This article is written by Shraileen Kaur, a student of ICFAI University, Dehradun. In this article, the author discusses in detail the historical background, objectives, scope, significance, and application of the Medical Termination of Pregnancy Act.

This article has been published by Sneha Mahawar.

Introduction

The right to reproduce is a right granted to women across numerous nations. This right holds great significance in society as it provides protection to women to bear and produce children without any compulsion, restraint, or prejudice. When a woman is compelled to have an abortion without her approval, her progenitive rights (Rights vested in the individuals to bear their offsprings) are breached. 

In layman’s terms, the word ‘abortion’ refers to a pregnancy that has been intentionally terminated. Women have experimented with many birth prevention methods throughout civilization, and they have also employed abortion to get rid of undesired children. 

Every time the woman carrying the child declares her desire to abort the child, a contentious debate about who will determine the destiny of the child in the womb—the pregnant woman, the family on the husband’s side, the family on the wife’s side, the government, or society at large—emerges on the screen. Even though we have already embraced an era of socially conscious civilizations, it is difficult to understand whether a woman still has to obtain consent in order to exercise her right to an abortion. We encounter the pro-choice versus pro-life dispute whenever the topic of abortion is brought up. 

The pro-life stance prohibits euthanasia, abortion, and other forms of human killing. However, pro-choice movement supporters contend that because every individual has unalienable rights to his or her body, the question of whether to have a child or not is entirely up to the individual in question. The pro-choice movement fights for the fundamental rights of women, including the ability to seek medically assisted methods of abortion or to facilitate their pregnancies. 

Forcefully exercising one’s right to abortion differs relatively less from opting for an abortion with one’s free will or following consensus-ad-idem with the spouse and his family. When a woman has an abortion against her husband’s wishes, she experiences physiological and psychological strain that might occasionally ruin her marriage as well.

Medical termination as a Fundamental Right

‘Abortion or termination of pregnancy’, as defined by Oxford Dictionaries, is “the deliberate termination of a human pregnancy, most often performed during the first 28 weeks.”

The two primary categories of abortion are:

Spontaneous abortion 

This type of abortion, which is often referred to as a miscarriage, takes place during pregnancy as a result of any complications. 

Induced abortion 

There are two categories of induced abortion: 

1. Therapeutic abortion- As implied by the name, this type of abortion is performed when the mother’s life is being protected or when the foetus has a serious medical condition such as hydrocephalus, which is a condition where the brain of the foetus is not fully developed. 
2. Elective abortion- Abortion that is performed for any purpose other than medical reasons is referred to as elective abortion.

Earlier, either voluntarily or involuntarily aborting a child was prohibited. Abortion was also not legalized until the Roe v. Wade (1973) ruling. Under this judgement, termination of pregnancy was also recognized as one of the fundamental rights and a component of the Right to Privacy. The Court ruled that a woman’s right to terminate a pregnancy during the first trimester cannot be restricted by the State. It was also stated that a woman’s biological and emotional health are both important, and the government can control such abortions during the second trimester. The freedom to have an abortion is seen as a fundamental human right.

On June 24, 2022, the Supreme Court of the United States of America overturned the earlier decision in the case of Dobbs v. Jackson Women’s Health Organisation (2022). However, the Apex Court also faced huge backlash for its decision by numerous organisations, renowned personalities like Michelle Obama, as well as ordinary citizens who are pleading that it is an infringement of the fundamental right to their bodies.

According to Article 21 of the Constitution of India, 

“No person shall be deprived of his life or personal liberty except according to procedure established by law, nor shall any person be denied equality before the law or the equal protection of the laws within the territory of India.”

Numerous distinguished jurists, as well as scholars, have interpreted Article 21 of the Indian Constitution. As per the scholars and jurists, the ambit of Article 21 is wide enough to include termination of pregnancy in it. The same was upheld in the case of K S Puttaswamy v. Union of India (2018).

K S Puttaswamy v. Union of India (2018)

In this case, the Supreme Court specifically acknowledged the fundamental right of women under Article 21 of the Constitution of India to make choices regarding the production of children. Hence, termination of pregnancy also comes under the ambit of ‘personal liberty’ mentioned under Article 21 of the Constitution of India. Likewise, the Medical Termination Act of 1971 also recognizes abortion as a qualified right. 

Suchita Shrivastava v. Chandigarh Administration (2009)

In this case, the Supreme Court observed that every woman holds certain rights related to reproduction, which include the right of women to give birth, raise children, as well as carry a pregnancy to its full term or terminate it. All these rights form a basic component of the privacy, integrity, and dignity of a woman, which are enshrined under the Indian Constitution. 

In case the fundamental right of aborting a child is violated, a woman is entitled to approach the judiciary for relief. Interpreting the law, the Apex Court stated that a pregnancy cannot be terminated in the third trimester or from the 24th week as it includes the threat to the life of the mother along with the child. However, in exceptional cases, through the decree of the court, the aggrieved party can opt for abortion. Such a decree shall be based not merely on the discretion of the judges but on the medical reports of the mother and recommendations by the medical board on the question of allowing abortion. The Court also stated that women have the right to their own bodies and that right can be transferred neither to the families nor to the government.

Not just in India, but even on the international platform, medical termination of pregnancy is regarded as a significant human right. Even the United Nations International Conference on Population and Development has embraced the rights of reproduction. In accordance with the international standards, the rights regarding reproduction include the following: 

1. Access to contraceptive methods
2. The right to a sterile and legitimate abortion
3. The freedom to choose one’s reproductive options without fear of brutality, coercion, or unequal treatment
4. The freedom from harmful practices like forced childbirth
5. The equal opportunity to the people from the LGBTQIA+ community to the same sexual and procreative care services as heterosexual people.

Medical Termination of Pregnancy Act, 1971

Before 1971 in India, abortion was considered illegitimate. Indian statutes lacked provisions related to the termination of pregnancy. However, certain provisions were made in the Indian Penal Code, 1860, related to abortion. 

Section 312 to Section 318 of the Indian Penal Code, 1860, dealt with “Offences related to newborn or unborn children.”

Legally, termination of pregnancy was criminalised under Section 312 of the Indian Penal Code, 1860. Hence, Section 312 stated that- 

“Whoever voluntarily tries to cause the miscarriage to a woman except in the good faith or where the woman’s life in danger shall be liable for imprisonment which may extend to three years and shall also be liable to fine.” 

Earlier, in India, if an individual tried to terminate a pregnancy, the person was punished with imprisonment along with a fine. For centuries, women died because of unhygienic and illegal methods used for terminating pregnancy.

Many nations, including Spain, Greece, and Great Britain, have liberalized abortion legislation over the past three decades. Nowadays, there are relatively few nations that still have tight and restrictive abortion regulations. When it first went into operation, the Medical Termination of Pregnancy Act of 1971 was thought to be pioneering.

Historical background of the Medical Termination of Pregnancy Act, 1971

In Indian society, abortion was seen as a stigma, and the ethics of women were challenged whenever they opted for any such method. Abortion was justified only in a few cases, such as- 

1. Physical or mental ailment on the part of the mother carrying the child.
2. In case of any sexual assault or rape. 
3. In case of a stillborn child or any functional disorder on the part of the child. 

Regarding the abortion laws in India, the Shantilal Shah Committee was established by the Central Family Planning Board of India in 1964. To increase its efficacy and to lower the incidences of botched abortions and maternal deaths that were linked to illegal and unsafe abortions, the report advocated liberalizing the rules governing abortion. Its purpose was to investigate and examine the moral, social, legal, and medical justifications for abortion. On 4th December 1966, the Shantilal committee sent a report with thorough observations of the then prevailing circumstances. A Medical Termination Bill was proposed in the Lok Sabha and Rajya Sabha in 1969 based on the committee’s recommendations, and the parliament approved it in 1971.

At the beginning of 1972, the Medical Termination of Pregnancy Act went into effect. In 1975, more changes were made to the statute that made it simpler and more useful. This law was put into effect with the intention of making it easier to have legalized abortions under specific circumstances. It allows for pregnancy termination by a qualified, recognized medical professional. It is fairly clear from the preface what exactly the act includes. Only a licensed healthcare professional has the right to end a pregnancy under specified conditions, according to the Medical Termination of Pregnancy Act, 1971.

Objectives of the Medical Termination of Pregnancy Act, 1971

The objective of the Medical Termination of Pregnancy Act, 1971 is enshrined under its Preamble. The Preamble of the Act states – 

“An Act to provide for the termination of certain pregnancies by registered medical practitioners and for matters connected therewith or incidental thereto”

According to the Medical Termination of Pregnancy Act of 1971, only specific pregnancies will be permitted to be ended by licensed medical professionals. The primary objectives of the Act are also to reduce the death rate of women from unsafe and illegal abortions and to optimize the maternal health of Indian women. Only after this legislation were women entitled to have safe abortions, but only under specific circumstances. 

Conditions for termination of pregnancy under the Medical Termination of Pregnancy Act

Section 3 of the Medical Termination of Pregnancy Act, 1971, states the conditions under which pregnancy can be terminated. 

According to Section 3 of the Medical Termination of Pregnancy Act, 1971

“When pregnancies may be terminated by the registered medical practitioners.”

1. A licensed health professional who terminates a pregnancy in accordance with the law should not be held in violation of any crime listed in the Indian Penal Code, 1860, or any other legislation at the time of the medical procedure.
2. Where the gestational period has not lasted longer than 12 weeks. 
3. Where the length and duration of the pregnancy has exceeded 12 weeks but not 20 weeks. The same should be decided on a case-to-case basis by the authentic assessments of the two doctors.
4. When there is a probability that the unborn child will have poor physiological and mental health and may also be disabled.
5. It is crucial to keep in mind that any girl under the age of 18 who is insane or of unsound mind cannot have her pregnancy terminated without her guardian’s or parent’s written authorization.
6. A woman’s bodily or mental health will be in great danger if the pregnancy is allowed to continue.

Hence, these are some of the conditions where medical termination of pregnancy is allowed. However, not all women have the privilege to opt for the termination of pregnancy as a matter of right. 

In the United States of America, women have the freedom to opt for medical termination of their pregnancy as a matter of right of reproduction, which is included under the fundamental right – The Right to Privacy. Until recently changed, this used to be the case in the United States of America. 

The scenario is not the same in India. In India, all women are not allowed to medically terminate their pregnancies. As per the Medical Termination of Pregnancy Act of 1971, only married women and rape victims are allowed to terminate their pregnancies. Unmarried women, widows, as well as divorced women, are deprived of their right to terminate their pregnancies. So, these women have two options – either to continue their pregnancy or to opt for illegal methods of termination of pregnancy. Even married women do not have a fully qualified right to abort as they are supposed to prove the failure of contraceptives to avail themselves of the facility of medically terminating the pregnancy. This violates the fundamental right to privacy. 

There are several other conditions under which the child can be aborted medically. These conditions are: 

1. As stated under Section 3(2)(b) of the Medical Termination of Pregnancy Act, 1971, termination of pregnancy is allowed till the 20th week and not more than that. 
2. As per Section 3(2)(b)(ii) of the Medical Termination of Pregnancy Act, 1971, there is a significant chance that the foetus, if it were to be delivered, would be severely handicapped due to physiological or mental defects. In this case, the pregnancy can be medically terminated. 

However, there are several tests that are performed in the 20th week of pregnancy to detect the abnormality of the foetus, and such abnormality is confirmed only after the completion of 20 weeks of the gestation period. This raised several questions about the applicability of the above-mentioned sections of the Medical Termination of Pregnancy Act, 1971. 

Other significant provisions of the Medical Termination of Pregnancy Act, 1971 include:

• Section 2(d) is another important provision of this Act. This provision provides the definition of a “Registered Medical Practitioner.” As per Section 2(d) – 

“A Registered Medical Practitioner means any medical practitioner who possesses the required medical qualifications which are defined under Section 2 of the Indian Medical Council Act of 1956 and whose name has been registered in the state medical register and who possesses the required medical skills in gynaecology and obstetrics which are prescribed under the said act.”

1. The destination of the pregnancy termination is specified under Section 4 of the Act. It implies that all public hospitals that are properly furnished with the required resources are allowed to offer abortion services.
2. Section 5(1) of the Medical Termination of Pregnancy Act, 1971 establishes two key conditions pertaining to abortion, which assert that if the concerned doctor acts in good faith as well as due diligence and determines that it is absolutely essential to carry out the termination of pregnancy, it would not be compulsory by law to accept the medical opinions of two registered medical practitioners. Additionally, it states that if it is discovered that the termination was conducted by a non-registered healthcare professional, it would constitute a criminal offence.

Shortcomings of the Medical Termination of Pregnancy Act, 1971

1. The Act does not provide a qualified right to terminate a pregnancy beyond 20 weeks. It also included numerous legal obstacles. Hence, there was a need to introduce a legal provision that increases the gestation termination period from 20 weeks to 24 weeks.
2. The Medical Termination of Pregnancy Act, 1971 failed in one of its basic objectives of providing safety to pregnant women and empowering them by providing a qualified right to terminate their pregnancy as per their free will. 
3. The Medical Termination of Pregnancy Act has been criticised for failing to keep up with contemporary technologies. It has to be amended because it was introduced in 1971 and technology at the time was not highly evolved. Hence, the introduction of new provisions was the need of the hour. 
4. As per the provisions of the act, the written consent of the guardian is required in case the girl is a minor or below 18 years of age, and above 18 years in case the woman is insane or lunatic. 
5. The Medical Termination of Pregnancy Act of 1971 was also accused of enhancing the complexity of already complex legal procedures. More convenient as well as simplified provisions are needed. 

Due to these shortcomings in the Medical Termination of Pregnancy Act 1971, an Amendment Act was introduced to remove the lacunae of the earlier Act. The Amendment Act was known as the Medical Termination of Pregnancy (Amendment) Act, 2002.

Medical Termination of Pregnancy Amendment Act, 2002

The majority of the women employed in the private health sector were the focus of this statute. The following provisions and purposes were taken into account by the Amendment Act: 

1. A committee that operated primarily at the district level was responsible for deciding whether to allow private establishments to provide abortion services;
2. The nature and magnitude, including the time and location of performing the pregnancy termination services, had to strictly comply with the provisions of the Act; otherwise, harsher penalties had been created for the same. 
3. To deal with the psychological illnesses that did not amount to mental disabilities, the term ‘lunatic’ was amended to ‘mentally ill person.’

The Medical Termination of Pregnancy Amendment Act of 2002 brought about changes, but there was still a need to upgrade the conditions of the private hospitals that provided abortion services. In order to regularise the operation of private hospitals, The Medical Termination of Pregnancy Rules, 2003 was promulgated.

Medical Termination of Pregnancy Rules, 2003

These rules laid down numerous provisions protecting the maternal health of the women and decreasing the numbers of mortality rates of both mother and the infant. Some of these provisions are as follows: 

1. Formation of a committee at the district level for better implementation of policies and decision-making that includes at least one woman, gynaecologists or surgeons, and local health professionals, along with some members of NGOs. 
2. The Rules of Medical Termination, 2003 also include the amenities, equipment, ancillary medically well-managed technology, and related services that are necessary to carry out the purpose and procedure of termination of pregnancy.
3. The rules further specify that the Chief Medical Officer (CMO) has an obligation to visit and inspect the site where abortions are practiced in order to check on its sanitation and medically safe conditions, as well as those of the surrounding areas.
4. The Rules of Medical Termination, 2003 also state that the Chief Medical Officer may produce a report on the matter and present it to the committee responsible for approving the committee’s composition and licencing of the practice if, under certain conditions, he identifies that the location where the practice of terminating pregnancies is performed is not up to standard. 

As a result, the committee, in satisfaction with the prevailing circumstances, has the option of suspending or even nullifying the owner’s permission to perform abortions. But to uphold the rule of law, the property’s owner is given a chance to speak and be heard by the committee before the issuance of the cancellation certificate.

Despite such stringent laws, the condition of both the foetus and the pregnant woman remained the same. Practices of illegal abortion were still prevailing. Incidents of throwing infant children in the dustbins and maternal deaths were increasing day by day, leading to the need for new laws. Hence, new laws were introduced in the form of the Medical Termination of Pregnancy (Amendment) Act, 2021.

Medical Termination of Pregnancy (Amendment) Act, 2021

With increasing technology and innovation in the healthcare sector, the need for better laws arose, which was fulfilled by the Medical Termination of Pregnancy (Amendment) Act, 2021. From the issue of the right to privacy to the issue of illegal gender assessment leading to female foeticide, all such issues were addressed by the Medical Termination of Pregnancy (Amendment) Act, 2021.

Historical background of the Medical Termination of Pregnancy (Amendment) Act, 2021

Dr. Harshvardhan Goyal of the Ministry of Health and Family Welfare tabled the Medical Termination of Pregnancy Bill 2020 inside the House of People on March 2, 2020, after consulting with numerous experts, medical professionals, consultants, and other ministries. The Medical Termination of Pregnancy Act of 1971, which deals with legal and authorized abortion, was being amended by this Bill. Additionally, the proposed Bill aimed to change some of the Act’s rules and regulations, making it more efficient.

The Bill also aimed to increase the legal window for an abortion between 20 to 24 weeks, enabling the practice of safely and securely terminating the undesired pregnancy for a woman. Additionally, it aims to improve pregnant women’s privacy, gestational age, and safety precautions.

The proposed legislation also aims to apply modern medical and health care practices that, regrettably, did not exist in the Act of 1971. For the termination of foetuses that were more than 20 weeks gestation, numerous public interest litigations were filed. so that all women, even those who have been sexually assaulted, raped, or have physical or mental disabilities, can end their pregnancies through medical means.

Significant attributes of the Medical Termination of Pregnancy (Amendment) Act, 2021

The Medical Termination of Pregnancy (Amendment) Act, 2021 aims to include rape and assault cases, incest survivors, married women, girls younger than 18 years, women with special needs, and women with foetal malformations of the foetus among those eligible for abortion. The Medical Termination of Pregnancy (Amendment) Act 2021 seeks to expand the scope of the Medical Termination of Pregnancy Act, 1971. The Act has several notable features, which are discussed further below.

1. It aims to amend the Medical Termination of Pregnancy Act of 1971. This Act will play a prominent role in meeting the Sustainable Development Goals that will contribute to eradicating the preventable maternal mortality rate. 

The Sustainable Development Goals concerned with the Medical Termination of Pregnancy (Amendment) Act, 2021 include a reduction in maternal mortality rate (SDG Target 3.1) as well as universal access to sexual and reproductive health and rights (SDG Target 3.7).

2. The Act states that in cases of terminating a pregnancy with a gestation period of 20 weeks, only one registered medical practitioner is required rather than two. The inclusion of the advice of two medical professionals was earlier stated in Section 3(2)(b) of the Medical Termination of Pregnancy Act of 1971.

3. It adds a new provision requiring the consultation of two or even more enrolled medical practitioners if a pregnancy is terminated between the ages of 20 and 24 weeks.

4. The Act aims to broaden the applicability of the Medical Termination of Pregnancy Act of 1971 by including a special classification of women such as specially-abled women, rape victims, girls younger than 18 years, and survivors of incest.

5. This Act also expects to enhance the highest gestation period for pregnancy termination from 20 weeks to 24 weeks, because many women can take full advantage of it and effectively terminate their pregnancies that risk their own lives.

6. The Act seeks to protect the confidentiality and privacy of women who wish to terminate their pregnancies. This is a novel idea that will safeguard women’s identities and uphold their right to privacy.

7. No medical professional will reveal the name of any woman who wishes to terminate the life of her child in the womb in accordance with any law in effect at the time of the introduction of the Act.

8. Situations, where a woman could medically terminate her pregnancy, include fear of grave danger to her overall health, foetal malformations, becoming pregnant due to failure on the part of any contraceptive method or device, and becoming pregnant from the rape. All such conditions can end up causing severe mental pain and grief in the mind of the conceiving female.

Fundamental flaws in the Medical Termination of Pregnancy (Amendment) Act, 2021

Like the earlier Acts introduced regarding termination of pregnancy had some lacunas, this Act also has certain shortcomings which hinder the applicability and potential of the overall act. Some of the fundamental flaws in the Act are as follows: 

Selective qualified right for abortion 

This Act would raise the gestation period needed for abortion from 20 to 24 weeks. Women who do have foetal irregularities discovered after the 20th week of pregnancy can now discontinue their pregnancy with legal and medical backing. Along with this rise in the upper gestational limit, combined with advances in medical technology, a woman can have a safe and efficient abortion.

However, this gestational limit is only for rape victims, incest victims, as well as women with severe physical and psychological conditions such as depression, physical disability, or lunatic. As a result, the Act even now lacks many significant provisions. Women who do not fall into one of the above-mentioned special categories will need special permission and will face legal ramifications if they want to have an abortion.

Lack of complete autonomy for women regarding the choice of abortion

Abortion is a woman’s inalienable right. A woman cannot be forced to have an abortion. Under the Medical Termination of Pregnancy Act of 1971, the reasons for having an abortion do not need to be proven; therefore, a woman must plead before a doctor for an abortion. It is difficult for a woman to end her suffering solely on the basis of her own free will. The Medical Termination of Pregnancy (Amendment) Act, 2021 does not provide a woman’s complete autonomy for making a choice of termination of her pregnancy by legally and medically ending her suffering. As a result, a woman is mentally and physically stressed in order to obtain the doctor’s approval to get an abortion.

Narrow scope by the exclusion of unmarried women

Section 3(2) of the Medical Termination of Pregnancy Act of 1971 states that a woman may seek an abortion if any form of contraception device used either by a married man or a married woman fails. However, this part of the provision discriminates against unmarried women. This provision was previously included in the new amendment.

However, the Act, through an amendment later, allowed for the termination of pregnancy of pregnant women who are unmarried and are in relationships.  The phrases ‘married woman and her husband’ have been amended to ‘woman and her partner.’

Such modifications can decrease the plethora of health problems that were previously faced by single pregnant women. Such women also face a lot of shame, guilt, and a sense of inferiority, which becomes a part of their daily life, leading to the majority of such women committing suicide.

Protecting the fundamental right to privacy of a pregnant woman

The legislature has pronounced to make extra effort through the amended act to protect the privacy of a female who undergoes an abortion. According to the new Act, only those authorised by law are permitted to know the current status of such a pregnant woman. This includes the doctors who are going to help the woman in exercising her right to terminate the pregnancy. If a medical professional violates this principle, he may face imprisonment for up to a maximum of one year, a fine, or both.

Formation of a medical board 

The new Act establishes the Health Board, whose mission is to particularly deal with cases where significant abnormalities in the foetus are discovered. According to the Medical Council, such pregnant women may terminate their pregnancy after twenty-four weeks if the risk of the baby being born with a mental or physical impairment stays high.

As a result, the Medical Termination of Pregnancy (Amendment) Act, 2021 is compatible with new advanced medical technology. However, many provisions are still missing. 

Other laws and initiatives pertaining to the termination of pregnancy in India

In India, there seem to be a variety of other abortion laws. In India, abortion is legal under certain conditions. According to a national estimate of abortions in India, every year, approximately 15.6 million abortions occur in India. Whereas many illegal, underreported, and unsafe abortions occur in India on a daily basis, resulting in the deaths of pregnant women. Apart from the Medical Termination of Pregnancy Acts of 1971 and 2021, the government and the Ministry of Family and Health Welfare have introduced several other initiatives and laws to promote safer abortion.

Comprehensive Abortion Care-Service Delivery and Training Guidelines of 2010

These guidelines contain all the clear and comprehensive data about abortion. It is also associated with legal problems and their solutions. In India, both state governments and union territories use these guidelines to provide thorough abortion care to women.

Comprehensive abortion care training package 

The Ministry of Health and Family Welfare created a formalized training program and arrangement that offers abortion providers, instructors, and operational guidelines. It was created in 2014 after consulting with all medical experts for the purpose of training physicians in all states as well as union territories.

State-level maternal and foetal health care programme 

As part of its National Health Mission, all states as well as union territories have been expected to formulate plans, strategies, and policies for the management of healthcare policies in public health facilities. The Ministry of Health and Family Welfare reviews them, and the budget is allocated accordingly.

Preconception and Prenatal Diagnostic Technique Act, 1994

To ensure safe abortion procedures and put an end to gender bias and biased determination of sex, the government passed the Medical Termination of Pregnancy Act, 1971 as well as the Preconception and Prenatal Diagnostic Technique Act in 1994, making foetal sex determination illegal.

Health Management Information System

It is a Ministry of Family and Health Welfare effort under the National Rural Health Mission that gives customers details about health care services provided in the public sector. 

National Mass Media Campaign

The Ministry of Health and Family Welfare initiated this in 2014 to make pregnancies safer. It was among the first media campaigns of its kind. It aimed to normalize abortions and promote safer abortion practices.

Suggestions

It is crucial in today’s world to establish social security regulations that do not worsen the problem for the mother who is carrying the child but instead help her exercise her procreative rights smoothly and without coercion or undue influence. This is because the matter of termination of pregnancy involves medical, cultural, and moral challenges. In order to eliminate the societal, biological, and moral stigmas associated with the termination of pregnancy, a line must be formed between the interests of three crucial institutions, namely the mother carrying the foetus, the government, and social institutions. 

Some of the problems pertaining to termination of pregnancy can be tackled by considering the following suggestions: –

1. Since the process of imparting sex education in India is highly questionable, academic institutions must make an effort to enlighten children about the risks associated with treatments like fertilization, surrogacy, and termination of pregnancy, among other things, so that they may handle such circumstances in the future with the greatest possible care and caution.
2. The Indian Central Government and the corresponding state governments ought to work together to raise the standard of services provided for medical abortions. The state-of-the-art technology concerning medical termination of pregnancy is the need of the hour. Medically diligent and adequate procedures, as well as facilities, must be used to safeguard pregnant women’s lives. 
3. Non-governmental organisations ought to volunteer to lead and organise counseling sessions on contraceptive measures.
4. It is essential to establish an urgent medical care helpline number where cases requiring rapid attention concerning abortion services can be handled without wasting time.
5. In times of emergency, initiatives must be taken to assist women who desire to abort their children using online platforms. Literacy and awareness workshops must be periodically arranged.

Conclusion

According to Faye Wattleton, a renowned American nurse-

“Reproductive freedom is critical to a whole range of issues. If we cannot take charge of this most personal aspect of our lives, we cannot take care of anything. It should not be seen as a privilege or as a benefit, but a fundamental human right.”

The Medical Termination of the Pregnancy Act, 2021 is a glimmer of hope for women who wish to get safe abortions and for those who want to lawfully end their unplanned pregnancies. However, India still needs to do much more to curtail and eventually end the practice of illegal abortions. The government must make sure that all professional standards and regulations are followed nationwide in hospitals and other healthcare facilities in order to allow the termination of pregnancies. 

Along with that, the issue of pregnancy termination needs to be settled in accordance with human rights, proper scientific principles, and technological improvements. The methods and procedures adopted to carry out the directives provided in the Medical Termination of the Pregnancy Act, 2021, determine its success or failure. These recommendations could benefit women who desire to have abortions only if they are carried out with the necessary diligence and care.

On the other hand, with the prevailing Amendment Act, more women will have direct exposure to safer pregnancy termination services, and those who need to end a pregnancy will be treated with respect, liberty, privacy, and fairness. While it is worthy of praise that the Central Government has taken such a courageous stance while maintaining a balance with the cultural diversity, belief systems, and conceptual frameworks that our nation upholds, the amendment still leaves women with several conditions, many of which become barriers to accessing a safe pregnancy termination.

Yet, one can be confident that the nation is making progress because the issue of termination of pregnancy, along with other women-related issues, is being addressed more emphatically than before.

Frequently Asked Questions 

1. Is termination of pregnancy criminalised in India? 

According to the Indian Penal Code, 1860, intentionally ending a pregnancy is a crime. The Medical Termination of Pregnancy Act of 1971 permitted doctors with a particular area of expertise to terminate a pregnancy under defined conditions. A doctor can give his or her consent to end a pregnancy at any point up to 12 weeks, and two medical professionals can agree to terminate it up to 20 weeks. It was only legal to abort a pregnancy if continuing the pregnancy would put the woman’s life at risk, cause serious injury to her psychological or physiological health, or result in defects in the foetus. Additionally, if it is essential to terminate the pregnancy at any point in order to save the woman’s life, such an act has legal backing.

For certain specified categories of women, the new Amendment Act has increased the maximum time for medical termination of pregnancy from 20 weeks to 24 weeks. Additionally, it creates medical boards at the state level and lifts the restriction in cases of serious foetal abnormality. The Statement of Objects and Reasons for the Act states that numerous cases have been filed in the Supreme Court and various High Courts asking for permission to terminate a pregnancy at later stages than the Act’s 20-week limit due to genetic anomalies or pregnancies in cases of sexual assault or rape. Additionally, it states that as scientific clinical technology develops, the maximum limit for medical termination of pregnancy may be increased, especially for vulnerable women and in cases of severe pregnancy complications.

2. Is the Medical Termination of the Pregnancy Act of 2021 inclusive of transgenders?

The Medical Termination of Pregnancy Act, 2021 permits pregnant women to end their pregnancies in only certain circumstances. Notably, the Transgender Persons (Protections and Rights) Act, 2019, in India, acknowledges transgender as a distinct gender. According to several medical studies, transgender individuals who are not exclusively women who transform from being female to being male may become pregnant after undergoing gender reassignment, justifying the use of pregnancy termination services. Because only female pregnancies are covered by the Medical Termination of the Pregnancy Act 2021, it is uncertain if transgender individuals will be safeguarded.

3. According to the recent Amendment Act, after the specified 24-week limit, can a pregnancy be terminated? 

According to the law, termination of pregnancy post the specified limit of 24 weeks is not allowed. However, in certain circumstances, a pregnant woman is free to approach the court to get permission for the termination of her pregnancy. These pleas must be justified on strong grounds of life risk or foetal abnormalities. Recently, the apex court granted a pregnancy termination approval after the limit of 24 weeks on the grounds of serious malformations in the foetus. However, there are multiple instances where such permission was disapproved by the court. 

References

• Medical Termination of Pregnancy Act, 1971 along with the Amendment Bill, 2020 : a critical analysis – iPleaders
• Medical Termination of Pregnancy Act: A Boon or a Bane for a Woman in India -A Critical Analysis
• https://www.ijlsi.com/wp-content/uploads/Changing-Face-of-Abortion-Laws-in-India-A-Critical-Investigation-with-Special-Reference-to-the-Medical-Termination-of-Pregnancy-Amendment-Act-2021.pdf
• MTP ACT, 1971 | Ministry of Health and Family Welfare | GOI

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