India's amended law makes abortion safer and more accessible

In a historic move to provide universal access reproductive health services, India amended the Medical Termination of Pregnancy (MTP) Act 1971 to further empower women by providing comprehensive abortion care to all.

The new Medical Termination of Pregnancy (Amendment) Act 2021 expands the access to safe and legal abortion services on therapeutic, eugenic, humanitarian and social grounds to ensure universal access to comprehensive care. The new law, which came into force from 25 March 2021, will contribute towards ending preventable maternal mortality to help meet the Sustainable Development Goals (SDGs) 3.1, 3.7 and 5.6.

“This is a win for the collective wish of women in India. The amendments have increased the ambit and access of women to safe and legal abortion services,” said Dr Sumita Ghosh, additional commissioner, Comprehensive Abortion Care, Child Health and Adolescent Health, Ministry of Health and Family Welfare (MoHFW), Government of India.

The changes consider the advances in medical technology, simplify requirement of providers, increase upper gestation limit for termination of pregnancy under specific conditions, and remove the gestation limit for cases that could burden the health system. The goal is to strengthen access to comprehensive abortion care without compromising dignity, autonomy, confidentiality, and justice for women who need safe and quality services.

“Coming 50 years after the passage of the historic MTP Act of 1971, the MTP Amendment Bill 2020 is an evolutionary landmark addressing some of the challenges posed by the 15.6 million abortions we manage each year in India. As the next step, we need to work towards advocating a more rightsbased approach by giving women greater autonomy and choice and to operationalise grassroots access with an expansion of provider base,” said Dr Nozer Sheriar, member, Technical Advisory Group, WHO-South East Asia Region, and Past Secretary-General and MTP Chair, Federation of Obstetric and Gynaecological Societies of India.

• Increasing the upper gestation limit from 20 to 24 weeks for special categories of women, including survivors of rape, victims of incest and other vulnerable women (differently abled women, minors, among others).
• The opinion of one provider needed for the termination of pregnancy up to 20 weeks of gestation. Requirement of the opinion of two providers for the termination of pregnancy from 20-24 weeks of gestation.
• Upper gestation limit to not apply in cases of substantial foetal abnormalities diagnosed by a Medical Board.
• Confidentiality clause. The name and other particulars of a woman whose pregnancy has been terminated cannot be revealed except to a person authorised by law.
• Extended MTP services under the failure of contraceptive clause to unmarried women to provide access to safe abortion based on a woman’s choice, irrespective of marital status.