Why India needs a new MTP Act?
The Union health ministry has drafted a fresh Medical Termination of Pregnancy (MTP) (Amendment) Bill, 2019 which is under inter-ministerial consultation. As the government has taken too long to bring the proposed amendments into force, the aged and outdated MTP Act 1971, ignoring the pace of changing times and medical advancements, continues to be a hindrance in reproductive rights of women in modern India, women health rights activities claim. The Bill is yet to be introduced in either houses of parliament.
What is MTP Act 1971?
The Medical Termination of Pregnancy (MTP) Act 1971 — a law that was considered ahead of its times — legalized abortion in India up to 20 weeks of pregnancy, based on certain conditions and when provided by a registered medical practitioner at a registered medical facility. Conditions under the MTP Act under which a pregnancy may be terminated are continuation of the pregnancy would involve a risk to the life of the pregnant woman or cause grave injury to her physical or mental health. Also, substantial risk that the child, if born, would be seriously handicapped due to physical or mental abnormalities; pregnancy is caused by rape (presumed to constitute grave injury to mental health) and pregnancy is due to failure of contraceptive in a married woman or her husband (presumed to constitute grave injury to mental health).
Why is it important to amend the MTP Act 1971?
According to a study published in the Lancet Global Health, 15.6 million abortions occurred in India in 2015 of which 78% of these were outside health facilities. Abortion was legalised 50 years ago, yet 10 women die every year as a result of unsafe abortions – making unsafe abortions the third-leading cause of maternal deaths in the country. Other barriers to safe abortion include the implementation of the Protection of Children from Sexual Offenses Act, 2012 (POCSO Act), and the Pre-Conception Pre-Natal Diagnostic Techniques Act, 1994 (PCPNDT) as result of which doctors hesitate to provide abortion services to women and young girls. In recent past there have been many PILs filed in courts seeking abortions.
“The existing MTP Act, 1971, has not kept pace with the changing times, needs and advancements in medical science. More women are now approaching the Courts to seek approval for abortion over 20 weeks, a provision that has been made available in a number of countries around the world. Majority of these pleas are due to foetal anomalies that are detected late and/or cases of sexual assault and rape, particularly of minors, where doctors are not willing to provide abortions, irrespective of gestational stage,” said Poonam Muttreja, Executive Director of the Population Foundation of India.
“This has led to delaying access to safe abortion care, subjecting women and girls to repeated examination by medical boards and at times denial of services. A decision to terminate a pregnancy, as provided by existing laws, is the right of the women and asking them to seek approval from a medical board stigmatises and further traumatises them. This is not only a violation of their rights but uncalled for given the advancement in technology,” said Muttreja.
MTP Act was passed by the Parliament in 1972. It protected women’s right to life through its provisions. Women health rights experts claim that it is now constrained by changing context. Women activists claim that within the current MTP Act itself there are several limitations such as abortion is the not the right of woman in India and can only be provided at the discretion of a medical practitioner. Currently, only trained MBBS doctors (of whom there is a dearth) can provide abortion services. The law states that abortions can only be provided up to 20 weeks. However, in recent years there have been many cases of women seeking abortions beyond 20 weeks due to foetal abnormalities that in many cases can only be detected after 20 weeks as well as in cases of rape.
There is ambiguity around the provisions in the MTP Act for unmarried women to terminate pregnancy due to contraceptive failure since considerable stigma is attached to having a non-marital pregnancy or birth. For second trimester abortions, the consent of two medical practitioners is required. This is particularly challenging in rural areas where many a times a second practitioner is not available.
“The amendments are overdue. This is long past right time. India is changing rapidly and people’s needs and their lives are no longer similar to what was in 70s when this Act was passed. MTP Act should therefore, be amended immediately to allow AYUSH doctors and Nurses to provide it. This is imperative if we need to ensure that every one who needs it, even in most remote and hard to reach area can legally access safe abortions,” said Kalpana Apte, Secretary General (CEO), Family Planning Association of India.
“The second urgency is about frequent legal intervention that is common these days. There is need for expanding the gestational age from 20 to beyond that. This is a health issue, not a legal issue. These individual cases should never need to go the court and MTP Act should be amended to provide guidance to doctors for every situation. It is past beyond right time,” she said.
How aged MTP Act 1971 curtails women’s reproductive rights?
According to MTP, women are allowed to terminate an unwanted pregnancy without providing any reason within 12 weeks and for pregnancy exceeding 20 weeks, women have to get certificate or recommendation from two certified doctors/medical practitioners.
“MTP Act ensures women’s right over her body, but it is also restricting the basic fundamental right to life. The Act protects women from a life-threatening situation if the pregnancy goes wrong. The MTP Act gives limited right to women for making the decision for herself to abort the fetus at a certain point of the pregnancy to protect their own health and life,” said Ranjana Kumari, Director, Centre for Social Research.
“It is a fundamental principle for women’s equality to be able to make decisions for own body, it also the first step towards gender equality that women must get total control over their rights, which is currently being denied. The Government cannot take away the ineliminable right of a citizen to protect and have control over their own body and make independent decisions,” said Kumari.
Kumari argued that in today’s world when medical advancement is taking place, Medical Safe Termination of Pregnancy should also be included in the agenda of the government. By questioning the MTP Act women are going take their right of Medical Safe Termination of Pregnancy whenever they need during the pregnancy term for betterment of physical as well as mental health.
“Interference of the state is not acceptable. A lot of Indian women are getting medical termination of pregnancy done where doctors are not really asking for the certificates before they conduct the procedure. So, it is important that the government must protect Indian women by removing these barriers and provide better quality treatment for MTP,” said Kumari.
“If a woman doesn’t want a child, according to her will, she should have the sole right over the decision to terminate the pregnancy. The mandatory recommendation of doctors should be removed completely. The right to terminate a pregnancy should only be of the woman, who goes through all this mentally, physically and emotionally,” she said.