Widening access to safe abortions

The Cabinet’s nod for long-pending proposed amendments to the Medical Termination of Pregnancy Act, 1971, is a progressive and necessary step. The most significant proposal in the Bill, which is to be introduced in Parliament this Budget session, is to allow abortions to be done up to 24 weeks of gestation—four more weeks than at present—for vulnerable women. This includes survivors of sexual assault and women with disabilities. The Bill also proposes that the upper limit will not apply in cases of substantial foetal abnormalities diagnosed by a medical board. Further, the Bill says that only one medical practitioner’s nod is required for an abortion up to 20 weeks. Two medical practitioners need to sign off on an abortion between 20-24 weeks. 

These are important proposals and would go a long way towards widening access to safe abortions in India. Too many, including children who have been sexually assaulted, have been forced to move the courts to terminate a pregnancy and have sometimes been left with no choice but to carry the pregnancy to term. The Bill acknowledges the developments in medical technology that allow for safe termination even at a later stage. However, as always, the devil will be in the details. 

Despite abortion being legal in India, a paper published in the British Medical Journal Global Health in May 2019 found, in its secondary analysis of government data in nine high-burden states where the average abortion rate is 4.8%, that a whopping 67% were unsafe. The study found that place of residence, religion, caste, age, education and socioeconomic status all affected the odds of a woman having an unsafe abortion, which is the fourth leading cause of maternal death globally. For the progressive changes proposed by the Bill to reach all women in India, it is imperative that the government study the barriers to widen access. Similarly the government must also study the POCSO act and examine whether its mandatory reporting provision and effective criminalisation of consensual underage sex are also depriving vulnerable girls of access to medical, including safe abortion, services.