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:
o If the pregnancy would be harmful to life or physical or mental health of the
o 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
● 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
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.
● 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
● 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
● The Government has recently 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
● The new rules have been framed under the Medical Termination of Pregnancy
(Amendment) Act, 2021 passed by Parliament in March this year.
Why in News?
● The new abortion rules notified by the Government recently recognise minors as a
vulnerable category and seek to make services more accessible to them. But social
stigma and conflict with POCSO Act, 2012, or the law against child sexual abuse, pose
● Minors were included as a special category because it was found that a large number of
them were approaching courts for permission to terminate pregnancies beyond 20
weeks. They were the third largest category after those with foetal abnormalities and
● The detection of pregnancies in case of minors gets delayed, and then after that the need
to negotiate and seek relevant care becomes all the more difficult.
● According to the National Family Health Survey (NFHS)-4 (2015-2016), women aged
between 20 to 24 years who were married before age 18 were at 27% and nearly 8%
women between the age of 15-19 years were already mothers or pregnant. Though
nationwide data under NFHS-5 (2019-2020) is yet to be released, data for 22 States
released in the first round shows underage marriage decreased in 17 States and
increased in three States, teenage pregnancies reduced in 16 States and increased in six
out of 22 States.
● Further, contraception services rarely reach adolescents. According to a study by the
Guttmacher Institute in March 2021, many adolescent women in India — 34 lakh —
want to avoid pregnancy. This includes 32 lakh married women and 1.95 lakh sexually
active unmarried women. Among women wanting to avoid a pregnancy, the proportion
who have an unmet need for modern methods is much higher for adolescents
(71%) than for all women of reproductive age (27%).
● Medical practitioners also note the obstacles posed by the Protection of Children from
Child Sexual Offences (POCSO) Act, 2012, in providing services. Section 19 of the Act
requires any person aware of a minor engaging in sex to report the matter to the local
police even if it was a consensual act as the law pegs the age of consent at 18 years.
● Globally, according to the Center for Reproductive Rights, India is behind 32 countries
that allow abortion on request with varying gestational limits. But it is ahead of 24
countries that prohibit abortion altogether, 42 countries that allow abortion only if a
woman’s life is at risk and 20 countries where it is permitted only on health grounds.