical methods.

  • Termination of pregnancy: Under the Act, a pregnancy may be terminated within 12 weeks, if a registered medical practitioner is of the opinion that:
    • continuation of the pregnancy may risk the life of the mother, or cause grave injury to her health,
    • there is a substantial risk that the child, if born, would suffer physical or mental abnormalities. For termination of a pregnancy between 12 to 20 weeks, two medical practitioners are required to give their opinion.
  • The Bill amends this provision to state that a pregnancy may be terminated within 20 weeks, with the opinion of a registered medical practitioner. Approval of two registered medical practitioners will be required for termination of pregnancies between 20 to 24 weeks. The termination of pregnancies up to 24 weeks will only apply to specific categories of women, as may be prescribed by the central government. Further, the central government will notify the norms for the medical practitioner whose opinion is required for termination of the pregnancy.
  • Under the Act, if any pregnancy occurs as a result of failure of any device or method used by a married woman or her husband to limit the number of children, such an unwanted pregnancy may constitute a grave injury to the mental health of the pregnant woman. The Bill amends this provision to replace ‘married woman or her husband’ with ‘woman or her partner’.
  • Constitution of a Medical Board: The Bill states that the upper limit of termination of pregnancy will not apply in cases where such termination is necessary due to the diagnosis of substantial foetal abnormalities. These abnormalities will be diagnosed by a Medical Board. Under the Bill, every state government is required to constitute a Medical Board. These Medical Boards will consist of the following members: (i) a gynaecologist, (ii) a paediatrician, (iii) a radiologist or sonologist, and (iv) any other number of members, as may be notified by the state government. Note that, the central government will notify the powers and functions of these Medical Boards.
  • Protection of privacy of a woman: The Bill states that no registered medical practitioner will be allowed to reveal the name and other particulars of a woman whose pregnancy has been terminated, except to a person authorised by any law. Anyone who contravenes this provision, will be punishable with imprisonment of up to one year, or with a fine, or both.

Need for overhaul:

  • The present abortion law, which is about five decades old, permits abortion up to a maximum foetal gestation period of 20 weeks.
  • In recent years, there have been strong demands to raise the foetal gestation period for abortion beyond 20 weeks.
  • If there is a delay in doing this scan, and it reveals a lethal anomaly in the foetus, 20 weeks is limiting.
  • The extension of limit would ease the process for the distressed pregnant women, allowing the mainstream system itself to take care of them, delivering quality medical attention.

Significance:

  • The move to amend the MTP Act, 1971 is a progressive step towards empowerment of women.
  • It will provide greater reproductive rights to women as abortion is considered an important aspect of the reproductive health of women.
  • Deaths and injuries from unsafe abortions are largely preventable provided services are performed legally by trained practitioners.

Abortion laws and facts:

Abortion laws vary across the world. It is learnt that around 60 countries prescribe gestational limits.

  • 52 % including France, the UK, Austria, Ethiopia, Italy, Spain, Iceland, Finland, Sweden, Norway, Switzerland and even Nepal, allow for termination beyond 20 weeks on the diagnosis of foetal abnormalities.
  • Some countries go beyond even these limits with laws in 23 countries-Canada, Germany, Vietnam, Denmark, Ghana, and Zambia-allowing for abortion at any time during the pregnancy on the request of the mother.
  • In UK, abortions are allowed at up to 24 weeks, with abortion guidelines formulated by the Royal College of Obstetricians and Gynaecologists including procedures for termination of pregnancies older than 20 weeks. It also states that, in pregnancy older than 21 weeks and 6 days, an injection to cause foetal death is given before the foetus is evacuated.
  • Despite a sustained government push over years, contraceptive use in India is not very popular.
  • According to a 2018 study by the Guttmacher Institute, 50% of pregnancies in six of the larger Indian states — Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu and Uttar Pradesh — are unintended.
  • Data from the National Family Health Survey 4 show that just 8% of couples in the country use modern contraceptive methods; only 53% use any method at all.
  • It found that 55% pregnancies in Assam, 48% in Bihar, 53% in Gujarat, 50% in Madhya Pradesh, 43% in Tamil Nadu and 49% in Uttar Pradesh are unintended.
  • According to a 2016 study published in The Lancet by the Guttmacher Institute and the World Health Organization, an estimated 56 million abortions took place globally each year between 2010 and 2014.
  • In 2015, a study in The Lancet Global Health, also by Guttmacher Institute and IIPS, estimated that 15.6 million abortions were performed in India in 2015.
  • This translates to an abortion rate of 47 per 1,000 women aged 15-49, which is similar to the abortion rate in neighbouring countries.
  • The number of pregnancies ranged from 1,430,000 in Assam to 10,026,000 in Uttar Pradesh.
  • Estimation of unintended pregnancies is important because many of them result in abortions and the availability of cheap and safe abortion services is one of the indicators of a robust health system.

Conclusion:

  • The Medical Termination of Pregnancy (Amendment) Bill, 2020 is for expanding access of women to safe and legal abortion services on therapeutic, eugenic, humanitarian or social grounds.
  • It is a step towards the safety and well-being of the women and many women will be benefitted from this.
  • Recently several petitions were received by the Courts seeking permission for aborting pregnancies at a gestational age beyond the present permissible limit on grounds of foetal abnormalities or pregnancies due to sexual violence faced by women.
  • The proposed increase in gestational age will ensure dignity, autonomy, confidentiality and justice for women who need to terminate the pregnancy.