Medical Termination of Pregnancy (Amendment) Bill, 2020

TH | Prelims + Mains | GS2 > Government policies for development in various sectors and issues arising out of implementation.

Context: Delhi HC has directed AIIMS to constitute a medical board to examine the condition of a 25-week pregnant woman.
According to the plea, the foetus inside the woman at the gestational age of 25 weeks suffered from Bilateral Renal Agenesis (both kidneys absent).

The Medical Termination of Pregnancy Act stipulates a ceiling of 20 weeks for termination of pregnancy.
Beyond the 20 weeks period, abortion of a foetus is statutorily impermissible.

Whether continuing with the pregnancy would involve a risk to the life of the mother or cause grave injury to her physical and mental health.
Whether there would be a substantial risk of the child being handicapped by physical or mental abnormalities.
If any of these medical eventualities is likely to arise, then the mother’s actual or foreseeable environment (mental & physical state) must also be taken into consideration.

The 20-week cap is somewhat arbitrary and has drawn rightful criticism.
Foetal impairments often get detected at the ultrasound done between 18 to 22 weeks, when the foetus is said to have “substantially developed”.

The Act regulates the conditions under which a pregnancy may be aborted.
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 2020 Bill 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 between 20 and 24 weeks.
The Bill sets up state level Medical Boards to decide if a pregnancy may be terminated after 24 weeks in cases of substantial foetal abnormalities.
In a case requiring abortion due to rape, that exceeds 24-weeks, the only recourse is through a Writ Petition.
The Bill require abortion to be performed only by doctors with specialisation in gynaecology/obstetrics.

There is a 75% shortage of qualified doctors.
The shortage may continue to limit the access of women to safe abortion services.
As per the National Health and Family Survey (2015-16), only 53% of abortions are performed by a registered medical doctor and the balance are conducted by a nurse, family member, or self.

Terminating a pregnancy is the choice of the pregnant woman (reproductive rights).
The state has an obligation to protect life, and hence should provide for the protection of the foetus.
Ministry of Health and Family Welfare to SC in 2019: “Women do not have the absolute right to abort”.
Many countries set a limit on what is called viability–the stage after which the foetus can survive independently outside the woman’s body.

Expecting the presence of two gynaecologists in rural areas to ascertain the need for abortion is irrational.
POCSO Act requires any person aware of a minor girl’s pregnancy to report her to the police, regardless of the girl’s consent (invasion of privacy public shaming suicides).
Due to legal complications, doctors refuse to perform abortions on minors unwanted pregnancies.
Waiting for the medical board’s decision could push the pregnancy beyond the 20-week period.
For example, HIV-positive rape victim from Bihar was denied abortion when she was 18 weeks pregnant & was forced to give birth as a result of delay by the Patna HC in 2017.
The boards do not consider the long-term effects of carrying a pregnancy and only allow abortions if there is an immediate risk to the life of the woman women’s right to health not upheld.