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 key changes in the Medical Termination of Pregnancy (Amendment) Act,2021 has brought in are:
- The gestation limit for abortions has been raised from the earlier ceiling of 20 weeks to 24 weeks, but only for special categories of pregnant women such as rape or incest survivors. But this termination would need the approval of two registered doctors.
- All pregnancies up to 20 weeks require one doctor’s approval. The earlier law, the MTP Act 1971, required one doctor’s approval for pregnancies up to 12 weeks and two doctors for pregnancies between 12 and 20 weeks. The approval of two doctors is now needed only for the 20-24 timeline reserved for abortion seekers of special categories.
- Women can now terminate unwanted pregnancies caused by contraceptive failure, regardless of their marital status. Earlier the law specified that only a “married woman and her husband” could do this.
- There is also no upper gestation limit for abortion in case of fetal disability if so decided by a medical board of specialist doctors, which state governments and union territories’ administrations would set up.
Many advocates are of the opinion that though the changes brought are of great importance but few things that are still lacking are that women do not have complete control over their reproductive choice and still gives doctors the final say. Another issue that has to be pointed out is that it is unfair that some abortions require approval of two doctors when given the situation of pandemic and shortage of doctors that seems pretty unfair.
Abortion remains stigmatised in India, even within the medical fraternity, as IndiaSpend reported in September 2020. There have been several reports of women being denied abortions on “moral” grounds by doctors or being asked to bring partners or parents along for the procedure. This is especially the case when the abortion is sought on grounds not related to a woman’s physical health, as specified in the MTP Act, but because it can cause “injury to her mental health” (also covered by the Act), these reports showed.
Some statistics on abortion:
Did you know? More than half or 56% abortions in India are unsafe and 10 Indian women die daily due to unsafe abortion, as per a 2015 report by Ministry of Health and Family Welfare that cites data from research done between 2001 and 2004.
Abortion is said to be safe if it is done with a method recommended by the World Health Organization that is appropriate to the duration of the pregnancy and the training received by the person providing or supporting the abortion. The WHO classifies abortions as safe, less safe, and least safe. The latter two being unsafe.
Only 20% of abortions take place in public sector facilities and 52% in private, as per the National Family Health Survey, 2015-’16. Further, NFHS 2015-16 showed that “only 53% of abortions were performed by registered medical doctors”.
Also, Restrictive abortion laws are associated with higher levels of maternal mortality: The average maternal mortality ratio is three times higher in countries with more restrictive abortion laws (223 maternal deaths per 1,00,000 live births) compared to countries with less restrictive laws (77 maternal deaths per 1,00,000 live births), according to the WHO.
Global examples show that easier access to abortion encourages women to seek pregnancy termination in the earlier weeks of gestation, resulting in better-managed abortions. Sweden, for example, has one of the most liberal abortion laws – it makes MTP available on request up to 18 weeks.
Downfalls yet that are yet to overcome:
Anubha Rastogi, a Mumbai based lawyer explained that if a pregnant woman does go to a certified provider and say that she is willing to opt for abortion and if the doctor says no that is it. She also goes ahead to point out Section 312 of the Indian Penal Code which labels “causing miscarriage” as an offence has not been scrapped yet. The MTP Act is seen as an exception to IPC; that is, abortion is available only under the conditions specified in it.
“There is a lot of grey area or overlap between MTP and other laws,” said advocate Rastogi. She cited the Protection of Children from Sexual Offences Act and the Drugs and Cosmetics Act, 1940. POCSO mandates that if a minor conceives, even though consensual sex (even though POCSO does not recognize consent of a person below 18 years), and wants to abort, the matter has to be reported to the police. The amended MTP law, though, largely guarantees privacy to the parties involved in abortion.
Similarly, medical abortion pills are classified as Schedule H drugs for which a pharmacist must maintain a record of sales under the Drugs and Cosmetics Act. This violates the confidentiality promised by MTP Act 2021, abortion advocates say.
 Akshita Nagpal, India’s amended abortion law still gives doctors, not women, the final say in terminating pregnancy, Scroll.in (Apr 29, 2021 · 01:30 pm), https://scroll.in/article/993527/indias-amended-abortion-law-still-gives-doctors-not-women-the-final-say-in-terminating-pregnancy
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