About MTP Act, 1971

• The Medical Termination of Pregnancy Act, 1971 provides for the termination of certain pregnancies by registered Medical Practitioners. It is possible to get an abortion under the Act if pregnancy is under 20 weeks.
• However, it is subject to several conditions and conducting an abortion without fulfilling the conditions is considered a crime.

What are the conditions?

• Under the MTP Act, the doctor can perform an abortion in the following situations:

• If the pregnancy would be harmful to life or physical or mental health of the pregnant woman;
• If there is a good chance that the child would suffer from physical or mental abnormalities which would leave him or her seriously handicapped.

Issues with the law

• Legal and medical experts felt that a revision of the legal limit for abortion is long overdue. 
• Foetal abnormalities show up only by 18 weeks, so just a two-week window after that is too small for the would-be parents to take the difficult call on whether to keep their baby and for the medical practitioner to exhaust all possible options before advising the patient to take the extreme step. 
• Since lack of legal approval does not prevent abortions from being carried out beyond 20 weeks, women are put under risk since the abortions then are often conducted in unhygienic conditions by untrained, unqualified persons. It is estimated that about 8% of maternal deaths happen due to unsafe abortions. 

Medical Termination of Pregnancy (Amendment) Act, 2020 

• In March 2021, the Parliament passed the Medical Termination of Pregnancy (Amendment) Act, 2020 that increases the time period within which an abortion may be carried out.

Highlights of the Act

• The Act allows abortion up to 24 weeks of gestational age for vulnerable categories of women and there is no limit of gestational age in case of pregnancies with substantial foetal abnormalities, diagnosed by a medical board.
• The Act proposes constitution of a Medical Board in every State and UT, which will decide on pregnancies beyond 24 weeks in cases of foetal abnormalities. 
• Each board will have one gynaecologist, one radiologist or sonologist, one paediatrician, and other members prescribed by the State/UT government.
• Currently, abortion requires the opinion of one doctor if it is done within 12 weeks of conception, and two doctors if it is done between 12 and 20 weeks. 
• The amendment Act allows abortion to be done on the advice of one doctor up to 20 weeks, and two doctors in the case of certain categories of women (central government will notify these categories) between 20 and 24 weeks. 
• For a pregnancy to be terminated after 24 weeks in case of substantial foetal abnormalities, the opinion of the State-level medical board is essential.

Criticisms

Huge vacancies

• A recent study by the Centre for Justice, Law and Society at the O.P. Jindal Law Global School has revealed that a panel of doctors to decide on termination of pregnancy beyond 24 weeks is “unfeasible” as 82% of these posts are lying vacant in the country.
• The report analysed district-wise availability of specialists, including surgeons, obstetricians and gynaecologists, physicians and paediatricians. 
• The data is based on the Ministry of Health and Family Welfare’s Rural Health Survey, which provides details of vacancies filled at secondary healthcare centres. Similar data for urban areas was unavailable. 
• The shortfall was starker in the northeast where Sikkim, Mizoram and Manipur had a total absence of obstetricians and gynaecologists, and a near total absence of paediatricians. Arunachal Pradesh and Meghalaya had a 100% shortage of paediatricians.

Infringes privacy

• The study also flags the constitution of the Medical Boards as draconian and invasive as they strip away autonomy from the pregnant person. 
• Even if the Boards are set up, pregnant persons who are in more remote areas of the country will incur many costs in travelling and this will add to their financial burden. 
• This legal reform will make access to abortion more challenging for many people, especially those from marginalised groups.

Inequality in access

• The World Health Organization also urges nations not to create barriers by including complex authorisation processes and noted that negotiating authorization procedures disproportionally burdens poor women, adolescents, those with little education and those subjected to, or at risk of, domestic conflict and violence, creating inequality in access.

Why in News?

• The Government has notified the Medical Termination of Pregnancy (Amendment) Rules, 2021, under which the gestational limit for termination of pregnancy has been increased from 20 to 24 weeks for certain categories of women. 
• These categories include survivors of sexual assault or rape or incest, minors and women whose marital status changes during an ongoing pregnancy.
• As per the new rules, the medical board will allow or deny termination of pregnancy beyond 20-24 weeks of gestation period only after due consideration and ensuring that the procedure would be safe for the woman at that gestation age and whether the foetal malformation has substantial risk of it being incompatible with life or if the child is born it may suffer from such physical or mental abnormalities to be seriously handicapped. 
• The new rules have been framed under the Medical Termination of Pregnancy (Amendment) Act, 2021 passed by Parliament in March this year.

Reference:

1. https://newsonair.gov.in/News?title=Govt-notifies-new-abortion-rules%2c-gestational-limit-for-pregnancy-termination-increases-to-24-weeks&id=427971