Abortion Right: The New Medical Termination of Pregnancy Bill vs Old MTP Act

Changes in the new MTP Bill: The amendments will increase the ambit and access of women to safe abortion services.

“The Rajya Sabha has approved the Medical Termination of Pregnancy (Amendment) Bill, 2021 to amend the Medical Termination of Pregnancy Act, 1971 on 16th March 2021. The Bill was approved in Lok Sabha on 17th March 2020.

It is for expanding access of women to safe and legal abortion services on therapeutic, eugenic, humanitarian or social grounds.

It is a step towards safety and well-being of the women and many women will be benefitted by 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 amendments will increase the ambit and access of women to safe abortion services and will ensure dignity, autonomy, confidentiality and justice for women who need to terminate pregnancy.”

The Bill is yet to be made an ACT with the necessary processes.

Legality

Medical termination of Pregnancy is LEGAL since 1971. It still holds true.

The objective of MTP act was and is still:

• To legalise abortions
• To offer safe abortion services to the woman intending TOP.
• To prevent unsafe abortion and thus prevent maternal disease and death
• To protect the registered medical practitioner who intends to help the woman out with the desired TOP.

There are strict laid down criteria by the govt. of India about doctors who are eligible to do medical abortions and where such an abortion can be legally allowed to be carried out, whether medically (with pills) or surgically.

Right

Availing medical termination of pregnancy within a specified age of pregnancy is the absolute right of the woman. Also, no pregnancy shall be terminated except with the consent of the pregnant woman.

Legal permissions according to MTP act 1971

The old MTP act would permit termination only up to 5 months i.e. 20 weeks under these circumstances:

• When continuation of pregnancy is a risk to the life of a pregnant woman or could cause grave injury to her physical or mental health;
• When there is substantial risk that the child, if born or dead would be seriously handicapped due to physical or mental abnormalities;
• When pregnancy is caused due to rape (presumed to cause grave injury to the mental health of the woman);
• When pregnancy is caused due to failure of contraceptives used by a married woman or her husband (presumed to constitute grave injury to mental health of the woman).

The welcoming changes in the new MTP act:

1. The age of pregnancy that can be legally terminated has been extended from 20 weeks to 24 weeks in certain special categories of women. It yet, does not specify the category but will include survivors of rape, victims of incest and other vulnerable women like differently-abled women and minors. This is because often these women would either not understand their bodily changes or would refrain from disclosing her concerns to her guardians owing to fear, shame and guilt.

This decision of MTP between 20-24 weeks however needs consent from 2 registered medical practitioners.

2. There is no upper limit to the gestation/ pregnancy age for termination if the unborn baby is found to have a substantial abnormality according to a medical board.

Abnormalities in the baby can be detected at various stages of pregnancy. Most gross abnormalities can be detected by 4 months. Some small “markers” of genetic abnormalities can be detected around 4 and ½ months which needs further testing like genetic testing. Often by the time the results of such testing come, the pregnancy age would be beyond 20 weeks.

Also there would be some defects especially cardiac or facial defects which might be evident in the USG beyond 20 weeks or even later.

This change in the new MTP Bill will allow the parents to terminate the pregnancy at any age once the abnormality is detected if they want to rather forcing the couple to give birth and seeing the child die at full term with pain.

3. The word ‘Married’ woman has legally been abolished from the bill and replaced by ‘woman” and her partner.

Again a very welcome change keeping in mind the rights of the woman then and now.

4. There is a special mention of maintaining and respecting confidentiality of the woman, intending to undergo an abortion within legal boundaries. Her name and other particulars will not be revealed to anyone except the person authorised “in any law for the time being in force.”

Which means if a woman above 18 years does not want to let her parents or guardians or even her partner to know that she wants a termination of pregnancy, she has the legal right to do so.

However, involvement of a parent or a legal guardian is a must for any abortion in a woman less than 18 years of age.

Dr Sudeshna Ray is a senior Gynecologist and Obstetrician attached to Jaslok and H N Reliance hospitals, Mumbai. The views expressed are the author's own.