All You Need To Know About Getting An Abortion In India

If you are looking for details about getting an abortion in India, this article will tell you how to go about it safely and legally.

If you are looking for details about getting an abortion in India, this article will tell you how to go about it safely and legally.

As joyful as it may be, bringing new life in to this world is also a huge long term commitment. So an unexpected pregnancy can, sometimes, be a frightening situation.

There may be numerous reasons why you may want to terminate the pregnancy. It is an unhappy situation, but to come through with your health, dignity and life intact, here are a few things you must know. In India, abortions are governed by the Medical Termination Of Pregnancy (MTP) act.

Where can you get an abortion in India?

For a safe and legal abortion you have to have it done by a registered medical practitioner (RMP). Most OBGYNs are authorized to perform abortions but other doctors too can obtain the requisite certification. An MTP may only be performed in facility approved by the government for the purpose.

The sooner the better

If you are sure you want an abortion, then medically and legally speaking, the earlier you get it done the better. Within the first 12 weeks you need the approval of only one registered medical practitioner to go ahead with the abortion. After 12 weeks you will need the approval of two RMPs.

If you get the MTP done within the first 9 weeks after your last period, you can have a medical abortion, which means you just need to take some medicines prescribed by the RMP and have a follow up checkup to make sure that the abortion was successful. There is no surgery necessary in this case.

The 2018 Women’s Sexual, Reproductive and Menstrual Rights Bill was aimed at eliminating the need for a medical practitioner’s opinion in cases that did not exceed 12 weeks. These were laid out by the 2014 draft bill which called for a revision of this pre-condition as well as a reduction in the opinions of medical practitioners from two to one.

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If your 9 week deadline has passed don’t panic

MTPs are legal in India until the 20th week. So even after 9 weeks a surgical abortion can be performed. The good thing about this surgery is, it does not require you to stay in the hospital for more than a few hours.

There are two methods of surgical abortions. For pregnancies between 7 and 15 weeks vacuum aspiration is recommended. The procedure takes 10 to 15 minutes and then recovery a few hours. For pregnancies beyond 15 weeks dialation and evacuation is recommended. This procedure is more complex than vacuum aspiration but still does not usually require extended hospital stay.

Worried about how your partner or family will react?

If you are an adult of sound mental health, then you do not need anyone’s permission or consent to have an abortion. Your boyfriend or husband need not even be notified. You don’t have to tell anyone about it and your doctor cannot force you to. However an abortion obtained without the husband’s knowledge could be considered grounds for divorce.

Unmarried women are entitled to legal abortion in India

Even if you are unmarried you are entitled to an abortion in India, without anyone’s consent provided you are an adult of sound mental health.

If you are a minor, however, you will need the consent of your parent or legal guardian. It may be difficult to tell your parents about your pregnancy, but it is the only way to obtain a safe an legal abortion in India.

Many girls have suffered severe medical problems, including incomplete abortions, as a result of approaching illegal facilities that are often unhygienic and fraught with infections. The sooner you get an abortion done, the lesser the chances of complications, so please do not hesitate to tell your parents as soon as you know.

What are the restrictions by law?

Abortions in India can only be obtained from an RMP who can approve it only under the following conditions.

  1. The continuance of pregnancy poses a serious risk of physical injury to the woman.
  2. There is a significant risk of the child being born with genetic abnormalities or other serious handicaps.
  3. There is a risk of serious mental injury to the woman.

Conditions which are considered to be a justification of mental injury are:

  • If the pregnancy is a result of rape or incest. Rape cases need to be reported by the doctor.
  • In case of married women, if the pregnancy is as a result of the failure of contraceptive methods.
  • If anything in the current or foreseeable environment of the woman could affect the mental health of the woman or cause her anguish if she proceeded with the pregnancy.

The 2016 case of Ms X and Dr Nikhil Daar further highlights the pertinence of these conditions.  Here, the woman was a rape victim whose foetus was suffering from a brain abnormality called anencephaly. This would make the baby vegetative from birth. When the ruling was finally pronounced by the Apex Court, the very first legal abortion beyond the 20-week upper limit was finally permitted.

Fortunately, the third reason is vague and introduces flexibility and allows doctors to make abortions available to most women who need it. These concerns have been revisited and amended in January 2020.

When is it difficult to get an abortion in India?

In India female foeticide is rampant. Doctors are liable for performing abortions that aid female foeticide. So doctors may refuse perform abortions if you have availed of sex determination tests.

In India pregnancies can be terminated only in the first 20 weeks. Pregnancies beyond 20 weeks may only be terminated with special permission from the courts. However, on May 29 2019, a petition was filed at the Supreme Court by Swati Agarwal, Garima Sekseria and Prachi Vats. They challenged the 20-week limit as well as Section 3(2) (a) of the MRT Amendment Bill on the grounds of violating the equality entailed by Article 14 and 21 of the constitution.

Proposed improvements to MTP act

  1. Some rare congenital abnormalities can only be detected after 20 weeks putting both the mother and foetus at risk. Fortunately the MTP amendment bill of 2014 seeks to extend the legal period of abortions to 24 weeks.  It was introduced in the Rajya Saba for the first time and then the Lok Sabha. This became a matter of urgency after the PIL filed by Amit Sahni the Delhi High Court asking for a raise to the 20-week limit in May 2019.
  2. The requirement of approval from 2 registered medical practitioners may be difficult to obtain in places having a dearth of medical personnel. So the amendment proposes replacing ‘registered medical practitioners’ with ‘registered healthcare providers’.

  3. The MTP act specifies failure of contraceptive device as a valid reason for abortions only in married women. The amendment seeks to extend this consideration to unmarried women too.

 The new amendment to the 1971 Medical Termination of Pregnancy Act (MTP) may help bridge some of these gaps. And women may finally be able to have greater freedom and protect their reproductive rights. In late January 2020, some of the proposed amendments of the MTP amendment bill of 2014 were finally taken into account. 

The Union Cabinet finally raised the upper limit of MTP from 20 to 24 weeks, especially for rape victims, women with disabilities, and victims of incest. From the old provision that made this eligible only for married women, it now covers any woman, regardless of her marital or relationship status.

The new amendment also places no limit for gestational age if there is evidence of foetal abnormalities. Thus, safeguarding maternal mortality and complications that may arise from birth complications and unsafe abortions. The judiciary will continue to play an important role in implementing and regulating existing decisions. 

Yet, this bill definitely could be even more inclusive and address some of the public health barriers that India faces. Some fear that the amendment may be misused given the persisting issue of foeticide in India. This new extension limit only covers victims of rape and high-risk pregnancies where the foetus suffers birth abnormalities.

The differences between states and what is called the ‘absence of scale in the provider base’ is a key concern. Public health experts believe that investments and resources remain scarce as data gathering is not standardised. The bill also considers only eugenic cases and may not truly entail the freedom and reproductive rights that women need, especially as it only considers cis-gendered women.

Personally, I believe that women should be given complete freedom in deciding if they want an abortion and neither doctors nor family members should have the power to prevent it. The new amendment could provide an impetus for change where abortions are made more affordable and available, an important hallmark of a strong healthcare system. The amendments of the 2020 Bill clearly state the MTP Act will provide ‘legal, affordable, and safe access to abortion.’

Women deserve easy access to safe abortions and it is the job of the government to ensure that sufficient number of doctors and facilities are made available for the purpose. Given the prevalence of female foeticide in India some precautions need to be taken.

Image source: Getty Images via Free for CanvaPro

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