SSRN Id2674819
SSRN Id2674819
SSRN Id2674819
ON
‘REPRODUCTIVE RIGHTS OF WOMEN: A
WAY TO GENDER JUSTICE’
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Electronic copy
Electronic copy available
available at:
at:https://ssrn.com/abstract=2674819
http://ssrn.com/abstract=2674819
CONTENTS
ABSTRACT
WHO CONTROLS WOMEN’S BODIES
REPRODUCTIVE RIGHTS IN INDIA
RIGHT TO ABORTION
WHAT IS ABORTION
THE HISTORIC DECISION OF ROE v. WADES
INTERNATIONAL INSTRUMENTS RELATING TO
ABORTION
ABORTION IN DIFFERENT COUNTRIES
ABORTION IN INDIA
CASE LAWS IN THIS REGARD
DECISION OF HIGH COURT OF MADHYA PRADESH
SAVITA HALLAPANAVAR CASE OF ABORTION
RISE IN ABORTION CASES
ABORTION SERVICES IN INDIA
RIGHT TO ABORTION OF THE MOTHER
v.
RIGHT TO LIFE OF THE UNBORN
CONCLUSION
BIBLIOGRAPHY
2|Page
Electronic copy
Electronic copy available
available at:
at:https://ssrn.com/abstract=2674819
http://ssrn.com/abstract=2674819
ABSTRACT
Women have been fighting the struggle for reproductive rights for centuries. Historically,
these rights are an especially controversial subject due to the moral, ethical, and religious
considerations.
Do reproductive rights merely mean the right to reproduce? Or is the issue inextricably linked
to the numerous questions that surround women’s reproductive freedom?
The ability to reproduce seems to be what sets women apart from men. But do women have
control over their own reproduction? Do women have the freedom to choose whether, when,
and how many children to have? Do women have access to safe birth control methods? Do
women have the right to safe abortion? Can sexuality be separated from reproduction? A big
‘NO’ in answer to many such questions led to the emergence of the women’s health
movement in different parts of the world in the early 1970’s. It started as small
‘consciousness raising’ groups, which began by spreading awareness among women about
the functioning of their bodies and gradually evolved into multi-faceted campaigns that have
significantly influenced health policies in many countries.
Human Rights are those rights, which should be available to every individual without any
discrimination of any kind. Recognition of the inherent dignity and of the equal and
inalienable rights of all members of the human family is the foundation of freedom. The most
important right of a Human is the Right to Life. It is the supreme human right from which no
derogation is permitted. It is inalienable. The Article 6(1) of the International Covenant on
Civil and Political Rights prohibit the arbitrary deprivation of life. But there are some
controversial issues related to this supreme right. One such issue is the question of Right to
abortion. Among other rights of women, it is believed that every mother has a right to
abortion, it is a universal right. But the rights of the mother are to be balanced with the rights
of the unborn.
Earlier the right to abortion was not permitted and it was strongly opposed the society. The
termination of pregnancy was termed to be a murder of the foetus. But due to the change in
time and technology, nowadays this right has been legally sanctioned by most of the nations
after the famous decision of Roe v. Wade by the US Supreme Court. But the oppositions are
still present and people do believe that it should be legally prohibited.
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The Feminist analysis of patriarchal control over reproduction by the women’s movement all over
the world has spearheaded individual and collective attempts to fight against it at all levels. At
the same time, women’s groups in third world nations have asserted that the debate on women’s
reproductive rights must account for the fact that reproduction is only one aspect of women’s
physiology and lives, and cannot be viewed in isolation. They argue that the understanding of
patriarchy must encompass far more complex realities, because we live in societies where
political, economic, cultural and social factors come together to influence women’s health and
determine understandings of fertility and infertility, sexuality, reproduction and gender roles.
The Indian perspective on reproductive rights has had to additionally take account of several
other inequalities and contradictions in society. On one hand, traditional feudal society has
sought to regulate every aspect of women’s lives. Religion, caste and cultural values have
played important roles in defining and controlling women’s fertility. And, sharp class
contradictions have not only created, but also heightened inequalities with a direct adverse
impact on women’s health. On the other hand, the history of colonialism has compounded the
situation further by contributing to the systematic destruction of indigenous structures of
healing and health systems, and imposing allopathy or ‘modern western medicine’ as the norm.
In the present scenario of economic liberalisation, this legacy has received a new lease of life,
resulting in the exploitation of Indian markets and people by multinational pharmaceutical
companies. Coupled together, these factors are causing rural-urban divides to sharpen further,
creating ever-increasing gaps in development and planning, access to resources and
opportunities. Overarching this scenario is the population control agenda of the first world that
is dictated through international financial institutions and implemented through Indian
population programmes and policies.
In Situation where women have no ‘right’ to clean drinking water, basic facilities, health care or
education; where society decides where women will live, how they will live (and often, how
they will die), who they will marry, whether they will study; where the State (and international
development and aid agencies) believe they have the ‘right’ to determine how many children
women will bear, when they will get sterilised and what form of contraception women must
‘opt’ for; it is apparent that the struggle for Indian women’s reproductive rights needs to go
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Human Rights are those rights, which should be available to every individual without any
discrimination of any kind. Recognition of the inherent dignity and of the equal and inalienable
rights of all members of the human family is the foundation of freedom. The most important
right of a Human is the right to life. It is the supreme human right from which no derogation is
permitted. It is inalienable. The Article 6(1) of the International Covenant on Civil and Political
Rights prohibit the arbitrary deprivation of life. But there are some controversial issues related
to this supreme right. One such issue is the question of Right to abortion. Among other rights of
women, it is believed that every mother has a right to abortion, it is a universal right. But the
rights of the mother are to be balanced with the rights of the unborn.
Earlier the right to abortion was not permitted and it was strongly opposed by the society. The
termination of pregnancy was termed to be a murder of the foetus. But due to the change in time
and technology, nowadays this right has been legally sanctioned by most of the nations after the
famous decision of Roe Vs Wade1 by the US Supreme Court. But the oppositions are still
present and people do believe that it should be legally prohibited.
The question which is the reason for this discussion is- whether a mother has a right to abortion
vis a vis the right to life of the unborn. What are the International instruments which sanction
the right to abortion.
1
410 U.S. 113 (1973)
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An abortion is the removal or expulsion of an embryo or foetus from the uterus, resulting in, or
caused by, its death.
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OF
ROE v. WADES
Roe v. Wade became one of the most politically significant Supreme Court decisions in
history, reshaping national politics, dividing the nation into "pro-choice" and "pro-life"
camps, and inspiring grassroots activism. This is a landmark United States Supreme Court
decision establishing that most laws against abortion violate a constitutional right to privacy,
thus overturning all state laws outlawing or restricting abortion that were inconsistent with
the decision. Jone Roe, the plaintiff wanted to terminate her pregnancy because she
contended that it was a result of rape. Relying on the current state of medical knowledge, the
decision established a system of trimesters that attempted to balance the state's legitimate
interests with the individual's constitutional rights. The Court ruled that the state cannot
restrict a woman's right to an abortion during the first trimester, the state can regulate the
abortion procedure during the second trimester "in ways that are reasonably related to
maternal health," and in the third trimester, demarcating the viability of the fetus, a state can
choose to restrict or even to proscribe abortion as it sees fit.
In response to Roe v. Wade, several states enacted laws limiting abortion, including laws
requiring parental consent for minors to obtain abortions, parental notification laws, spousal
consent laws, spousal notification laws, laws requiring abortions to be performed in hospitals
but not clinics, laws barring state funding for abortions, laws banning most very late term
abortions. The Supreme Court struck down several state restrictions on abortions in a long
series of cases stretching from the mid-1970s to the late 1980s.
In the Supreme Court of Canada, interpreting Article 7 of the Canadian Charter which
guarantees an individual's right to life, liberty and freedom and security of a person. In the
leading case of Morgentalor Smoling and Scott vs. R2, the Court focused on the bodily
security of the pregnant women. The Criminal Code of the country required a pregnant
woman who wanted an abortion to submit an application to a therapeutic committee, which
resulted in delays. The Supreme Court found that this procedure infringed the guarantee of
security of a person. This subjected the pregnant woman to psychological stress.
2
(1988) 44 DLR (4th) 385
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3
(1980) 3 EHRR 408
4
(1992) 73 DR 155
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Article 1 of the American Declaration of Rights and Duties of Man and the Inter American
Commission of Human Rights say that abortion is legalized until the end of first trimester
Right to life is protected from the moment of its conception by Articles 6(1) of the ICCPR,
Article 2 of the European Convention of Human Rights and Article 4 of the African Charter
of Human Human and People's right. But they are silent on the issue of when does life begin.
But the interpretations have forced us to believe that the child is not to be protected from the
time of its inception. The right to life of the foetus has to be balanced with the rights of the
mother.
International courts and tribunals have not addressed the difficult philosophical issue of when
life begins, but have focused on the meaning of the language used in the relevant treaties.
They have generally held that the references to every human being or everyone or every
person do not include an unborn foetus.
The right of a woman to her private life has been the basis on which a number of international
bodies have upheld the right of a woman to have an abortion. The right to freedom of
expression and access to information has been used to argue for the right of women to receive
information about abortion options. The right to access abortion may also be based on the
right of a woman to decide freely and responsibly on the number and spacing of her children.
In a January 2006 CBS News poll in US, which asked, "What is your personal feeling about
abortion", 27% said that abortion should be "permitted in all cases," 15% that it should be
"permitted, but subject to greater restrictions than it is now," 33% said that it should be
"permitted only in cases such as rape, incest or to save the woman's life," 17% said that it
should "only be permitted to save the woman's life," and 5% said that it should "never" be
permitted. An April 2006 Harris poll on Roe v. Wade , asked, "Do you favor or oppose the
part of Roe v. Wade that made abortions up to three months of pregnancy legal", to which
49% of respondents indicated favour.
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Abortion remains one of the most controversial issues of women’s rights. In fact, it was the
struggle for legalisation of abortion that sparked off the women’s health movement in the
U.K. and U.S.A. Yet, in many countries of the world, including industrialised countries of the
West, abortion is still illegal, or conditional i.e. women can resort to abortion only in case of
rape, or if the life of the mother is seriously threatened. Clandestine/illegal abortion is the
cause of serious health complications and even death of women the world over.
The abortion debate stems from widely differing perspectives about when ‘life’ begins. ‘Pro-
life’ advocates, i.e. those against women’s right to abortion, say that ‘life’ begins at
conception, and aborting a foetus is tantamount to murder. ‘Pro-choice’ advocates, i.e. those
campaigning for women’s right to abortion, say that ‘life’ begins only after the foetus is
‘viable’ i.e. it can survive outside the mother’s body. Inherent in this controversy is the
conflict of interests between the right of the woman to choose whether or not to go ahead
with the pregnancy, and the interests of the foetus, which ‘pro-lifers’ claim, is an entity with a
right to life. The pro-life position, advocated mostly by the Catholic Church, the Jewish
orthodoxy and some sections of Islamic clergy, and newly emerging right-wing groups in the
recent past, holds sway in many countries. In the United States, abortion became legal, albeit
with restrictions, only as recently as 1973. However, anti-abortion forces began to mobilise,
and the Hyde Amendment, enacted in 1976 banned state medical insurance for abortion,
making it virtually inaccessible to the majority of women, especially the poor, black and
Hispanic women who could not afford to have abortions outside the public health system.
The anti-abortion movement, though it calls itself “pro-life”, is in fact indifferent to fate of
millions of women who die of unsafe abortion. Moreover, pro-lifers, in their campaign to
restrict the right to abortion have no hesitation in using violent tactics like harassment of
medical practitioners performing abortions, and the bombing of abortion clinics.
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As far as India is concerned, there are many statues, which deal with this point. Now we
enumerate Indian law to ascertain stance from both sides i.e. mother and unborn child.
Section 312 of the INDIAN PENAL CODE, 1860 causes miscarriage punishable. It says:
312. Causing miscarriage. - whoever causes a woman with child to miscarry, shall, if such
miscarriage be not caused in good faith for the purpose of saving the life of the women, be
punished with imprisonment of either description for a term which may be extend to three
years, or with fine, or with both; and if the woman quick with child, shall be punished with
imprisonment of either description for a term which may extend to seven years, and shall also
be liable to fine.
EXPLANATION: - A woman who causes herself to miscarry is within the meaning of this
section.
Section 312 punishes the person who causes the miscarriage to women. Explanation
appended to provision clarifies that women has no right to miscarry herself. The word
miscarriage is used synonymously with the word abortion. Section 3125 gives the right of
motherhood to woman and provides ample protection to this right but simultaneously takes
away the right of abortion to the woman; it means she herself has no right over her body. It's
not only question of right of woman over her body because a question of right to life of child
in woman's womb also arises. There is a clash between right to life of unborn child and right
of women over her body i.e. right of abortion. This issue also raises one more issue when life
begins- it could be immediately after the egg is fertilised; when the foetus gets a soul; when
the foetus can be independently outside the mother or when the mother delivers the baby. But
according to the Jeffrey M. Drazen. ( Editor in Chief of the journal of The New England
Journal of Medicine) when life begins is a philosophical question. As aforesaid, in U.S
abortion at the beginning of pregnancy is not punishable but there is no distinction in India on
such basis except in quantum of punishment: as Section 312 prescribes up to three years
imprisonment or fine or both for causing the miscarriage a woman with child and up to seven
years and also liable to fine for causing miscarriage to women quick with child. The meaning
of the term woman with child simply means pregnant woman. The moment a women
5
Indian Penal Code
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But question arises about the right of unborn child when life of woman is in peril due to that
pregnancy. Law can be cruel little bit but not absolutely: as section allows abortion in good
faith for the purpose of saving the life of the woman. Right of abortion is further extended by
The Medical Termination of Pregnancy Act. The Statement of Objects and Reasons of The
Medical Termination of Pregnancy Act are: The provisions regarding the termination of
pregnancy in the Indian Penal Code which were enacted about a century ago were drawn up
in keeping with the then British Law on the subject. Abortion was made a crime for which the
mother as well as the abortionist could be punished except where it had to be induced in order
to save the life of the mother. It has been stated that this very strict law has been observed in
the breach in a very large number of cases all over the country. Furthermore, most of these
mothers are married women, and are under no particular necessity to conceal their pregnancy.
In India, abortion was legalised by the Medical Termination of Pregnancy Act, 1972. Yet,
even today, a majority of women do not have access to safe abortion services. Legal abortion
services are not easily accessible, and women continue to resort to unsafe practices and self-
induced abortions, making a mockery of the legalisation of abortion. Studies estimate that
there are 2.2 illegal abortions for every legal abortion. Moreover, legalising abortion has, and
continues to clearly be a tool for coercive population control. Women who approach
government facilities for abortions are forced to ‘accept’ contraception/sterilisation after the
abortion is performed.
Unsafe abortion is a major cause of death and health complications for women of child-
bearing age. Although it is difficult to get data on illegal abortions, it is estimated that world-
wide, one-third of all abortions are illegal. 20 million unsafe abortions are performed
annually, and estimates of the number of women who die from unsafe abortions all over the
world range from 70,000-200,000 each year. While fighting for the women’s right to safe
abortion, the women’s movement has also cautioned women about the dangers of repeated
abortions. Making safe and reliable contraceptives available to all women, including
adolescents, would go a long way in reducing the need for abortion.
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Abortion was being practised earlier by many. Because it was illegal, it was practised in a
clandestine manner. The passing of the Act made medical termination of pregnancy legal,
with certain conditions for safeguarding the health of the mother.
Abortion is severely condemned in Vedic, Upanishadic, the later puranic(old) and smriti
literature. Paragraph 3 of the Code of Ethics of the Medical Council of India says: I will
maintain the utmost respect for human life from the time of conception.
The Supreme Court has said that the right to privacy is implicit in Article 21 of the
Constitution and a right to abortion can be read from this right.
The Medical Termination of Pregnancy Bill was passed by both the Houses of the Parliament
and received the assent of the President of India on 10th August, 1971. It came on the Statute
Book as the "The MTP Act, 1971"6. This law guarantees the Right of Women in India to
terminate an unintended pregnancy by a registered medical practitioner in a hospital
established or maintained by the Government or a place being approved for the purpose of
this Act by the Government. Not all pregnancies could be terminated.
A woman's right in this respect is doubtful because her right is dependent on certain
conditions: proof of risk to her life or grave injury to her physical or mental health,
substantial risk of physical or mental abnormalities to the child if born and a situation where
abortion could only save her life, all to be arrived at by the medical practitioners. Can a
woman request a medical practitioner to perform an abortion on the ground that she does not
6
The Medical Termination of Pregnancy Act
7
Section 3 of the Medical Termination of Pregnancy Act
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The case, is of an unmarried girl of 18 years who is praying for issue of a direction to
terminate the pregnancy of the child in her womb, on the ground that bearing the unwanted
pregnancy of the child of three months made her to become mentally ill and the continuance
of pregnancy has caused great anguish in her mind, which would result in a grave injury to
her mental health, since the pregnancy was caused by rape. The Court granted the permission
to terminate the pregnancy.
The accused had committed rape on minor girl aged about 12 years and made her pregnant.
The allegations are that two other co-accused took this girl, and they terminated her
pregnancy. So the charge on them is firstly causing miscarriage without consent of girl. The
Court held all the three accused guilty of termination of pregnancy which was not consented
by the mother or the girl.
In this case a woman wanted to have abortion on the ground that she has a 6 months old
daughter. She approached the petitioner for an abortion. And the petitioner agreed to it for a
consideration. But somehow the condition of the woman worsened in the hospital and she
was shifted to another hospital. But it resulted in her death. The abortion was not done.
The petitioner who was a registered medical practitioner had to establish that his action was
done in good faith ( includes omission as well ) so that he can get exemption from any
criminal liability under section 3 of the MTP Act, 1971.
8
1996 CriLJ 3795
9
2000 CriLJ 671
10
(2004) 3 CALLT 609 HC
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The woman was married to Navneet. Applicants are younger brothers of said Navneet while
Bhagwan Katariya was the father of said Navneet. After the complainant conceived
pregnancy, the husband and the other family members took an exception to it, took her for
abortion and without her consent got the abortion done.
The Court opined that if we refer Section 3 of the Medical Termination of Pregnancy Act,
1971, a doctor is entitled to terminate the pregnancy under particular circumstances and if the
pregnancy was terminated in accordance with the provisions of law, it must be presumed that
without the consent of the woman it could not be done. Present is a case where a permanent
scar has been carved on the heart and soul of the woman by depriving her of her child. And
the Doctor will be liable.
Thus, the case laws show that a woman has an absolute right to abortion and no one can take
away this right from her. The Judiciary has been playing a vital role in securing these rights
to women. Right to abortion is a fundamental right of privacy.
11
2001 (4) MPHT 20 CG
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19th January, 2013, INDORE, The High Court of Madhya Pradesh at Indore issued an order
allowing Hallo Bi, a pregnant female prisoner, to exercise her reproductive rights under the
Medical Termination of Pregnancy Act (Act). Hallo Bi had been sold into prostitution by her
husband and after months of continuous instances of rape, she became pregnant. In the order,
the Court wrote, “We cannot force a victim of violent rape/forced sex to give birth to a child
of a rapist. The anguish and the humiliation which the petitioner is suffering daily, will
certainly cause a grave injury to her mental health.”
This is a positive development for Hallo Bi and sets an important precedent for similar
circumstances by affirming rape victims’ right to lawful termination of pregnancy under the
1971 Act. Unsafe abortions are one of the leading causes of maternal mortality in India with
approximately 6.7 million abortions performed every year at unregulated facilities, often by
medical practitioners untrained in abortion services.
In early December 2012, Human Rights Law Network (HRLN) Reproductive Rights Unit
Assistant Director, Ms. Karla Torres, read an article in the Times of India about a pregnant
woman who was in prison for murdering her husband and had been ordered to make a written
application to the High Court for a termination of pregnancy. After communicating with
HRLN advocate Mrs. Shanno Shagufta Khan in Indore and meeting with Hallo Bi, HRLN
filed a petition requesting the High Court to allow for a medical termination of pregnancy.
The petition also stressed the Act’s silence on this issue and asked the High Court to issue
guiding directions. As both the Act and the jail manual are silent on this aspect, the High
Court had requested Hallo Bi to submit a written application for a medical termination of
pregnancy. The High Court subsequently denied Hallo Bi’s application. HRLN’s petition
stressed that the High Court had erred in not allowing Hallo Bi’s application as the power to
refuse the same did not lie with the High Court.
Under the Act, the decision to terminate a pregnancy is between a woman and her doctor(s).
As such, once a medical practitioner is of the opinion that the pregnant woman falls within
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Although the High Court found that Hallo Bi’s circumstances satisfied the MTP Act, the
Court did not include guiding directions. Notwithstanding, HRLN plans to request a review
of the petition so that this issue is taken up afresh and guiding directions are issued.
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On 21 April 2014, the Supreme Court ordered the Union of India and the State of
Maharashtra to respond to fundamental rights violations resulting from implementation of
The Medical Termination of Pregnancy Act (1971). A Writ Petition filed by the Human
Rights Law Network (HRLN) on behalf of Mrs. X and Mrs. Y argues that the outdated and
arbitrary 20-week limit on medical termination of pregnancy violates women’s fundamental
rights to life, health, dignity, and equality.
At her first antenatal checkup, doctors told Mrs. X that her fetus had severe abnormalities and
would not survive more than a few hours after delivery. Mrs. X was 26 weeks pregnant and
therefore could not legally obtain a medical termination of pregnancy under the MTP Act.
Mrs. X was forced to continue the pregnancy, visit the hospital regularly, and participate in
social events to celebrate the birth of her child, all while carrying a fetus that she knew could
never survive. After three days of excruciating labor pains, Mrs. X delivered a baby that
ultimately died less than three hours later. In her affidavit Mrs. X states, “The whole process
was extremely painful. In normal circumstances a mother goes through all the discomfort just
for the joy of giving birth to the baby. However in my case there was no joy as I was aware of
the poor outcome of the baby. All this could have been avoided if my pregnancy was
terminated in time.”
In the 19th week of her pregnancy, doctors told Mrs. Y that her foetus may have had a
congenital malformation characterized by partial absence of brain tissue. Additional test
results would not be available until after the 20th week of pregnancy. Under the limits
imposed by the Medical Termination of Pregnancy Act, Mrs. Y was forced to make the
excruciating decision to terminate her pregnancy without a full understanding of the medical
facts.
Out of the 26 million births that occur in India every year, approximately 2-3% of the
foetuses have a severe congenital or chromosomal abnormality. With new technology, many
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The debate in this issue basically boils down to pro-choice and pro-life support. The pro-
choice and pro-life antagonists argue over whether a woman should have the right to abort a
pregnancy when she decides that she is either unable or unwilling to invest a lifetime of
resources in the foetus that she is carrying. The pro-life proponents claim that such an act is
equivalent to murder because the foetus must be considered a viable human being from the
time of conception. The pro-choice proponents, on the other hand, advocate a woman’s rights
to control her own body, her right to an induced abortion, especially when her own life is in
danger. They argue that when the foetus is detrimental to the survival of the pregnant woman,
she should be allowed to choose whether she wants to save her own life herself by exercising
her natural rights over her own life and body or she wants to try saving her baby.
In this perspective, it is interesting to examine the position and awareness of the issue of
abortion laws in India. In other societies, activists talk about the abortion as something that
also involves the ending of a potential human life. However, here, we do not discuss the issue
of women’s reproductive rights and abortion on terms of pro-life and pro-choice. We don’t
talk and argue about the rights of the mother vis-à-vis those of the unborn baby. In our
society, abortion is more of a visceral and possibly sentimental issue, and the causes leading
to abortion are looked down upon as things that are extremely shameful for a woman, by the
so-called moral guardians of the society. Here, the topic of a case of abortion and the factors
leading to it are discussed in a hushed whisper, a disapproving tone and cluck of the tongue.
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Abortion exists in India. Indian society also strongly encourages it, but hardly when the life
of the mother is in danger. Many conservative families in patriarchal Indian families urge the
mother to go for abortion, when they get the information through illegal scans that the
ensuing baby is a girl child; or when, some woman from the family has got pregnant before
marriage. That is when abortion ceases to be an issue which champions a feministic point of
view, but rather turns detrimental from a perspective of women’s rights.
As mentioned earlier, the issue of abortion in India is not based on the pro-life and pro-choice
divide which debates, elsewhere in the world are based on. From a strictly legal point of
view, abortion in India is pro-choice. The fact that India has been plagued by the disturbing
facets of overpopulation demands, legality of abortion is a practical solution. The primary
reason why abortion is legal in India has only little coherence with it being a basic, personal
right and has more to do resources and development. Moreover, in the Indian society, where
unwanted pregnancy is a social taboo, had abortion not been legal, it would have led to
problems galore. Many a woman would have been forced to go for abortions in clandestine
and unsafe medical conditions, to avoid ‘social shame’. That in turn, would have led to gross
violations of the law coupled with dangerous medical consequences, possibly even death.
However, one of the primary objectives of such a law is to remove the tag of taboo attached
with the topic of abortion in the Indian society, something which hasn’t been achieved yet.
Keeping the legality of the issue aside, we need to ponder over as to why, incidents related to
abortion and unwanted pregnancy are rarely regarded as anything other than shameful events,
slips of judgement or symptoms of malaises in the society.
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Ultimately, legislation is not the only and moreover, effective tool to ensure that women are
aware of and have easy access to their reproductive rights. We have to move beyond the
black letter of the law to address such an issue, which is so central to women’s rights. The
law is worth its salt when women can go for abortions without being branded sluts, without
any sort of social repercussions. Of course, there should be room enough for debate on
whether a mother’s life should be given primary importance as opposed to that of the foetus
or an unborn baby. The medical safety aspect of abortion cases should also be taken into
consideration, while discussing the issue. Furthermore, the logistical problems of abortions
being legalized and its potential subsequent misuse should also be open to debate, especially
in a society like that of India’s, where the frequency of cases in which female foetuses are
surgically killed even when there is no iota of danger to the mother’s life, is far too high. But
seeing the topic of abortion and reproductive rights of women as a social taboo doesn’t really
make much sense.
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12
http://indianexpress.com/article/india/india-others/rise-in-abortion-cases-contraceptives-failing-most-
commonly-cited-reason/ BY:- ANURADHA MASCARENHAS
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The MTP Act is quite liberal and yet why do we have such a situation where an
overwhelming number of abortions being done either by uncertified (otherwise qualified)
practitioners or by unqualified persons? Answering this question is not easy. Doctors believe
that the process of registration and certification is so cumbersome and bureaucratic that it is
not worth the effort. The health officials say that the doctors do not come forward for
certification/registration because they do not want to adhere to the standards laid down in the
Act and do not like being monitored. As usual the truth lies somewhere in the middle.
The malaise is not confined to abortion and abortion services alone but to the entire health
care system, especially private health care services. Anyone in this country can set up
medical practice in any part of the country. Neither the State nor the professional bodies have
shown any concern in regulating this. Today there are estimated to be as many unqualified
medical practitioners as there are qualified ones, and looking at estimates of abortion the ratio
of qualified to unqualified abortion providers would be close to 1:6.
In the last decade both the issue of abortion as well as regulation of health care services have
emerged as major areas of concern. Abortion and abortion care services and regulation of the
private health sector in the context of quality of care have become important areas for social
science and policy research. As a result a lot of information and documentation on these
issues has been done.
CEHAT as an organisation has been a major contributor to research, action and advocacy in
both these areas. Today CEHAT houses the Secretariat of a major national initiative called
the Abortion Assessment Project – India (AAP-I), which involves coordinating multi-centric
studies on abortion providers and household studies to make direct estimates of abortion
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Review Government policy towards abortion care, availability of funds, its flow and
policy / programme environment in the country -–including Family Planning and
abortion care.
Assess and analyse abortion services, including organisation, management, facilities,
technology, registration, training, certification and utilisation in the public and private
sector.
Study user perspective with special focus on women's perceptions of quality,
availability, accessibility (including barriers to utilisation of safe abortion facilities),
confidentiality, consent, post-abortion contraception and attitude of service providers.
Study social, economic and cultural factors that influence decision-making: impact of
changing social values, male responsibility, family dynamics and decision making.
Document costing and finance issues related to the above.
Estimate rate of abortion, resultant morbidity and mortality; causes of spontaneous
and reasons for induced abortion.
Disseminate information on abortion issues widely and do advocacy on issues of
concern in the context of reproductive rights of women.
On the basis of these objectives the following components of the project have been worked
out:
1. Overview paper on policy related issues, series of working papers based on existing
data / research and workshops to pool existing knowledge and information in order to
feed into this project.
2. Multicentric survey of abortion providers and facilities in six States
3. Eight qualitative studies on specific issues to complement the multicentric studies.
These will be done by researchers, grassroots groups and medical establishments and
will not be confined to the six states (this component of the study is coordinated by
HealthWatch).
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This five pronged approach will, hopefully, capture the complex situation as it is obtained on
the ground and also give policy makers, administrators and medical professionals' valuable
insights into abortion care and what are the areas for public policy interventions and
advocacy.
The present publication is located in this context and endeavours to put together some papers,
articles and a database on the various dimensions of the abortion issue.
Though women have been practicing various forms of birth control and abortion, their access
to these services have been restricted by a number of social and legal hurdles. Also reasons
like lack of power for women in exercising their right to determine their sexuality, fertility
and reproduction add to the dimension of the access to the abortion services. Amar Jesani
and Adithi Iyer, in their paper Women and Abortion13 review this situation of abortions,
historically, tracing the problems faced in the formulation of the abortion policies. The
legalization of abortion faced a lot of hurdles from anti- abortions and pro-life advocates
coupled with the absence of the vital role of the women's group. A civil right to abortion also
does not amount to social right carrying all the necessary enabling conditions that make it
concretely realizable and universally available. The authors conclude by saying that abortion
is not merely an issue of political and legal conflict but of social, cultural and moral conflict
as well.
Taking the issue of legalization further Malini Karkal in her paper “Abortion Laws and the
Abortion Situation in India"14 traces the birth of the MTP Act in 1971, before which
abortions in India were governed by the Indian Penal Code of 1862 and the code of Criminal
13
http://www.cehat.org/go/uploads/Publications/a14.pdf accessed on September 13, 2015
14
http://www.finrrage.org/pdf_files/RepTech%20General/Abortion_Situation_in_India_1991.pdf accessed on
September 15, 2015
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Reviewing the actual situation, given the above legal and social scenario, the
paper Situation Analysis of MTP in Gujarat, Maharashtra, Tamil Nadu and Uttar
Pradesh undertaken by COURT explains the lack of attention given to abortion in the
reproductive health programmes. Induced abortions conducted under unsafe condition
account for uncounted deaths. During the last two decades there has been an increase in
reported MTP cases and the number of MTP institutions. But still the number of MTP cases
conducted at private clinics and nursing homes are under reported. The reasons for this vary
from non-recognition of the clinic to income tax regulations. This four-state study also
reveals an increasing demand for MTP services though the number of registered clinics
remains low. To worsen the situation inadequacies exist in training and posting of doctors
and also in the relation between decision-makers and implementers. Thus intensive advocacy
is required to strengthen MTP services in order to achieve reproductive health goals.
The reasons as to why still women receive these unsafe abortion services, though abortion
has been legalized in India with the MTP Act in 1976 is spelled out by Sunita Bandewar in
her paper Unsafe Abortion15. The pro-choice approach advocates the focus to shift from
unsafe abortion being an issue of public health concern, to access to safe and legal abortion as
a women's right issue. Abortion care facilities need to be accessible, approachable, adequate
and available at public care centers, services being provided by trained and skilled personnel
with post abortion counseling. The lack of these and over and above factors such as
confidentiality, low cost of travel, marital & socio- economic status, lack of consensus &
support from the family members and so on, women tend to turn to unsafe intervention by
local abortionists. The persistent problems of poor quality abortion care facilities can also be
15
http://www.cehat.org/go/uploads/Publications/a130.pdf ACCESSED ON SEPTEMBER 16, 2015
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Giving a real life scenario of these unsafe practices by quacks, Dr. Shyam Ashtekar in his
article 'Rural India's Criminal Abortionist'16 explains a number of incidences witnessed
during his medical practice such as small sticks jutting out of the woman's uterus, scooping
out a foetus with a spoon, scraping the vagina etc., by use of medical technology.
In the above context, a state level consultation meeting, as part of Cehat's advocacy initiatives
on the abortion issue was organized with the aim of bringing about sound and feasible
recommendations in view of improving access to safe and legal abortions. The report 'Access
to Safe and Legal Abortion'18 explains the priority areas for improving access to abortion
care services, promoting menstrual regulation and training paramedics in menstrual
regulation. The issues are identified and there are suggestions made to overcome the
limitations in the MTP Act that are related to registration procedures and the lacunae in
implementation of the Act. Suggestions are also made for medical legislation, cost of services
and commitment of the public health care system to provide MTP services and health
education.
16
http://www.cwds.ac.in/library/services/balika.pdf ACCESSED ON SEPTEMBER 16, 2015
17
http://www.womenstudies.in/elib/foeticide/fo_sex_detection.pdf ACCESSED ON SEPTEMBER 18, 2015
18
https://www.guttmacher.org/pubs/2006/07/10/PreventingUnsafeAbortion.pdf ACCESSED ON SEPTEMBER
18, 2015
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vs.
Religious, moral, and cultural sensibilities continue to influence abortion laws throughout the
world. The right to life, the right to liberty, and the right to security of person are major issues
of human rights that are sometimes used as justification for the existence or the absence of
laws controlling abortion. Many countries in which abortion is legal require that certain
criteria be met in order for an abortion to be obtained, often, but not always, using a
trimester-based system to regulate the window in which abortion is still legal to perform. In
this debate, arguments presented in favour of or against abortion focus on either the moral
permissibility of an induced abortion, or justification of laws permitting or restricting
abortion. Arguments on morality and legality tend to collide and combine, complicating the
issue at hand. Abortion debates, especially pertaining to abortion laws, are often spearheaded
by advocacy groups belonging to one of two camps. Most often those in favor of legal
prohibition of abortion describe themselves as pro-life while those against legal restrictions
on abortion describe themselves as pro-choice. Both are used to indicate the central principles
in arguments for and against abortion: "Is the foetus a human being with a fundamental right
to life" for pro-life advocates, and, for those who are pro-choice, "Does a woman have the
right to choose whether or not to have an abortion".
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"The touch of children is the delight of the body; the delight of the ear is the hearing of
their speech". A mother has got a natural duty to provide the maximum best possible to her
offspring. However, situations may arise where she indulges in activities, which injuriously
affect the foetus. It may be due to ignorance, carelessness or acts done wilfully. Abortion is
an issue to be left to the decision of the mother. However, taking viability of a legal standard,
necessary protection should be provided to the unborn. It is also beneficial to the mother,
where the state or voluntary organizations are ready to take care of the unborn. There is no
meaning in conferring a right to the mother to destroy the foetus. Her right is limited to have
a termination of pregnancy. It is also said that delivering 20 million babies annually would be
a greater strain on the nations medical services and economic resources than, say, performing
one to five million abortions a year.
The law has to take care of the liberty of the mother as well as the unborn. As a hospitable
community we should seek ways of providing support for lonely and frightened mothers, and
for lonely and abandoned babies. We need to offer women with unplanned pregnancies as
much love and support as they require and to assist them in finding compassionate
alternatives to abortion.
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BOOKS
WEBSITES
www.indiaangloinfo.com
www.indiatogether.org
www.unfpa.org
www.amnestyusa.org
www.hrln.org
www.indianexpress.com
www.cehat.org
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