Context

• The U.S. Supreme Court has reversed the landmark 1973 Roe v. Wade ruling that legalized abortion nationwide.
• Hence, while the West is curtailing abortion rights, the Indian legislations like Medical Termination of Pregnancy (Amendment) Act, Surrogacy Regulation Act and Prohibition of Child Marriage (Amendment) Bill, 2021, collectively give new meaning to women empowerment (Nari Shakti) in India.

Signification of abortion

• Unwanted pregnancies unexpectedly curtail the life choices of parents, especially mothers, and may limit their mental well-being and personal growth. Further, children born unwanted may suffer reduced opportunities.
• Illustratively, the WHO links the likelihood of children being born “wanted” to greater parental investments in their education.

Status of reproductive autonomy in India

• Constitutional grants: India’s constitutional ethos commits to the protection of personal liberty through Article 21. Thus, abortion or termination of pregnancy is a woman’s prerogative.
• Banning commercial surrogacy: The Surrogacy (Regulation) Act, 2021 bans commercial surrogacy, which is punishable with a jail term of 10 years and a fine of up to Rs 10 lakhs.
  • The Act also prohibits couples who are not of Indian origin from availing surrogacy in the country and allows only locals with certified, medical reasons necessitating gestational surrogacy to avail of it.
  • Circumstances: Given global inequalities, India became a lucrative “biomarket” for surrogate mothers. The bodies of poor Indian women became “bioavailable” to the residents of the Global North, spurring commercialisation of motherhood, the commodification of women and their reduction to their reproductive capacity.
  • Against cultural ethos: In a country with a long-standing cultural lineage of revering mothers, careless commercial surrogacy appeared to be in stark contrast with the cultural ethos. Responding to this dissonance, the Surrogacy (Regulation) Act, 2021, replaced commercial surrogacy with ethical, altruistic surrogacy.
• Medical Termination of Pregnancy (Amendment) Act, 2021: Under the Act, a pregnancy may be terminated up to 20 weeks by a married woman in the case of failure of contraceptive method or device. It allows unmarried women to also terminate a pregnancy for this reason.
  • Special consideration: MTP Amendment Act, 2021 also increases the upper gestation limit from 20 to 24 weeks for special categories of women, including survivors of rape, victims of incest and other vulnerable women (differently abled women, minors, among others).
  • Self-determination: The MTP (Amendment) Act, 2021, is a step in the right direction. It ensures that expectant mothers exercise self-determination in welcoming new life to their homes.
• Raising marriageable age: The Prohibition of Child Marriage (Amendment) Bill, 2021 seeks to push the marriage age for women from 18 years to 21 years. Since fertility, child-bearing and child-rearing are unmistakably associated with marriage, by proposing to raise the legal marriageable age for women, policymakers are heralding welcome changes that delay pregnancy.
  • Influences: The PCM (Amendment) Bill, 2021 is well-founded in the face of evidence cited by the World Health Organization (WHO), which holds that adolescent mothers aged 10 to 19 years are prone to higher risks of eclampsia, puerperal endometritis, and systemic infections in comparison to women aged 20 to 24 years. Moreover, children born to such mothers additionally face higher risks of low birth weight, preterm delivery and severe neonatal conditions.
• Ayushman Bharat- Jan Arogya Yojana (PM-JAY): Under this, a health cover of Rs 5 lakh per family per annum is provided and a wide range of packages pertaining to obstetrics and gynaecology are offered.
• Other legislations: Plethora of other legislations also give special care to women health as follows:
• Pradhan Mantri Matru Vandana Yojana (PMMVY) partially compensates her wage loss before and after pregnancy.
• Pradhan Mantri Surakshit Matritva Abhiyaan (PMSMA) provides free antenatal care to pregnant women on every 9th day of the month, easing the financial burden of pregnant women.
• Janani Suraksha Yojana: It is a safe motherhood intervention under the National Rural Health Mission (NHM) which integrates cash assistance with delivery and post-delivery care.
• LaQshya program: Under the aegis of Ministry of Health and Family Welfare, LAQshya aims at improving quality of care in labour room and maternity Operation Theatre (OT).

Outcomes of legislation

The above mentioned concerted efforts have resulted in significant favourable outcomes as follows:

• Enhanced institutional deliveries: It culminated in a manifold increase in institutional deliveries from 79 per cent in National Family Health Survey, NFHS-4 to nearly 89 per cent in NFHS-5.
• Reduced MMR: The declining Maternal Mortality Ratio (MMR) from 167 per lakh live births in 2011-13 to 103 per lakh live births as of 2019 is heartwarming.
• Family planning: It is noteworthy that the unmet need for family planning in terms of limiting or spacing child-bearing decreased from 12.9 per cent to 9.4 per cent between NFHS-4 (2014-15) to NFHS-5 (2019-21).
• Adolescence pregnancy: However, on a standalone basis, nearly 7 per cent of females aged 15-19 years were already mothers or pregnant at the time of NFHS-5, a marginal decline over NFHS-4’s 7.8 per cent.
• Such young mothers are poorly aware of feeding practices and baby care, making them more likely to have stunted or wasted children.
• Hence, together the MTP Act, 2021 and the PCMA Bill, 2021, if enacted can axe the vicious cycle of early marriages, consequent early pregnancies and poor maternal and child health outcomes.

Comparison with the West

• Liberal politico-legal apparatus : India’s legislation as MTP (Amendment) Act is a liberal achievement over countries where abortions are disallowed since conception, even in the most traumatizing circumstances of sexual abuse or incest.
• Unbiased standards: Moreover, while the West is curtailing abortion rights, India is extending the ceiling of permissible abortions by PCM (Amendment) Bill, 2021. By proposing to revise the permissible marriageable age, the government has held men and women to the same, unbiased standards.
• Menstrual hygiene: Also, while menstrual hygiene remains a conversation hushed in whispered tones in parts of the world, India’s PM addressed the issue from the ramparts of the Red Fort with 1.3 billion Indians listening intently.

Conclusion

• The present government has instilled conscientiousness into the calculus of policy-making with changing times. For instance, The MTP (Amendment) Act navigates the 20 weeks challenge posed by the MTP Act, 1971 and is a nod to advances in the field of health and reproductive science.
• Thus, Coupled with the moratorium on commercial surrogacy and the proposal to equalise men’s and women’s ages at marriage, India is positioned securely in the highest echelons of countries that safeguard reproductive autonomy.
• Incumbent law and policy-makers have skillfully given reproductive choice a life-cycle twist. Even as the West retrogresses, India shows the path to a progressive society