The Medical Termination of Pregnancy Act, 1971 is a provider-centric law. It does not accord women the right to abortion on request. A number of conditions guide its implementation. However, there are important provisions with regard to consent and confidentiality that can ensure that women are able to obtain an abortion on their own terms.
For example, the law allows persons above 18 years to provide consent and does not require spousal or guardian consent. Similarly, confidentiality is mandated. These are important provisions that those seeking abortions need to be aware of. However, there is very low knowledge about the law amongst abortion seekers. Providers themselves lack knowledge about the law and/or impose their own values in the abortion decisions that women make. One example of this is to ask married women to seek spousal consent prior to providing an abortion.
The Indian abortion law requires certification of facilities and providers to provide abortion services. The 2002 amendment to the law resulted in some important gains. Registration of facilities was decentralised to the district level to enable speedier registration of facilities and providers. The amendments also separated the facility level requirements for the provision of medical abortion – first trimester and second-trimester abortions.
This, on paper, is meant to ensure registration of higher number of facilities that provide medical and first trimester abortions due to the simplified requirements. In reality, this has not been the case. The district level mechanism that is meant to provide certification often remains non-functional.
There are a number of grounds for which women can seek abortions up to 20 weeks including contraceptive failure. In the past year, there has been a spotlight on women seeking late-term abortions beyond the legal limit of 20 weeks on account of fetal abnormality and in some instances rape and incest where there has been a delay in seeking medical care. This has renewed the debate on the need to increase the gestation limit to seek abortions to 24 weeks from the current limit of 20 weeks.