The Indian Government has recently taken progressive steps in women’s reproductive health rights by notifying new rules under the Medical Termination of Pregnancy (Amendment) Act, 2021. The amendment, which seeks to modify the previous Medical Termination of Pregnancy (MTP) Act of 1971, introduces several pivotal changes that broaden the scope for women seeking safe, medical terminations of their pregnancies.
Key Changes Introduced in the Rules
One of the most significant differences in the 2021 Act is the extension of the gestational limit for abortion from 20 weeks to 24 weeks. This provision is applicable to seven specific categories of women, namely survivors of sexual assault, rape, or incest; minors; women who have undergone a change in their marital status during an ongoing pregnancy due to widowhood or divorce; women with physical disabilities; mentally ill women; women carrying a fetus with a high risk of severe physical or mental abnormalities; and women pregnant in humanitarian crisis situations or during emergencies.
Establishing State-Level Medical Boards
The 2021 Amendment also mandates the establishment of state-level medical boards. These boards will oversee cases where a pregnancy may need termination after the stipulated 24 weeks due to fetal malformation. The board must decide whether to accept or reject an application for abortion within three days of receipt. If accepted, the procedure must take place within five days of the board receiving the request.
Significance of the New Rules
The newly instituted rules are expected to contribute significantly towards reducing preventable maternal mortality—a key focus of the Sustainable Development Goals (SDGs) 3.1, 3.7, and 5.6. While SDG 3.1 targets reduction in the maternal mortality ratio, SDGs 3.7 and 5.6 strive for universal access to sexual and reproductive health services, making these changes instrumental in meeting these goals. The rules represent an important stride towards ensuring greater access to safe abortion services for women, thereby safeguarding their dignity, autonomy, and confidentiality.
Persistent Challenges and Issues
Despite the significant advances brought about by the new rules, they fall short of addressing an intrinsic limitation of the MTP Act: a woman’s basic right to choose to terminate her pregnancy. The creation of state medical boards may exacerbate existing accessibility issues, especially for women residing in rural areas. Additionally, as the Act permits only doctors specialising in gynaecology or obstetrics to perform abortions, access could be further hindered given the severe shortage of such specialists—up to 75% in rural community health centres. Women, particularly in rural settings, may continue to find accessing safe abortion services challenging. Moreover, societal constraints remain a hindrance as many women still lack reproductive autonomy, facing numerous barriers when seeking to undergo abortions.
