Abortion in India
Abortion in India has been partially legal since 1971.
- 1 Legal status
- 2 Sex-selective abortion
- 3 Indications for early medical abortion
- 4 Contraindications for medical abortion
- 5 References
- 6 External links
The Indian Penal Code, which was enacted in 1860 and was written in accordance with British law at the time of is creation, declared induced abortion as illegal. Induced abortion was defined as purposely "causing miscarriage",. Abortion practitioners would either be incarcerated for up to three years, fined, or both; women undergoing abortions could be imprisoned for up to seven years and also be charged an additional fine. The only exception was when abortion was induced in order to save the life of the woman. Despite the fact that this passage in the penal code was changed in Great Britain in 1967, India did not change it until 1971.
Countless women died attempting illegal abortions as a result of the penal code, and it was a combination of this and the growing population that made the country reconsider its initial stance. In 1964, the Central Family Planning Board of the Government of India met and formed a committee designed to examine the subject of abortion from medical, legal, social, and moral standpoints. The Abortion Study Committee, lead by the then Health Minister of the state of Maharashtra Mr. Shantilal Shah, spent the next two years studying the issue, and submitted a report with its suggestions in December 1966. This report considered the penal code to be too restrictive and recommended that the law's qualifications should be relaxed; many of these suggestions were included in the subsequent Medical Termination of Pregnancy (MTP) Act.
1971 and beyond
Per India’s abortion laws, only qualified doctors under stipulated conditions can perform abortion on a woman in an approved clinic or hospital. The Indian abortion laws fall under the Medical Termination of Pregnancy (MTP) Act, which was enacted by the Indian Parliament in the year 1971. The MTP Act came into effect from April 1, 1972 and was once amended in 1975.
The Medical Termination of Pregnancy (MTP) Act of India clearly states the conditions under which a pregnancy can be ended or aborted, the persons who are qualified to conduct the abortion and the place of implementation. Some of these qualifications are as follows:
- Women whose physical and/or mental health were endangered by the pregnancy
- Women facing the birth of a potentially handicapped or malformed child
- Pregnancies in unmarried girls under the age of eighteen with the consent of a guardian
- Pregnancies in "lunatics" with the consent of a guardian
- Pregnancies that are a result of failure in sterilisation
The length of the pregnancy must not exceed twenty weeks in order to qualify for an abortion.
At the time the Act was passed, people feared the overcrowding of hospitals and an increase in promiscuity in teenagers, young adults, and young widows. Sex-selective abortions favouring males was also a concern.
According to the Consortium on National Consensus for Medical Abortion in India, every year an average of about 11 million pregnancies are medically terminated, and 20,000 women die every year due to abortion related complications. Most abortion-related maternal deaths are attributable to illegal abortions. In the following table Number of abortions reported includes legal reported induced abortions.
|Number of abortions
Post-natal diagnostic techniques like Medical Ultrasonography are capable of determining the sex of the foetus. In many parts of India, daughters are not preferred and hence sex-selective abortion is commonly practiced. According to The Pre-Natal Diagnostic Techniques(Regulation and Prevention of Misuse) Amendment Act, 2002 the following are cognizable, non-bailable and non-compoundable offences
•Conducting or associating or helping to conduct Pre-Natal Diagnostic tests,
•Sex selection on a woman or a man or both on any tissue, embryo, conceptus fluid or gametes derived from either or both of them
•Advertisement or communication in any form in print, by electronic media or internet by units, medical professionals or companies on the availability of sex determination and sex selection in the form of services, medicines, or any kind of techniques.
Three years imprisonment and fine of Rs.10,000 and five years imprisonment and fine of Rs.50,000 for subsequent offence for service providers is stipulated by the law ; those who seek aid shall be punishable with a term that may extend to three years and a fine that may extend to fifty thousand rupees for the first offence and for any subsequent offence with imprisonment which may extend to five years and with fine which may extend to 1 lakh.
Indications for early medical abortion
General condition to be fulfilled
Any woman coming to a health facility seeking termination of pregnancy the following aspects have to be assessed and found appropriate:
- frame of the mind of patient and her acceptability of minimum three follow-up visits
- ready for surgical procedure if failure or excessive bleeding occurs
- family support
- permission of guardian in case of minor per MTP Act 1971
- easy access to appropriate health care facility
Abortion in India can be done till 20 weeks of pregnancy. But an opinion of a second doctor is necessary between weeks 12 and 20. Only registered medical practitioners as prescribed by the MTP Act are authorised to prescribe mifepristone with misoprostol for medical abortion (Definition 2(d) of section 2 and MTP rule 3). Mifepristone with misoprostol for termination of early pregnancy not exceeding seven weeks, may be prescribed by a registered medical practitioner as prescribed under section 2 (d) and rule 3, having access to a place approved by the Government under section 4 (b) and rule (1), for surgical and emergency back-up when such a back-up is indicated. This may include primary health care-clinic or hospital-based set-up. Initial workup, counseling, prescription and administration could be in a clinic or in the consulting room. Home administration of misoprostol may be advised at discretion in certain cases with an access to 24-hours emergency services.
Choice between Medical and Surgical Abortion
- Vacuum Aspiration (Suction evacuation) is the most commonly used method for termination of early pregnancies. However, being a surgical technique, it is associated with risks of infection, perforation of uterus, incomplete abortion and post-procedure uterine synechiae formation (Asherman's Syndrome).
- The success of abortion with drugs depends on multiple factors including the regimen used, dosage schedule, route of administration and gestational age.
- Mifepristone with misoprostol is favourable if pregnancy is = 7 weeks.
- Surgical abortion is preferred if patient desires concurrent tubal ligation.
- If a woman fulfills the criteria for selecting either method, final choice to be given to the woman.
Contraindications for medical abortion
For cases in which a pregnant woman has a serious medical disease and continuation of pregnancy could endanger her life, the Indian MTP act lays a clear guideline under which medical abortion is contraindicated.
Contraindications due to Medical Reasons
- smoking > 35 years
- anemia – hemoglobin < 8 gm %
- suspected /confirmed ectopic pregnancy / undiagnosed adnexal mass
- coagulopathy or women on anticoagulant therapy
- chronic adrenal failure or current use of systemic corticosteroids
- uncontrolled hypertension with BP >160/100mmHg
- cardio-vascular diseases such as angina, valvular disease, arrhythmia
- severe renal, liver or respiratory diseases
- uncontrolled seizure disorder
- allergy or intolerance to mifepristone / misoprostol or other prostaglandins
- lack of access to 24-hours emergency services.
These include the cases in which
- women unable to take responsibility
- anxious women wanting quick abortion
- language or comprehension barrier
- not willing for surgical abortion in case of failure
- Chandrasekhar, S. India's Abortion Experience Denton, TX: University of North Texas Press, 1994.
- "Medical Termination of Pregnancy, 1971". Medindia.com. Retrieved 2008-12-10.
- "Introduction". Consortium on National Consensus for Medical Abortion in India. Archived from the original on 20 November 2008. Retrieved 2008-12-03.
- "Current status of abortion in India". Consortium on National Consensus for Medical Abortion in India. Retrieved 2008-10-11.
- Historical abortion statistics, India Historical abortion statistics, India
- Guidelines for Medical Abortion in India
- Katz, Neil S. Abortion in India: Selecting by Gender. 20 May 2006. 1 Jan. 
- Medical abortion information for women in Hindi language The International Consortium for Medical Abortion (ICMA) Information Package on Medical Abortion