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There were expectations that the 2021 amendments to the MTP Act would make it contemporary & progressive. But it's still a far cry from being truly inclusive.
Merely legalising abortion does not guarantee accessibility or necessarily translates into access. A lot of work remains to be done still.
In its 50 years of existence, the Medical Termination of Pregnancy Act has been amended only twice, once in 2002 and in 2021. In the meantime, there has been remarkable progress in medical technology.
This includes, availability of safe and simple technologies for abortion like manual vacuum aspiration and medical drugs. There are diagnostics that help identify severe foetal anomalies closer to and after 20 weeks gestation.
Apart from advances in medical technology, understanding and appreciation of women’s need to have complete control over their bodies has increased. As evidenced by several progressive judgements in India and international convention commitments (such as Puttaswamy judgment of the Supreme Court, Anil Kumar Malhotra v Ajay Pasricha, Suchita Srivastava v Chandigarh Admin) and international platforms like Convention on Elimination of All forms of Discrimination against Women, International Conference on Population and Development.
There was great expectations that the amendments to the MTP Act would truly make it contemporary and progressive, establishing India’s leadership in setting the global agenda on a sensitive subject. While what has been amended is a step ahead from the 1971’s Act, it still is a far cry from being truly inclusive and this is just the tip of the iceberg. Larger issue of access to safe abortion care and women’s rights remains largely untouched.
Unavailability of Medical Abortion (MA) pills legally is a disservice to pregnant persons. Sadly, overregulation has caused such problems. The belief that reducing access to MA drugs will help arrest the declining child sex ratio is a contributor.
MA drugs are indicated for use up to nine weeks gestation. Sex determination through ultra sonography is not possible during this period. Ultra sound can determine the sex of the foetus only at 13-14 weeks (early second trimester). However, more than 85 % of abortions in India, occur in the first trimester.
Then MTP Act has somehow become entangled in the fight against gender-biased sex selection. As a result, chemists claim they face additional scrutiny if they stock MA drugs. They are informally told not to sell MA drugs, keep copies of prescriptions and in some cases, keep track of the identity of the purchaser- a clear violation of the MTP Act which assures confidentiality.
There is an urgent need to clear the prevailing misunderstanding among drug regulators and health officials about MA drugs and sex selection. Abortion pills should be treated just like any other schedule H drug and are not singled out for additional scrutiny.
Merely legalising abortion does not guarantee accessibility or access. The true measure of success of the amendments is implementation & how it is able to bridge gaps. A lot of work remains to be done in terms of access, rights-based approach, telemedicine and task sharing.
It’s important to discuss judiciary’s responsibility in furthering access to safe abortion.
The analysis of 194 writ petitions filed by women seeking to have their pregnancy medically terminated, identified several issues. The length of the gestation period and the opinion of the medical boards were common in cases of rejection. Neither factor considers their medical reports or the impact on the woman.
Meanwhile, the past year and half has been nothing short of a hellish experience for abortion seekers in the country! With facilities becoming dedicated COVID facilities, providers have been unavailable to provide services. The situation for an abortion seeker was no less than a nightmare. Though abortion is notified as an ‘essential service’ the gap between providers and abortion seekers is much wider now than ever!
We have attempted to bridge the gap by populating a database of approved MTP providers so that pregnant persons can connect to a verified provider.
There is an urgent need to look into the rules and regulations of the MTP Act from a fresh perspective.
Image source: Unsplash
Debanjana is a vocal SRHR advocate working on gender rights and climate justice for the past 17 years. She has been awarded the Women in Corporate Allies Award 2020 by Women’s Web for her read more...
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