The United States (US) Supreme Court’s decision to overturn the historic 1973 Roe v. Wade ruling made the US only the fourth country since 1994 to roll back abortion rights. Given the country’s agenda-setting power, wherein it shapes global discourse on norms and rules, the ruling not only led to mass protests in the US but also had a cascading effect on countries across the world, many of whom have used this as a warning to either strengthen or examine their own abortion and reproductive rights and laws.
The United Kingdom, Canada, Spain, Norway, and Belgium, for instance, all reaffirmed their commitment to protecting abortion rights. Equally, however, there are concerns that right-wing parties in Europe with close links to the Catholic Church could use this as a springboard to push for a similar change in their countries, such as Lega Nord in Italy, which celebrated the US Supreme Court ruling as a “great victory.”
One of the darkest days for women’s rights in my lifetime. Obviously the immediate consequences will be suffered by women in the US - but this will embolden anti-abortion & anti-women forces in other countries too. Solidarity doesn’t feel enough right now - but it is necessary. https://t.co/T1656BPQuL
— Nicola Sturgeon (@NicolaSturgeon) June 24, 2022
Closer to home, there are concerns that the US’ ‘pro-life’ movement could jeopardise abortion rights in India, which accounts for one in seven abortions in the world. Poonam Muttreja, the chief of Population of India, has raised concern that the judgement could “stigmatise reproductive health worldwide.”
Abortion has been legal in India since 1971, and while it has not achieved the status of a constitutional or fundamental right, it continues to be largely protected under statutes. In fact, the Medical Termination of Pregnancy (MTP) Act of 1971 was amended last year to further expand access to abortion.
Apart from medical conditions such as a threat to the mother and the foetus’ physical or psychological health, the MTP Act makes abortions accessible to women who became pregnant after a sexual assault, whose marital statuses have changed following conception, and minors. The 2021 amendment also extended the abortion limit from 20 to 24 weeks. Moreover, the law does not mandatorily require a spouse’s consent either.
Crucially, the 2021 amendment also permitted unmarried women to undergo abortions if the pregnancy resulted from a failure in contraception. This provision was previously only accessible to married women, forcing unmarried women to rely on “quacks or illegal service providers.”
Commentators both within and outside India celebrated the amendment. In fact, the World Health Organisation (WHO) even released a statement applauding the law as a “historic step” toward the goal of “providing comprehensive abortion care to all.”
However, a closer look into the reality of abortion access in India provides a grimmer picture than legal protections may offer. For instance, the United Nations Population Fund estimated that 67% of abortions in India from 2007 to 2011 were ‘unsafe.’ Although the 2021 amendment has since sought to make abortion even more accessible to discourage unsafe practices, it ignores the root causes of the inaccessibility of abortions, which does not lie in legal protections.
The government has notified new rules under which pregnancy can be terminated upto 24 weeks for certain categories of women.The Medical Termination of Pregnancy (Amendment) Act, 2021 came into force with effect from September 24, 2021. pic.twitter.com/09f4lqHNLA
— Vasudha Venugopal (@vasudha_ET) October 13, 2021
In India, social stigma disincentivises abortions, with many women complaining that medical practitioners resort to moral policing by portraying the service as “immoral.” A 2021 report by the YP Foundation found that women also face severe privacy challenges, with two-thirds of women reporting that they were forced to disclose their marital status. Furthermore, half the women were made to provide parental or spousal consent, despite no such legal requirement.
Apart from societal hurdles, the MTP Act requires abortions to be conducted by doctors specialising in gynaecology or obstetrics but fails to recognise the dire shortage of doctors in India, particularly in rural areas, forcing many women to turn to illegal service providers. In fact, according to the Ministry of Health and Family Welfare’s 2019-2020 report on Rural Health Statistics, there is a 70% shortage of gynaecologists and obstetricians in rural areas.
'While the West is curtailing abortion rights, the Medical Termination of Pregnancy (Amendment) Act, Surrogacy Regulation Act and Prohibition of Child Marriage (Amendment) Bill, 2021, collectively give new meaning to Nari Shakti in India.'
— Bhupender Yadav (@byadavbjp) June 27, 2022
Must read piece by Smt @smritiirani ji. pic.twitter.com/Ce85Ebs45U
One of the leading causes of the disconnect between laws and the societal and medical realities of India lies in the failure to approach the issue of abortion from a rights-based standpoint.
For instance, the MTP Act focuses on providing medical practitioners with guidance on when and where pregnancies can be legally terminated in order to protect them from criminal liability prosecution. In contrast, the privacy of a woman is only briefly mentioned in a short section that bars practitioners from disclosing the details of their patients.
Unmarried women pregnant from consensual sex cannot terminate pregnancy older than 20 weeks: Delhi High Court
— Bar & Bench (@barandbench) July 16, 2022
Read story: https://t.co/1rXlvK4bKq pic.twitter.com/EZfizL0TMi
In this regard, the WHO posits that taking a rights-based approach would reorient abortion laws to focus on “safe, timely, affordable, and respectful abortion” and “comprehensive abortion care services – which includes information, management of abortion, and post-abortion care.” It argues that this would reduce unsafe abortions and consequently the maternal mortality rate (MMR).
According to a 2022 special bulletin by the Registrar General of India, seven states have “very high” MMRs, with over 130 maternal deaths per 100,000 live births. The overall average in India still stands at a whopping 113 deaths per 100,000 live births, of which one-third are caused by unsafe abortions.
That being said, the solution isn’t necessarily so simple. Given India’s high rate of female foeticide and the criminalisation of prenatal sex determination, legal authorities are concerned that expanding abortion rights could advance gender equality in one sphere but undermine it in another. This concern is made all the more compelling by evidence that many sonography centres continue to provide pre-natal sex determination services despite it being outlawed. However, the issue of medical centres and practitioners skirting the law must be treated as separate from abortion rights. There is insurmountable evidence to show that restricting the termination of pregnancies merely results in women seeking out unsafe services. Therefore, Indian rights campaigners must use the momentum and anger generated by the US Supreme Court decision to push for greater abortion access and freedoms in order to guard against a similar rollback of hard-won rights.