The Supreme Court’s refusal on Tuesday to allow a woman to abort her 26-week-old unborn baby with Down Syndrome is a setback after its progressive women-centric January ruling. In this, it relaxed the 20-week ceiling on legal abortion to allow a woman to abort her 24-week baby with anencephaly, a life-threatening congenital defect where a baby is born without parts of the brain, skull and scalp. Children with Down Syndrome, which is associated with characteristically flat facial appearances, have lifelong mild to moderate disabilities because of impaired brain and physical growth and are predisposed to health problems like congenital heart defects, sleep apnea, and Alzheimer’s disease, among others.
India’s Medical Termination of Pregnancy (MTP) Act legalises abortions up to 20 weeks if there is threat to the mother’s life or her physical or mental health, or if the unborn baby has abnormalities, but many women end up using unsafe abortions methods because they don’t know where or who to go to because there are not enough legal providers. Keeping in mind the limitations of the abortion law, the Union health ministry has proposed amendments to relax the cut-off period for legal abortions to 24 weeks and increase the number of skilled providers. The new amendments set no upper limit for abortions if the baby has “substantial foetal abnormalities,” which are yet to be defined in the rules that will be drafted after the bill is approved by Parliament. The proposed changes are with the Cabinet for approval before being tabled in Parliament. Whether Down Syndrome makes the cut as a “substantial foetal abnormality” is not known, but the right to abort is as much a rights issue as a medical one. Unwanted children get no state support, and neither do children with disabilities, who have to be cared for all their lives by their parents, usually the mother.
Women must have control over the decision-making related to her life and body and India must guard against a rights issue being hijacked by the moral police. Women desperate to end unwanted pregnancies find ways to do it, often at great risk to their health. Awareness that abortion is legal in India is abysmally low, ranging between a low 36% in Bihar and Jharkhand to a dismal 12% among Jharkhand youth in the age group of 15-24 years, which is another reason why women reach services late or not at all. Unsafe abortions kill 10 women in India each day, with an estimated 6.8 million women each year choosing unsafe methods to end unwanted pregnancies. Unsafe abortion is responsible for 8% of all maternal deaths in India, which makes it the third biggest cause of women dying of childbirth-related causes in the country. Strong laws and medical services that give women the right over their bodies can prevent hundreds of thousands of these deaths.