Restrictive Indian Abortion Laws Require Reform

With the widely controversial Donald Trump Policy roller coaster both making global headlines and impacting an immediate ripple-effect if you like on women’s abortion rights worldwide, the already heated abortion debate now enters a hard-line period of conflicted exchange in many global countries, developed and undeveloped alike, including of course, the Mother of the East, India.

In 1971, abortion was made legal in India when the Medical Termination of Pregnancy Act was passed with an aim to reduce illegal abortion and maternal mortality. In a society that frequently considers sexuality as taboo, the MTP act was a welcome move and a validation of a woman’s fundamental right. It also established bodily sovereignty wherein each woman has the sole right to make decisions about what happens to her body. The word ‘abortion’ has always been a sensitive topic. Throughout history, induced abortions have been a source of considerable debate and controversy. Many countries still consider it as murder, while women’s rights insist it to be a woman’s fundamental right to have control over her body.

Here are some things you should know about Abortion in India. So stay safe and well informed.

What is Abortion?

Mainstream Wikipedia defines abortion as the removal or expulsion of an embryo or fetus from the uterus, resulting in, or caused by, its death. This could occur either spontaneously as a miscarriage, or be artificially induced through chemical, surgical or other means.

When can it be done?

Abortion in India is legal only up to twenty weeks of pregnancy under specific conditions and situations which are broadly defined as:

  1. The continuance of the pregnancy would involve a risk to the life of the pregnant woman or of grave injury of physical or mental health
  2. There is a substantial risk that if the child were born, it would suffer from such physical or mental abnormalities as to be seriously handicapped.

A woman has the right to abort:

  • If the woman has a serious disease and the pregnancy could endanger her physical/mental health
  • If the continuation of pregnancy could lead to substantial risk to the newborn leading to serious physical / mental handicaps
  • If the pregnancy is the result of rape
  • If the socio-economic status of the mother hampers the progress of a healthy pregnancy and the birth of a healthy child.
  • If the contraceptive device irrespective of the method used (natural methods/ barrier methods/ hormonal methods) failed

Permission/Consent:

  • If a woman is married, her own written consent is sufficient. Her husband’s consent is not required
  • If a woman is unmarried and over 18, she can provide her own written consent
  • If a woman is unmarried and under 18, she must provide written consent from her guardian
  • If a woman is mentally unstable, she must provide written consent from her guardian

Where and Who can perform the abortion:

Abortions can be performed in any medical institution that is licensed by the government to perform medically assisted terminations of pregnancy. Such institutions must display a certificate issued by the government.

Abortions must be performed by a doctor with one of the following qualifications:

  • A registered medical practitioner who has performed at least 25 medically assisted terminations of pregnancy
  • A surgeon who has six months’ experience in obstetrics and gynaecology
  • A person who has a diploma or degree in obstetrics and gynaecology
  • A doctor who was registered before the 1971 Medical Termination of Pregnancy Act and who has three years’ experience in obstetrics and gynaecology
  • A doctor who registered after 1971 and has been practising in obstetrics and gynaecology for at least a year

Types of Abortion treatment:

There are two types of abortion treatment, ‘Medical’ and ‘Surgical’ abortion:

Medical abortion: A type of non-surgical abortion which involves taking medication to cause an early miscarriage. Abortifacient pharmaceutical drugs made by combination of two medications, mifepristone and misoprostol is an option for women who are 10 weeks pregnant or less.

Abortion pill from 10 weeks up to 24 weeks: Involves taking medication to cause the womb to contract and push out the pregnancy.

Surgical abortion: Surgical abortion is a procedure that ends a pregnancy by removing the fetus and placenta from the mother’s womb and involves a quick, minor operation. There are two types of surgical abortion:

Vacuum aspiration ( first trimester) which removes the pregnancy by gentle suction with local anaesthetic.

Dilation and evacuation is done when an abortion occurs in (second trimester) of pregnancy. It usually includes a combination of vacuum aspiration, dilation and curettage and the use of surgical instruments (such as forceps) to clear the uterus of fetal and placental tissue.

Evolution of the MTP Act

To understand the issues surrounding abortion in India, it is necessary to contextualise the evolution of the MTP Act, which liberalised abortion laws in India. The MTP was enacted two years before the landmark judgement of the US Supreme Court in Roe v Wade – which held that laws which criminalise all abortions, except those required to save a mother’s life, were unconstitutional and violated the right to privacy of a pregnant woman. But this right should be balanced against the right of the state’s legitimate interest in protecting both the pregnant woman’s health and the potentiality of human life at various stages of pregnancy.

The Medical Termination of Pregnancy Act, 1971 needs to be amended to better address the varying concerns of Indian women be they rape survivors, married women or sexually active single women.

Women’s Health in India: A Business Opportunity Also?

Womens-Health-in-India-A-Business-Opportunity-Also

India is the second most populous country in the world, with over 1.29 billion people. 48.4% of the total population is female. Despite the two decades of rapid economic growth in India, women’s health is generally worse than other countries. Indian women usually suffer from different health concerns due to poor nutrition, reproductive issues, medical problems, mental problems, low social status, poverty and violence. The health of Indian women has a direct link to their status in the society. Because of discrimination, women’s health lags behind those of males.

Women in India face issues like lack of maternal health, malnutrition, suicide, domestic violence, breast cancer and diseases like AIDS. More than 70% of women in India have some kind of health problem due to inadequate knowledge. Lack of maternal health decreases women’s ability to work and participate in economic activities and it adversely affect their child’s health. Maternal mortality in India contributes to nearly 20% of maternal deaths worldwide. High levels of maternal mortality can be attributed to limited access to care and disparities of economic conditions. Urban areas with adequate medical resources have lower maternal mortality compared to rural areas. States with higher literacy rates tend to have greater maternal health and lower infant mortality.

India has one of the highest rates of malnutrition in women among developing countries. Maternal malnutrition is associated with child birth defects and increased risk of maternal mortality. The government needs to address the issues on malnutrition to have a beneficial outcome to women and children. Suicide is a major problem in India, suicide rate was found higher in women compared to men in India. The most common reasons for women’s suicide are depression, gender discrimination, domestic violence and anxiety. Female sex workers who face different forms of discrimination has higher suicide rate.

Domestic violence in physical, psychological and sexual form is a major issue in India. Domestic violence is currently viewed as a hidden epidemic by the World Health Organisation. 31% of women in India reported to having been the victim of domestic violence but the actual number could be much higher. A study found that more poor women fall victim to domestic violence compared to middle and high-income women. One of the biggest factors associated with domestic violence against women in India was the prevalence of alcohol use by men within the households. Physiotherapy and Psychotherapy plays a major role in rehabilitating victims of domestic violence.

There is a growing cancer epidemic in India, with a large increase in the number of Indian women with cancer particularly breast and cervical cancer. Middle aged women between 40 and 55 years especially those from the lower economic status who fail to carry out regular health check-ups due to financial constraints are mostly affected by cancer. Early detection through regular screening such as mammography and colposcopy can aid in significantly controlling the prevalence of cancer in the country.

HIV and AIDS epidemic in India is spreading rapidly affecting women’s health. Women represent approximately 40% of HIV cases in India. Despite the alarming growth of the disease, most women in India have little knowledge of AIDS. A study found that a large majority of Indian women had never heard of it. The rise in infections can primarily be attributed to lack of education and lack of access to contraceptives like condoms. The government public health system should provide education and adequate measures such as free HIV testing to combat the growing epidemic.

More than forty-eight per cent of Indian population are female. Women’s health in India presents a big business opportunity for enterprising companies. The opportunities for companies to cater to women are enormous. They could find a whole new range of commercial opportunities in women’s health concerns. The growing population and rising health needs of women may create new opportunities for companies to meet these challenges. Healthcare is one of India’s largest sectors in terms of revenue and employment. The healthcare is comprised of hospitals, medical tourism, clinical trials, health insurance, medical equipment, telemedicine and outsourcing. The healthcare sector in India is growing at a rapid pace and any company will be wise to target this growing sector.