Medical termination of Pregnancy – What needs to be changed?

An amendment to Medical termination of pregnancy act is pending in Parliament. Several cases have come to the Supreme court asking it grant permission to abort over 20 week old foetus. Parliament needs to take up the long-pending bill on updating provisions for abortion so that decision regarding health of expectant mother and foetus is taken up by medical boards rather than Supreme Court.

The context

• The supreme court has rejected the plea of a 10 year old rape victim to abort her 32 week old foetus after a medical panel informed the Court that an abortion will endanger both the girl foetus.
• Court’s order regarding abortion of over 20 week old foetus have been on a case to case basis. It relies on the report of Medical experts for making decisions regarding granting permission for abortion.

What does the law says? – Medical termination of Pregnancy Act

• The Medical termination of Pregnancy acts mandates that abortion is not permitted beyond 20 weeks of pregnancy.

• An exception to the law is made if a registered medical practitioner certifies to a court that the continued pregnancy is life-threatening for the mother or the baby.
• Medical practitioners are expected to evaluate whether continuing with the pregnancy would involve a risk to the life of the mother or the foetus.

The issues

1. Women are forced to undertake the cumbersome process of approaching different courts, for permission to medically terminate their pregnancies which are over 20 weeks.
2. As of now, women who have crossed the 20-week limit need a judicial order to even get medically examined on their plea for abortion.
3. The cases which have come to the Supreme Court range from child rape victims to destitute women to women with substantial foetus abnormalities.
4. The 20-week cap for abortion is somewhat arbitrary as foetal impairments often get detected at the ultrasound done between 18 to 22 weeks, when the foetus is said to have “substantially developed”.
5. WHO has noted that restricting legal restrictions on abortion do not result in fewer abortions nor in significant increases in birth rates.
6. Restricting legal access to abortion does not decrease the need for abortion, but it is likely to increase the number of women seeking illegal and unsafe abortions.
7. Legal restrictions on abortion may lead women to seek services in other countries/states.
8. Majority of expectant mothers in India seek advice from Midwives and Accredited Social Health Activists (ASHA) and ultrasounds are only done when something unusual is suspected.
9. Though the government launched Pradhan Mantri Surakshit Matritva Abhiyan under which doctors at private and government facilities are required to provide free antenatal care on the ninth of every month free ultrasound scanning are not offered mostly

The draft Medical Termination of Pregnancy (Amendment) Bill of 2014

• An amended Bill of the 1971 law which extends the bar from 20 to 24 weeks has been in Pending in the parliament for the past three years.

• The Bill provides that the length of pregnancy shall not apply in a decision to abort a foetus diagnosed abnormalities.
• It allows a woman to take an independent decision in consultation with a registered health-care provider.
• Under the draft bill a“registered health care provider”, which includes recognised practitioners of Ayurveda, Unani and homoeopathy could also perform abortions.

The way forward

• A permanent medical board be set up at State-level to examine the cases till the Bill is pending for amendment of the MTP act can lessen the burden on Supreme court.
• Laws and policies that facilitate access to safe abortion  it will result in a shift from previously clandestine, unsafe procedures to legal and safe ones.
• Laws and policies on abortion should protect women’s health and their human rights.
• Regulatory, policy and programmatic barriers that hinder access to and timely provision of safe abortion care should be removed.
• Given the advancements in medical science, a lot of abnormalities can be determined by an ultrasound midway through a pregnancy.
• The long-pending amendment to the  Medical termination of Pregnancy Bill  needs to get passed.

Remarks

Laying down objective standards to be followed by health-care providers is the way ahead as relying on court-ordered termination of pregnancies, is not the desired route for the delivery of justice in abortion cases.

UPSC Corner

Prelims : Indian Polity and Governance – Constitution, Political System, Panchayati Raj, Public Policy, Rights Issues, etc.

Mains   :   GS 2 mechanisms, laws, institutions and Bodies constituted for the protection and betterment of these vulnerable sections.

Prelims Perspective

Model question

With regard to medical termination of Pregnancy Act 1971 which of the following statements is/are correct?1\

1. The act mandates that abortion is not permitted beyond 24 weeks of pregnancy.
2. The Amendment Bill to the act provides that the length of pregnancy shall not apply in a decision to abort a foetus diagnosed abnormalities.

Select the correct answer using the codes given below

1. 1 only
2. 2 only
3. both 1 and 2
4. Neither 1 nor 2

Mains Perspective

Model questions

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. Comment

Sources: The Hindu The Hindu The Hindu The Hindu The Hindu