Why a law is needed for abortion?

• Many women, when denied legal abortions, turn to unqualified providers or adopt unsafe methods of termination.
• Various estimates indicate that unsafe abortions account for 8% of maternal deaths in India.
• 15.6 million abortions took place in India in 2015 out of which about 11.5 million took place outside health facilities.

Concerns

• The Medical Termination of Pregnancy Act has limitations that pose barriers to women and girls seeking legal abortions.
• A woman’s right to decide for herself, did not and still does not fall within the intent or ambit of the MTP Act.
• When it comes to foetal abnormalities and pregnancies resulting from rape, this limit of 20 weeks is proving to be a hurdle for both the woman and the provider.
• Women seeking an abortion after the legal gestation limit often have no option but to appeal to the courts for permission to terminate the pregnancy.

Illegal Abortions

• Abortion of under 4 to 5 months pregnancy- The punishment for getting an illegal abortion is jail time of up to 3 years and/or fine.
• Both patients and doctors are considered to have committed a crime unless it fulfills the above condition.
• Abortion of over 5-month pregnancy- If abortion takes place when movements of the foetus can be sensed, the punishment is jail time of up to 7 years and fine unless it was done in good faith to save the life of the patient.
• Abortion without consent - If anyone else forces the pregnant woman to have an abortion or performs one without her agreeing to it, the punishment is jail time of up to 10 years and fine.
• Abortion resulting in death - If the patient dies because of a botched abortion or an abortion carried out by an unskilled person, the doctor who conducted the operation can be punished with jail time of up to 10 years and fine.
• If the abortion was conducted without the patient’s permission, the punishment is a jail for life.
• Intentionally causing the death of a foetus can also be prosecuted under other provisions of the Indian Penal Code, 1860 under which the punishment can extend up to 10 years.

Consent of a Person

• The doctors have a duty to get the consent of a pregnant woman in order to perform the abortion.
• If a woman is below 18 (a minor) or suffering from a mental illness, the doctors have a duty to get the guardian’s permission as well.
• If a doctor performs an abortion without consent, he or she can be punished with a jail term extending up to 10 years and fine.

Steps Taken by the Government for Safe Abortions
The Government provides safe and comprehensive  abortion care (CAC) services to women in health facilities under RMNCH+A (Reproductive, Maternal, Newborn, Child and Adolescent Health) program of National Health Mission.
Guidelines on Comprehensive Abortion care services and Medical Methods of Abortions (MMA) have been provided to all the States.

When Roe Vs Wade judgement was given ?

• In 1973, in the landmark Roe vs Wade judgment, the Supreme Court of the United States made the right to abortion a constitutional right, establishing a benchmark for abortion laws across the world.
• In this case, the US Supreme Court struck down laws that made abortion illegal in several states and ruled that abortion would be allowed up to the point of foetal viability, that is, the time after which a foetus can survive outside the womb.
• Foetal viability was around 28 weeks (7 months) at the time of the Roe judgment, experts now agree that advances in medicine have brought the threshold down to 23 or 24 weeks (6 months or a little less).
• Foetal viability is often seen as the point at which the rights of the woman can be separated from the rights of the unborn foetus.
• Abortion laws across the world rely on this metric but those opposing abortions argue that this is an arbitrary timeframe that legislation and the court in Roe adopted.

Debate regarding Abortion

• The abortion debate is the ongoing controversy surrounding the moral, legal, and religious status of induced abortion.
• In many western countries, the sides involved in the debate are the self-described "pro-choice" and "pro-life" movements.
• Pro-choice emphasizes the woman's choice whether to terminate a pregnancy.
• On the contrary, the pro-life position stresses the humanity of both the mother and fetus, arguing that a fetus is a human person deserving of legal protection.
• Each movement has, with varying results, sought to influence public opinion and to attain legal support for its position.
• Many people believe that abortion is essentially a moral issue, concerning the beginning of human personhood, rights of the fetus, and bodily integrity.

Where abortions are altogether are banned?

• Abortions are illegal in 24 countries, where about 90 million or 5 per cent of women of reproductive age reside, according to the global advocacy group, Center for Reproductive Rights.
• These include Senegal, Mauritania, and Egypt in Africa, Laos and the Philippines in Asia, El Salvador and Honduras in Central America, and Poland and Malta in Europe.
• As per the hardline laws in some of these countries, women are imprisoned for getting abortions. In El Salvador, for instance, several women who have undergone abortions have been found guilty of “aggravated homicide”, including in cases of miscarriage.
• Malta is the only country in the European Union that bans abortions under all circumstances. Just last year, the country witnessed a massive pro-choice movement calling for the country’s centuries-old abortion laws to be reversed. Meanwhile, in 2021, Poland introduced a near-total ban on abortions, allowing the procedure only in cases of rape, incest, or when the mother’s life is at risk.
• In Africa, while the number of unintended pregnancies has dropped by about 15 per cent in the last three decades, abortions have shot up by about 13 per cent, according to data compiled by Guttmacher Institute. Many African nations have either banned abortions altogether, or severely restricted them.
• In Nigeria, the procedure is only permitted if the mother’s life is in danger. Meanwhile, in Zimbabwe and Botswana, it is allowed in cases of incest, foetal defects and rape.
• Around 50 countries — including Libya, Indonesia, Nigeria, Iran and Venezuela — permit abortions if a woman’s health is at risk. Several others allow it in cases of rape, incest or foetal abnormality.
• For instance, Brazil allows abortion only in cases of rape or foetal disability. In such cases, the woman will need approval from one doctor and at least three clinical experts. A health ministry regulation in 2020 stated that doctors are required to report to the police anyone who seeks an abortion after being raped.
• In Canada, Australia and much of Europe there are few restrictions other than gestational limits. While Canada has no law granting the right to an abortion, it is still permitted at all stages of pregnancy regardless of the reason for 34 years. In 1998, the country’s Supreme Court struck down a longstanding federal law banning abortions.
• The court ruled that the law violated a woman’s right to “life, liberty and security of the person” that was enshrined in Canada’s Charter of Rights and Freedoms.
• Most European countries permit abortions within gestational time limits, which most commonly is about 12-14 weeks. But in many countries, there are a variety of exceptions that allow abortions to take place even later. For instance, in the UK, pregnancy can be terminated right up until birth in cases of foetal disability.
• Notably, many traditionally conservative Catholic countries in Europe and Latin America have expanded abortion rights following widespread protests by pro-choice groups and women’s rights activists.

Who released the new guidelines for abortions recently?

• Recently, the World Health Organization (WHO) presented new guidelines on abortion care. These, it claimed, would prevent more than 25 million unsafe abortions annually.
• The new guidelines include recommendations on many simple interventions at the primary care level that improve the quality of abortion care provided to women and girls.
• The new guidelines will support interested countries to implement and strengthen national policies and programmes related to contraception, family planning and abortion services, helping them to provide the highest standard of care for women and girls.

New Guidelines

• These include task sharing by a wider range of health workers, ensuring access to medical abortion pills, which mean more women can obtain safe abortion services and making sure that accurate information on care is available to all those who need it.
• Telemedicine: It also includes the recommendations for the use of telemedicine, which helped support access to abortion and family planning services during the Covid-19 pandemic.
• Removing Political Barriers: It also recommend removing medically unnecessary political barriers to safe abortion, such as criminalisation, mandatory waiting periods before receiving a requested abortion, third-party authorisation for abortion, restrictions on which health workers can provide abortion services.
• Such barriers can lead to critical delays in accessing treatment and put women and girls at greater risk of unsafe abortion, stigma and health complications, while increasing barriers to education and their ability to work.
• Restricting access to abortions does not reduce the number of abortions that take place. In fact, restrictions are more likely to push women and girls into unsafe practices.
• Providing Enabling Environment: A person’s environment plays a crucial role in shaping their access to care and influencing their health outcomes. An enabling environment is the foundation of quality comprehensive abortion care.

The three cornerstones of an enabling environment for abortion care are:

• Respect for human rights including a supportive framework of law and policy.
• Availability and accessibility of information.
• A supportive, universally accessible, affordable and well functioning health system.

How recent judgement will impact the US people?

The current case pertains to challenging the Mississippi law on abortion.

• In 2018, the state of Mississippi banned most abortions after 15 weeks — much before fetal viability, and sooner than was allowed by Roe — throwing a direct challenge to the 1973 judgment.
• In 2019, “heartbeat” abortion law was passed in Mississippi, an even more restrictive measure that banned most abortions once fetal cardiac activity could be detected — which is about six weeks.
• The heartbeat law said that physicians who performed an abortion after a fetal heartbeat was detected could have their medical licenses revoked.
• The law made no exceptions for pregnancies caused by rape or incest.
• This law too was blocked by a district judge, and in February 2020, the 5th Circuit Court of Appeals in New Orleans agreed with the decision.
• Since there is no federal law protecting the right to abortion in the US, the overturning of Roe would leave abortion laws entirely up to the states.
• In essence, in overlooking the checks and balances of Roe vs Wade and in disabling personal agency, the matter will no longer be set within the paradigm of women’s rights.
• It is also likely to impact the larger framework of human rights, tilting it away from the poor and the voice-less.

Way forward

• Access to legal and safe abortion is an integral dimension of sexual and reproductive equality, a public health issue, and must be seen as a crucial element in the contemporary debates on democracy that seeks to provide the just society that abhors all sort of discrimination.
• The silence around unsafe abortion leads to deaths of women and hides important problems that lie at the intersection of these concerns, such as the formidable barriers for adolescent girls to access reproductive health services, including abortion services.
• The right to safe abortion is an important facet of women’s right to bodily integrity, right to life and equality and needs to be protected.