Civil Society Recommendations on making the Medical Termination of Pregnancy

(Amendment) Bill 2020 a Rights Based Legislation

We welcome the move to amend the Medical Termination of Pregnancy Act 1971 and the
government‘s intention to ensure ―safe, affordable, accessible abortion services‖ and that
―advancement of medical technology for safe abortion‖ becomes a reality for women of India as
mentioned in the Statement of Objects and Reasons of the MTP Amendment Bill 2020. In order
to strengthen the proposed amendment and make it a piece of progressive and rights-based
legislation, we would strongly urge the government to consider the following:

1. The amendment to Clause 3 be changed:

a. to allow abortions up to twelve weeks (first trimester) at will of the pregnant person
b. the extension of gestation limit from 20-24 weeks be applicable to all pregnant
persons and not be restricted to only ―certain categories of women‖
c. opinion of a single provider for gestation up to 24 weeks (instead of two
providers for 20-24 weeks gestation).

2. The provisions of sub-section (2) of Clause 3 relating to the length of the pregnancy and
upper gestation limit should be extended to include survivors of sexual abuse/rape as
well as those who face a change in circumstances, and not just restricted to the diagnosis
of substantial foetal anomalies. The change in circumstances referred to here has been
elaborated in Annexure II.

3. To ensure confidentiality is safeguarded, the proposed clause ―5A‖ should be changed to

say that the provider should not disclose any particulars of the pregnant person whose
pregnancy has been terminated, unless directed by a court of law. The current proposal
which allows particulars to be disclosed ―to a person authorized by any law for the time
being in force‖ can potentially be misused to harass people and providers compromising
the safety of pregnant persons.

4. Medical Boards‖ should not be constituted. Requiring pregnant persons to be examined

by a medical board violates the rights to dignity, privacy, and decisional autonomy of the
pregnant person. Multiple invasive examinations of the pregnant person by the Board
can be intimidating and humiliating. These boards are a form of third-party authorization
that is highly burdensome, especially due to the financial drain on persons needing to
appear before the Board repeatedly, and they also lead to substantial delays in abortion
access.

5. We propose that the term ‗abnormalities‘ be replaced by the word ‗anomalies‘ as

‗abnormalities‘ reinforces the notion that foetuses with potential disabilities or medical
conditions are undesirable. The term implies that persons with disabilities are ‗abnormal‘
and those without disabilities are ‗normal‘ and therefore more valued and wanted.

6. We propose that the term ‗woman‘ in the Bill be replaced by ‗person‘ or ‗pregnant
person‘ in order to include transgender people. Access to abortion services is necessary
for transgender, intersex and gender-diverse persons. This is in line with the 2014
NALSA judgment and the Transgender Persons (Protection of Rights) Act 2019 which
recognise the principle of self-determination of gender identity. Any legislative
framework on abortion must ensure that all individuals have access to safe, affordable
and legal services
 7. As per the MTP Rules 2003, Medical Abortion (MA) drugs are approved for use only up
to seven weeks of gestation, while the Drug Controller General of India has approved
the MA combipack up to nine weeks. The MTP Amendment Bill 2020 should eliminate
this inconsistency and approve Medical Method of Abortion in line with the WHO
recommendation.

8. When the MTP Rules are framed/revised, we would urge that widespread consultations
are held with civil society organizations, providers and legal experts so that the rules keep
the interest of the pregnant persons at the centre.

9. The Bill must be referred to a Standing Committee and public comments must be invited
in order to ensure that all stakeholder perspectives are taken into consideration.

The above suggestions are based on existing evidence and experience of abortion provision in
India and globally. Annexure I provides the detailed evidence and rationale. Annexure II
provides Clause-by-Clause Comments and suggested changes to the proposed amendments.
Annexure III provides some general recommendations for the Bill and Annexure IV lists a few
important opinion articles on this issue.

Supreme Court of India‘s jurisprudence upholds the right of pregnant persons to exercise
reproductive choices without any interference. In the landmark case of Suchita Srivastava v.
Chandigarh Administration (2009), the Court expressly stated that reproductive choices can be
exercised to procreate as well as to abstain from procreating. In the 2017 privacy judgment,
Puttaswamy v. Union of India, Justice D.Y. Chandrachud noted that reproductive choice should be
read as an essential ingredient of reproductive rights, within the personal liberty guaranteed
under Article 21. The decisions in Navtej Johar v. Union of India (2018) and Joseph Shine v. Union of
India (2019) also recognise the importance of sexual autonomy and its linkages to reproductive
and decisional autonomy.

We recommend that the proposed changes to the amendments be considered by the

Government of India, so that the new law is in line with the Supreme Court jurisprudence and
the Statement of Objects and Reasons of the MTP Amendment Bill 2020. This will ensure
dignity, autonomy, confidentiality and justice for anyone who needs to terminate their
pregnancy.

Annexure I: Evidence/Rationale for Suggested Changes to the MTP Amendment Bill

2020
Annexure II: Clause-by-Clause Comments and Suggested Change
Annexure III: General Recommendations for the Bill
Annexure IV: Important Opinion Articles on the issue
Annexure V: Logos of civil society organisations endorsing the recommendations
Annexure I: Evidence/Rationale for Suggested Changes to the MTP Amendment Bill 2020

S. Proposed Amendment Suggested Changes Rationale

No in tabled Bill
1a. (------) Abortion in the first -The Draft 2014 Amendment Bill had
trimester should be made proposed that termination of pregnancy up to
the right of a pregnant 12 weeks should solely be ―on request of a
persons, allowing them to woman‖
seek abortions at will of the
pregnant person. -66 countries around the world including
Canada, Nepal, Netherlands, Sweden, South
Africa and Vietnam allow abortion at will of
the pregnant person.1

1b. Upper gestation limit The increase in gestation -Several developmental and structural foetal
extended from 20 to 24 limit from 20-24 weeks anomalies can be detected only between 20-
weeks for ‗certain should be extended for all 24 weeks and the decision to abort can be
categories of women‘ pregnant persons. delayed. 53% of women who sought judicial
intervention for foetal anomalies were in the
20-24 weeks gestation. 2

-Countries like Finland, Netherlands,

Singapore, Spain and UK allow women to
access abortion up to 24 weeks on social
grounds or for foetal anomalies

-Countries like Ethiopia, allow it for over 24

weeks gestation. Countries like Vietnam and
Canada do not prescribe any gestation limit
for abortion and allow women on social
grounds and at will of the pregnant person.

1c. Requirement of opinion Opinion of only one -The requirement of opinion of two
of one provider for provider should be providers may make it difficult for many
termination of applicable for 20-24 weeks pregnant people to access 20-24 weeks
pregnancy up to 20 gestation. abortion, particularly those in rural areas and
weeks and two small towns due to the following:
providers between 20-24
weeks gestation. -There is an acute shortage of specialists
(Obstetrician and Gynaecologists) who are
approved MTP providers for second
trimester and above (over 12 weeks).

-A majority of these specialists are

concentrated in urban areas.

-A single provider can perform the

1
https://reproductiverights.org/sites/default/files/documents/World-Abortion-Map.pdf
2
Assessing the Judiciary’s role in Access to Safe Abortion https://pratigyacampaign.org/wp-
content/uploads/2019/09/assessing-the-judiciarys-role-in-access-to-safe-abortion.pdf
 procedure.

-Only 12-23% of facilities providing abortion

are in the public sector and of these abortion
providing facilities, only 13-40 % provide
second trimester abortion. Many of these may
have only one provider and will not be able to
provide services for 20-24 weeks gestation.3

-In private sector only 15-54% of facilities

providing abortions provide second trimester
abortion.
2. (----) The gestation limit for -The mental trauma of carrying to term a
vulnerable groups pregnancy that has been a result of rape is
specifically for survivors of immense and violates right to life and dignity.
sexual assault, rape, minors
and incest should be -About 41% of vulnerable women (rape
removed entirely and they survivors) beyond 20 weeks who sought
should be allowed access to judicial intervention in the last few years had
abortion post 24 weeks. crossed the 24 weeks gestation.4

3. Medical practitioner Medical Provider should not -The MTP Regulations 2003 state that the
shall not reveal the disclose any particulars of a particulars of the woman, along with details
particulars of any pregnant person whose in the admission register, are to be kept secret
woman whose pregnancy has been and not disclosed to any person.
pregnancy has been terminated, unless directed
terminated except to a by a court of law. -The 2017 Puttaswamy judgment held that
person authorised by The right to privacy of a privacy is a fundamental right.
law. pregnant person who seeks
abortion services should be -On ground conflation of the MTP Act with
clearly enumerated in the PCPNDT Act results in officials asking for
Act. documentation of women who seek abortion.
Allowing any person authorized by law to ask
for details may compromise a pregnant
person‘s privacy and safety. 5

4. Upper gestation limit -The opinion of the doctor -Subjecting pregnant persons whose provider
not to apply in cases of regarding substantial foetal has diagnosed substantial foetal anomaly, to
substantial foetal abnormality should be additional and repeated medical assessments
abnormalities diagnosed sufficient. by Medical Boards is a violation of their
by Medical Board rights and agency.
-Medical board should not
be constituted to decide on -Decision making by medical boards can be
such cases. delayed, humiliating and can negatively
3
Abortion and Unintended Pregnancy in Six Indian States: Findings and Implications for Policies and Programs
https://www.guttmacher.org/report/abortion-unintended-pregnancy-six-states-india
4
Assessing the Judiciary’s role in Access to Safe Abortion https://pratigyacampaign.org/wp-
content/uploads/2019/09/assessing-the-judiciarys-role-in-access-to-safe-abortion.pdf
5
Availability of Medical Abortion Drugs in the Markets of four Indian States https://pratigyacampaign.org/wp-
content/uploads/2019/09/availability-of-medical-abortion-drugs-in-the-markets-of-four-indian-states-2018.pdf
 impact the mental health of a pregnant
person.

-As per the bill, medical boards should

consist of a) a Gynaecologist b) a
Paediatrician c) a Radiologist or Sonologist
and any other member as notified by the state
governments. Though, the powers and
functions of the boards will be prescribed in
the rules; the availability of such specialists in
many district headquarters in public sector is
very limited.

-Repeated invasive exams by unfamiliar

doctors on medical boards can be
stigmatizing.

-The setting up of the medical boards goes

against the spirit of the MTP Act which relies
on the opinion of the pregnant person‘s
healthcare provider as opposed to boards.

-A Pratigya Campaign study found that that

courts rely largely on these medical board
opinions to approve terminations. Boards
take into account various factors, including
viability of the foetus, a consideration that is
not present in the Act, thereby completely
neglecting the health risks of continuing an
unwanted pregnancy. 6

5. (--) Use of the term ‗anomalies‘ The term ‗abnormalities‘ reinforces the
instead of ‗abnormalities‘ notion that foetuses with potential disabilities
throughout the Act or medical conditions are undesirable. With
such language, the legislation continues to
advance eugenic rationale.
6. (--) The use of ‗woman‘ in the Access to abortion services is necessary for
Bill be replaced by ‗person‘ transgender, intersex and gender-diverse
or ‗pregnant person‘ in persons. This is in line with the 2014 NALSA
order to include transgender judgment and the Transgender Persons
people. (Protection of Rights) Act 2019 which
recognise the principle of self-determination
of gender identity.
7. (--) Expansion of provider base Given the advancement in medical
to include Nurses, ANMs technology – availability of medical abortion
and AYUSH doctors as and manual vacuum aspiration, other cadres
first trimester abortion of health care workers like Nurses, ANMs,
providers including for AYUSH doctors can be trained to provide

6
Assessing the Judiciary’s role in Access to Safe Abortion https://pratigyacampaign.org/wp-
content/uploads/2019/09/assessing-the-judiciarys-role-in-access-to-safe-abortion.pdf
 medical abortion first trimester abortions. World Health
Organisation recommends this in their 2015
guidelines ‗Health Worker roles in providing
safe abortion care and post abortion
contraception‘.

-Countries like Vietnam, South Africa,

Bangladesh (for menstrual regulation),
Sweden etc. permit these cadres to provide
first trimester abortion.

-Expanding the provider base would improve

access to abortion care, particularly rural in
rural areas and have a huge impact in terms of
reducing maternal mortality and morbidity.
8. (----) Medical Method of
Abortion should be - WHO in 2019 included MA drugs in the
approved in line with WHO Core List of Essential Medicines (previously
recommendation and up to it was in the Complementary list).The earlier
the gestation limit in the list had advisory stating ―that close medical
MTP Act. supervision is required for use of
mifepristone-misoprostol for medical
abortion‖ . This advisory is not mentioned in
WHO‘s latest list of essential medicines,
which clearly indicates that MA drugs can be
used with minimum level of medical
supervision and the risks associated with it
are minimal.
Annexure II: Clause-by-Clause Comments and Suggested Change

Clause Clause Text Comment Suggestion/Alternative

No.
2 In the Medical Termination of The problems with We strongly urge that Medical
Pregnancy Act, 1971 (hereinafter constitution of a Medical Boards not be constituted as
referred to as the principal Act), in Board have been detailed they are a violation of the
section 2,— below. pregnant person‘s rights to
dignity, privacy and autonomy.
(i) after clause (a), the following clause
shall be inserted, namely:—
'(aa) "Medical Board" means the
Medical Board constituted under
sub-section (2C) of section 3 of the
Act;';

2 (ii) after clause (d), the following clause (--) (--)

shall be inserted, namely:—
'(e) "termination of pregnancy" means a
procedure to terminate a
pregnancy by using medical or surgical
methods.'.

3 In section 3 of the principal Act, for While this amendment is We propose that Clause 3 be
sub-section (2), the following sub- progressive as it increases reframed as follows:
sections shall be substituted, namely:— the overall gestational limit
"(2) Subject to the provisions of sub- to 24 weeks, it is still In section 3 of the principal
section (4), a pregnancy may be inadequate as it leaves out Act, for sub-section (2), the
terminated by a registered medical many persons who may following sub-sections shall be
practitioner,— need abortions but are not substituted, namely:—
covered within the
(a) where the length of the pregnancy categories that the Rules "(2) Subject to the provisions
does not exceed twenty weeks, if may prescribe. of sub-section (4), a pregnancy
such medical practitioner is, or may be terminated by one
The termination of registered medical
(b) where the length of the pregnancy pregnancy up to 20 weeks is practitioner,—
exceeds twenty weeks but does not still based on the opinion of
exceed twenty-four weeks in case of one registered medical (a) at will of a pregnant
such category of woman as may be practitioner, while between person, where the length of
prescribed by rules made under this 20-24 weeks, the opinion of the pregnancy does not exceed
Act, if not less than two registered two medical practitioners is twelve weeks;
medical practitioners are, of the required. This is an
opinion, formed in good faith, that— additional barrier to (b) where the length of the
abortion access. The Draft pregnancy exceeds twelve
(i) the continuance of the pregnancy 2014 Amendment Bill had weeks but does not exceed
would involve a risk to the life of the proposed that termination twenty-four weeks, if the
pregnant woman or of grave injury to of pregnancy up to 12 registered medical practitioner
her physical or mental health; or weeks should be ―on is, of the opinion, formed in
request of a woman‖ . good faith, that—
(ii) there is a substantial risk that if the
 child were born, it would suffer The Explanations require (i) the continuance of the
from any serious physical or mental reframing in order to pregnancy would involve a risk
abnormality. include many more to the life of the pregnant
vulnerable persons and to person or of grave injury to
Explanation 1.—For the purposes of expand access to abortion her physical or mental health.
clause (a), where any pregnancy occurs services for transgender
as a result of failure of any device or persons. This would bring it
method used by any woman or her in line with the principle of Explanation 1.—For the
partner for the purpose of limiting the self-identification purposes of clause (b), the
number of children or preventing recognized by the NALSA anguish caused by an
pregnancy, the anguish caused by such judgment and the unwanted pregnancy may be
pregnancy may be presumed to Transgender Persons presumed to constitute a grave
constitute a grave injury to the mental (Protection of Rights) Act injury to the mental health of
health of the pregnant woman. 2019. the pregnant person.‖

Explanation 2.—For the purposes of Explanations 1 and 2

clauses (a) and (b), where any restrict abortion access to
pregnancy is alleged by the pregnant cases of contraceptive
woman to have been caused by rape, failure or to those who are
the anguish caused by the pregnancy survivors of rape. There are
shall be presume to constitute a grave many other reasons why a
injury to the mental health of the person may need to
pregnant woman. terminate an unwanted
pregnancy.

An unwanted pregnancy
(for reasons other than rape
or contraceptive failure) can
also severely impact a
person‘s mental and health.
Abortions should not be
limited to these grounds.
All pregnant persons should
be entitled to avail of
abortion services up to 24
weeks, in consultation with
their RMP. It is safe to
conduct abortions after 24
weeks.

3 (2A) The norms for the registered (--) (--)

medical practitioner whose opinion is
required for termination of pregnancy
at different gestational age shall be such
as may be prescribed by rules made
under this Act.

3 (2B) The provisions of sub-section (2) Given that that termination Medical Boards should not be
relating to the length of the of pregnancy can be carried constituted.
pregnancy shall not apply to the out safely post-24 weeks,
termination of pregnancy by the there is no rationale for For abortions post-24 weeks,
medical practitioner where such limiting it only to cases the opinion of one
termination is necessitated by the where the foetus has been gynaecologist (whom the
diagnosis of any of the substantial diagnosed with substantial pregnant person has been
foetal abnormalities diagnosed by a ―abnormalities‖ . consulting), in consultation
Medical Board. with no more than one other
We propose the inclusion medical practitioner, may be
(2C) Every State Government or Union of pregnant persons from required.
territory, as the case may be, vulnerable groups within
shall, by notification in the Official this clause, and recommend Hence, we submit that the
Gazette, constitute a Board to be called that it not be limited to following clause be inserted in
a Medical Board for the purposes of cases of substantial foetal Section 3, sub-section (2)
this Act to exercise such powers and ―abnormality‖ .
functions as may be prescribed by rules
made under this Act. We also strongly urge that ―(c) The provisions of sub-
Medical Boards not be section (2) relating to the
(2D) The Medical Board shall consist constituted. length of the pregnancy shall
of the following, namely:— not apply to the termination of
(a) a Gynaecologist; There have been pregnancy by the medical
(b) a Paediatrician; documented difficulties practitioner where such
(c) a Radiologist or Sonologist; and which cause substantial termination is necessitated for
(d) such other number of members as delays in access to MTP survivors of rape or sexual
may be notified in the Official services such as early or violence, or by the diagnosis of
Gazette by the State Government or forced marriages, lack of substantial foetal anomalies, or
Union territory, as the case may be." knowledge regarding due to a change in
contraception, rape or circumstances, as assessed by
sexual violence, delay in the pregnant person‘s
recognizing the pregnancy, gynaecologist, in consultation
delay in decision making with one other registered
due to lack of autonomy, medical practitioner if
intimate partner violence, required.
difficult family
circumstances, and lack of We also suggest that the term
mobility especially in case ‗abnormalities‘ be replaced by
of persons with disabilities, the word ‗anomalies‘ as
or institutionalized persons. ‗abnormalities‘ reinforces the
The Statement of Objects notion that foetuses with
and Reasons of the Bill also potential disabilities or medical
points to the need for conditions are undesirable.
increased gestational limit
as many survivors of sexual
violence have been
compelled to approach the
courts seeking abortions. A
change in circumstances
may also lead to a
pregnancy becoming
unwanted after 24 weeks,
such as when there is
separation from or death of
a partner, or a change in
financial situation.

The requirement of Medical

Boards in order to diagnose
‗substantial foetal
abnormalities‘ that
necessitate termination
violates the rights to
dignity, privacy, and
decisional autonomy of
the pregnant person.

These boards are a form of

third-party authorisation
that is highly burdensome
and leads to substantial
delays in abortion access.
Diverse composition of the
Board with three or more
members means that it will
be impossible to reach a
decision quickly.

The Boards would also act

as a serious barrier for
pregnant persons needing
their approval since the
expert composition
required for such a Board
may exist only in the metro
areas. For those living in
rural areas, there would be
substantial costs and delays
involved.

Moreover, multiple invasive

examinations of the
pregnant person by the
Board can be intimidating
and humiliating. Many
individuals may resort to
unsafe abortions instead.

Finally, the problems

inherent in third-party
authorisation have been
highlighted at the
international level. The UN
Human Rights Special
Procedures Working Group on
the Issue of Discrimination
 against Women in Law and in
Practice released a statement
in 2017 asserting that any
legislative requirements for
abortion should not cause
delays that would prevent
the carrying out of
termination before the
pregnancy becomes too
advanced. Similarly, the
Committee on the Elimination of
Discrimination against Women
has raised concerns about
third-party authorisation
requirements, and the World
Health Organization has
acknowledged that third-
party authorisation
requirements undermine
women‘s autonomous
decision-making. Thus, the
requirement of Medical
Boards for diagnosing fetal
―abnormalities‖ is
unnecessarily bureaucratic.

4 After section 5 of the principal Act, the The exception that allows ‗a The right to privacy of a
following section shall be inserted, person authorized by any pregnant person who seeks
namely:— law‘ to obtain the abortion services should be
particulars of the woman clearly enumerated in the Act.
"5A. (1) No registered medical whose pregnancy has been
practitioner shall reveal the name and terminated violates the We also propose that the
other particulars of a woman whose spirit of the provision section be re-framed as
pregnancy has been terminated under which is meant to ensure follows:
this Act except to a person authorised strict confidentiality and
by any law for the time being in force. protect the privacy of the ―5A. (1) No registered medical
(2) Whoever contravenes the person undergoing practitioner shall reveal the
provisions of sub-section (1) shall be termination. name and other particulars of
punishable with imprisonment which any person whose pregnancy
may extend to one year, or with fine, or In light of the Puttaswamy has been terminated under this
with both.". judgment which stated that Act.
privacy is a fundamental
right and in the spirit of the (2) Whoever contravenes the
MTP Regulations 2003 provisions of sub-section (1)
which stated that the shall be punishable with a
particulars along with the fine.‖
admission register would be
kept secret and not
disclosed to any person, this
amendment needs to be
revisited.
 Penal provisions create a
chilling effect on the
provision of abortion
services. The confidentiality
clause should be framed
similar to the provisions of
the MTP Regulations which
prohibited disclosure of any
details.

5 In section 6 of the principal Act, in The recommendations for We propose the inclusion of
sub-section (2), after clause (a), the (ac) and (ab) have already Adivasi and Dalit persons,
following been given above. nomadic persons, migrant
clauses shall be inserted, namely:— workers, sex workers,
For (aa), as stated internally displaced persons,
"(aa) the category of woman under previously, the amendment victims of intimate partner
clause (b) of sub-section (2) of is inadequate as it does not violence, persons with
section 3; include many vulnerable disabilities, institutionalised
(ab) the norms for the registered groups of people. persons, girls with forced and
medical practitioner whose opinion is early marriages, transgender
required persons and all those who are
for termination of pregnancy at all vulnerable to delayed
different gestational age under diagnosis, lack of adequate
sub-section (2A) of section 3; information and access to
(ac) the powers and functions of the abortion services resulting in
Medical Board under seeking termination of
sub-section (2C) of section 3." pregnancy beyond the 24 week
gestation limit of the Act.
Annexure III: General Recommendations for the Bill

1. Gestational Limit and Requirement of RMP Opinions

The Bill proposes that for pregnancies up to 20 weeks, the opinion of one RMP is required to
terminate. For pregnancies between 20-24 weeks, the opinion of two RMPs is required.

We submit that up to 12 weeks‘ gestation, the termination should be allowed solely at the will of
the pregnant person in consultation with their doctor. The consent of the pregnant person must
be paramount here. From 12-24 weeks, one RMP is sufficiently qualified to determine the safety
of termination procedure and perform it. Abortions should be available for all persons regardless
of the reason. The anguish caused by an unwanted pregnancy can be severely detrimental to a
person‘s mental and physical health and ought to be taken into consideration. Hence, abortions
should not be limited to the grounds of contraceptive failure or sexual violence or to certain
categories of women only. . It is safe to conduct abortions after 24 weeks. All pregnant persons
should be able to avail of abortion services up to 24 weeks, without needing to fulfil any
restrictive conditions. It would create unnecessary barriers to abortion service to require the
opinion of two RMPs at this stage.

Post the 24-week limit, a panel of two RMPs (gynaecologists) may be constituted to determine
whether the termination can be performed. . It is safe to conduct abortions after 24 weeks. Any
more than two RMPs would contribute to delays and lead to greater anguish for the pregnant
person.

2. Third-Party Authorization

There should be no third-party authorization, including judicial authorization, for termination of

pregnancies.

Medical Boards are a form of third-party authorization and have been recognized at the
international level as violative of the human rights of pregnant persons. Articles 3 and 17 of the
ICCPR provide that the "right of a woman or girl to make autonomous decisions about her own
body and reproductive functions is at the very core of her fundamental right to equality and
privacy, concerning intimate matters of physical and psychological integrity‖ . The unnecessary
layer of authorization added by a Board (or the judiciary) are contradictory to the values of
autonomy and dignity that the Indian Constitution also espouses.

Furthermore, we submit that RMPs are qualified to determine whether an abortion can be
performed safely post-24 weeks. We propose, therefore, that the pregnant person‘s consent and
the opinion of their gynaecologist be the main considerations for terminations post-24 weeks. If
required, the gynaecologist may consult one other doctor.

3. Conflict with POCSO Act

The Protection of Children from Sexual Offences (POCSO) Act 2012 considers all sexual
activity between minors (under the age of 18) to be a sexual offence. This means that consensual
sexual activity between adolescents will be treated as an offence, and as per Section 19 of the
Act, must be mandatorily reported to the police or the Special Juvenile Police Unit. The
mandatory reporting requirement deters many adolescents from seeking abortion services due to
the fear that they or their partner will face criminal sanctions. The requirement also conflicts
with the proposed confidentiality provision in the Bill. It is crucial that pregnant adolescents are
able to approach doctors for safe abortions or even to obtain information about these services.
Not removing the mandatory reporting requirement criminalizes adolescent sexuality and results
in many adolescents resorting to risky, unsafe abortion methods.

4. Expansion of Provider Base

In order to enable large number of pregnant people to benefit from ―advancement in medical
technology for safe abortion‖ , we urge that qualified and trained nurses, as well as other suitably
qualified healthcare providers, be included in the list of abortion providers to provide early
abortion, especially medical method of abortion. Recommendations of the World Health
Organization with regard to who can provide an abortion should be seriously considered.

5. Need for Consultation

For the MTP Act to adequately address the barriers to abortion access faced by women and girls,
consultation with all the stakeholders is necessary and indispensable. Widespread consultations
ought to be conducted with healthcare providers, lawyers, activists, Dalit and Adivasi rights
advocates, sex workers, disability rights advocates, transgender persons and other vulnerable
groups. The Bill should be revised and re-drafted in light of the consultations.
Annexure IV: Important Opinion Articles on the MTP Amendment Bill 2020

1. The amendments in the MTP Act bill are flawed |Hindustan Times- oped by Vrinda
Grover- https://www.hindustantimes.com/analysis/the-amendments-in-the-mtp-act-
bill-are-flawed-analysis/story-H0DZJUAWWopQZKPzbLXyJL.html

2. Are we truly advancing women‘s rights? | The Pioneer- oped by VS Chandrashekar-

https://www.dailypioneer.com/2020/columnists/are-we-truly-advancing-women---s-
rights-.html

3. The above oped was reproduced in Business World - Does The MTP Amendment Bill
2020 Really Advance Women‘s Rights?

4. Proposed Changes to Abortion Law Continue to Sideline Pregnant Persons | The Wire-
oped by Dipika Jain - https://science.thewire.in/health/proposed-changes-to-abortion-
law-continue-to-sideline-pregnant-persons/
Annexure V: Coalition of Civil Society Organisations