Across the world, abortion has been a highly contentious topic of discussion. And even as the tug of war between the pro-life and pro-choice schools of thought continues, medical experts and activists state that India's 1971 law which legalises abortion urgently needs amendment.
Last week, a 22-year-old woman moved the Supreme Court, seeking permission to abort a foetus that was detected with anencephaly, a defect that may lead to parts of the brain and the skull to not develop adequately.
The contention is that the woman found out about the defect in the 21st week of gestation, which is beyond the 20-week limit for abortion set by the Medical Termination of Pregnancy (MTP) Act of 1971.
The SC had, in July last year, allowed for termination of pregnancy in a case where the woman had been raped. The SC has referred the present case to the same panel that had ruled on last year's case.
Prior plans to amend the Act
As per the present MTP Act, abortions are permitted within 20 weeks of pregnancy after two medical practitioners agree that it won't harm the woman. The act also recognises the need for an MTP only in cases of failure of contraception or unplanned pregnancies in married women.
The Health Ministry has, on multiple occasions in the past three years, stated that it is working on amending the law. On 23 December, once again the ministry stated that it plans to amend the MTP Act.
The Centre had released the draft of a revised MTP Act three years ago, which sought to push the deadline to 24 weeks, but there has been no progress on that front.
Why the Act needs to be amended
Dr Nikhil Datar, Medical Director, Cloud Nine Hospitals, had moved the apex court in 2008, seeking permission for a patient to abort her foetus, which had been found to have cardiac abnormalities, post the 20-week deadline.
He, among many other doctors, have said that many anomalies in the brain and heart show up around or post 20 weeks into pregnancy, and that the MTP Act should be amended accordingly.
So why is there a need for an urgent amendment of the Act?
Datar says the Supreme Court, in the last one year, has passed five judgements, allowing abortions post the 20-week period. There is no data to show how many opt for abortions post the 20-week gestation period. However, medical statistics show that 1% of all pregnancies have abnormalities, which gives a glimpse of the magnitude of the problem.
"Even if one were to optimistically assume a situation where out of 10,000 abnormalities, one case arises where the abnormality in the foetus is diagnosed post the 20-week period, the number of women wishing to go for adoption after the foetus is diagnosed with an abnormality would be somewhere around 1000 per year. This, in itself, is a good number," he says.
"To provide another figure, in the last one week, I have received calls from three doctors who talked of cases where they spoke of detection of a serious abnormality in the foetus post the 20-week period and where the woman had opted for abortion."
While the courts have been proactive and supportive of women seeking abortions, not everyone has the time and money to approach the court for remedy.
Datar does abortions free of cost, but there are very few legally-certified doctors who provide service without any charge.
"There is an absolute immediate need to amend the rules, and if not that, the Supreme Court can issue guidelines on the matter, like it has done on many other issues, allowing for abortions on various conditions post the 20-week period," he says.
Dr Lalita Mayade, a gynaecologist, voiced a similar opinion as Datar. She argued that an amendment could help liberalise the present MTP Act, with an increase in the number of unplanned pregnancies.
No scientific grounds for 20-week deadline
The other issue is the hasty decisions women and their families take due to the fear of the 20-week deadline period.
When the pressure of the deadline is removed from the women's mind, they make a more informed decision on whether to abort or not
Datar explains that there is no scientific or ethical basis for the 20-week deadline, and that it is purely arbitrary. "The fear of the deadline causes patients to inadvertently opt for aborting otherwise normal pregnancies, due to insufficient information," he states.
The 'myth' that follows is that post the 20-week period, abortion can cause risk to the mother's life, which is completely unfounded. China and the UK, for example, allow for abortions up till 24 weeks into the pregnancy.
Edited by Shreyas Sharma
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