[Answered] Critically examine salient features of Medical Termination of Pregnancy (Amendment) Bill, 2020.

The Medical Termination of Pregnancy (Amendment) Bill, 2020 seeks to amend the Medical Termination of Pregnancy Act, 1971. The bill aims to reduce not only unsafe abortions but also ensure that vulnerable women get every right to decide about her pregnancy.

Salient features of Medical Termination of Pregnancy (Amendment) Bill, 2020:

1. Increased gestation limit: The bill has enhanced the upper gestation limit from 20 to 24 weeks for special categories of women. It would include vulnerable women including survivors of rape, victims of incest and other vulnerable women (like differently-abled women, minors) etc.
2. Opinion of professional: Bill has proposed a requirement of the opinion of one doctor for termination of pregnancy, up to 20 weeks of gestation and introducing the requirement of opinion of two doctors for termination of pregnancy for 20-24 weeks of gestation.
3. Medical board: Upper gestation limit will not apply in cases of substantial foetal abnormalities diagnosed by the Medical Board. The composition, functions and other details of the Medical Board to be prescribed subsequently in Rules under the Act.
4. Identity protection: Name and other particulars of a woman whose pregnancy has been terminated shall not be revealed except to a person authorised in any law for the time being in force.

Importance of Medical Termination of Pregnancy (Amendment) Bill, 2020:

1. Reproductive rights: The Supreme Court has recognised women’s right to make reproductive choices and their decision to abort as a dimension of their personal liberty (in Mrs. X v. Union of India, 2017) and as falling within the realm of the fundamental right to privacy (in K.S. Puttaswamy v. Union of India, 2017).The bill will strengthen reproductive rights of women.
2. Sexual abuse: In case of rape, the woman is weak or underage. Such girls don’t even know they are pregnant and fall prey of unsafe abortion practices. It is important to allow abortion of pregnancies due to sexual violence faced by women as they have every right to choose what they want. Medical Termination of Pregnancy (Amendment) Bill, 2020 aims to expand access of women to safe and legal abortion services on therapeutic, humanitarian or social grounds.
3. Access to safe abortion: According to a study published in the Lancet Global Health, 15.6 million abortions occurred in India in 2015 of which 78% of these were outside health facilities. Mortality of pregnant women is about 8% due to unsafe abortions. The bill will help women getting access to safe abortion.
4. Need of change: The existing MTP Act, 1971, has not kept pace with the changing times, needs and advancements in medical science. More women are now approaching the Courts to seek approval for abortion over 20 weeks, a provision that has been made available in a number of countries around the world.
5. Judicial burden: The proposed amendments will definitely reduce the burden on the judiciary, especially given the plethora of cases seeking permission for abortion beyond the prescribed duration of 20 weeks.

Issues in the Medical Termination of Pregnancy (Amendment) Bill, 2020:

1. Lack of autonomy: At all stages of the pregnancy, the healthcare providers, rather than the women seeking abortion, have the final say on whether the abortion can be carried out. This is unlike the abortion laws in 67 countries, including Iceland, France, Canada, where a woman can get an abortion ‘on request’ with or without a specific gestational limit. Thus there is a lack of autonomy in making the decision to terminate their pregnancy.
2. Burden on women: To get a pregnancy terminated solely based on her will, the woman may be compelled to lie or plead with the doctor. Pregnant women have to bear additional mental stress, as well as the financial burden of getting a doctor’s approval.
3. Limited option: Due to advancements in science, foetal abnormalities can even be detected even after 24 weeks. This means that even if a substantial foetal abnormality is detected and the mother doesn’t want to bear life-long responsibilities and the mental agony associated with it, the law gives her no recourse. Bill doesn’t allow abortion on request at any point after the pregnancy. 
4. Access to doctor: The 24-week modification will help a niche group of women who discover foetal abnormalities. Such women have access to doctors. But there are concerns about those who have no access to doctors. Millions of rural women have do not have access to a safe and transparent route to abortion and doctor recommendation. Thus they would suffer as the bill makes the doctor recommendation final without exception.
5. Lack of information: The major reason for unwanted pregnancies is inadequate information about the contraception available. Rural Indian women are far behind when it comes to awareness of methods like IUDs and injectable. Thus, after pregnancy, an unsafe abortion is often the way out for them. Availability of improved contraceptives and easy access to friendly and competent staff is a big gap which needs to be filled.

India is changing rapidly and people’s needs and their lives are no longer similar to what was in the 70s when this Act was passed. It is must to ensure that all norms and standardised protocols in clinical practice facilitate safe abortions across the country. This is imperative if we need to ensure that every one who needs it, can legally access safe abortions.