Does the MTP Amendment Bill 2020 really advance Women’s Rights?

The recently approved Medical Termination of Pregnancy (MTP) Amendment Bill 2020 by the cabinet has generated quite some buzz.    Rightly so, since this is only the second time the MTP Act is being amended in its 49 years of existence.  Many news reports and editorials have hailed the amendments as much required, progressive, advancing women’s rights and enabling women access the benefits of medical advancements. The amendments come in the backdrop of the Centre’s response to a PIL filed in 2019 in the Supreme Court seeking amendment in abortion laws, which said “A pregnant woman’s right to abort her pregnancy is not an absolute right, and the right to abortion must be balanced against the compelling state interest of protecting the mother’s health and the life of the fetus/unborn child.” A stand which cannot in any way be considered as advancing women’s rights.

Initial reports suggested that the gestational limit for abortion has been increased from 20 to 24 weeks, for all women, which was welcomed by many. However the fine print says that the increase in gestational limit is only for “special categories of women” (vulnerable women including survivors of rape, victims of incest and other vulnerable women - like differently-abled women, minors etc.).  The move to remove upper gestation limit in cases of substantial foetal abnormalities is indeed welcome, but it comes with a rider. Medical Boards (whose composition, functions and other details to be prescribed subsequently in Rules under the Act.) will decide if women can have an abortion on this ground. It moves the decision making from the woman and her doctor to a ‘medical board’ consisting of multiple members, thereby legitimising third party authorisation which was never the intention of the original MTP Act. Subjecting women to multiple medical checkup and assessment by an unfamiliar board in no way advances their  rights and surely does not seem to keep her interest at the center.  

The MTP Act guarantees women confidentiality, an aspect valued greatly by women who seek abortion care.  Under the Act, the name and other particulars of the women terminating a pregnancy can be shared only if ordered by the courts. The cabinet approved amendments include a clause “Name and other particulars of a woman whose pregnancy has been terminated shall not be revealed except to a person authorized in any law for the time being in force.” This could be problematic for many women especially vulnerable women.  Over the years we have seen barriers to abortion care increase due to conflation of the MTP Act with PCPNDT Act and POCSO Act. The proposed amendment could enable officials implementing PCPNDT Act, POCSO Act and even the Drugs and Cosmetics Act (which governs medical abortion drugs) to seek information on women seeking abortion from doctors and chemists, compromising client confidentiality and putting women at serious risks.

For any legislation or policy to be hailed as landmark or progressive, it should benefit a vast majority of the target audience the legislation/policy is meant to serve or it should be expanding the boundaries on the issue it seeks to address. The proposed amendments fail this test miserably.  For the overwhelming majority of the estimated 15.6 million women (over 99%) who seek to terminate their pregnancy every year, the amendment does not change anything.  Even for the small number of women who will benefit, the amendments do not go far enough. Many countries, both developed and under-developed, including some in the sub-continent already have a much liberal abortion law. Seventeen countries including Vietnam, South Africa, Bangladesh and Sweden allow nurses and non- physicians (as recommended by WHO) to provide first trimester abortion using medical methods or manual vacuum aspiration (over 90% of abortions in India are estimated to be first trimester abortion).

There are countries where gestational limits are higher (Austria, Sweden, Korea) or where there is no gestational limit prescribed (Canada, Vietnam, Norway, Switzerland, China), where abortion is a women’s right (Canada, Vietnam) In India it still continues to be a conditional right. The proposal requiring only opinion of one provider up to 20 weeks gestation is indeed useful for women who seek termination in the second trimester (currently opinion of two providers is required).

To summarise, the proposed amendments addresses, to some extent, only the tip of the iceberg.  For the vast majority of women who need to terminate a pregnancy, the amendments will not make any difference. It is unlikely to make any dent in the maternal mortality and morbidity due to unsafe abortions. Even when compared to the draft MTP Amendment Bill 2014, developed after wide ranging consultation with a number of experts and stakeholders, the proposed amendments seem inadequate. In its current form, the MTP Amendment Bill 2020 cannot by any stretch of imagination be termed as progressive, women-centered or advancing women’s rights and agency.  The full draft of the bill is yet to be circulated widely and hopefully there are no more surprises in store.  

The intention of the government seems to be right, but the execution seems to fall short. Hopefully some of the issues can be addressed when the Rules under the Act are framed. Given the advances in medical technology, current discourse on women’s rights and available evidence, it is an opportune time to make the MTP Act truly women-centric.  Women’s health and rights in general, and abortion in particular, are increasingly under threat globally. A great opportunity exists for India to take a leadership role in setting the global agenda. This would require the government to review what is proposed and overhaul the amendments, so that a contemporary MTP Act, which serves the needs of women and advances their rights, is tabled in the parliament. If this opportunity is not grabbed, we will be failing 50% of our population. Should Indian women wait for another two decades to exercise full control over their bodies?