why is the women's movement silent on abortion-

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Why is the women's movement silent on abortion?

By Anjali Deshpande

The Union Ministry of Health is examining the Medical Termination of Pregnancy

(MTP) Act with a view to raising the time limit for abortion from 20 weeks to 24 weeks.

What would the moral and ethical implications of this move be? And why has the

women's movement in India been strangely silent on these important developments?

At a time when the law on abortion in India is about to see some changes, women's

groups are strangely silent. Though feminists have long stressed the right to abortion

as part of the right to their bodies, the Ministry of Health's recent moves have met with

silence, even indifference.

Around two months ago, a couple, the Mehtas, approached the Bombay High Court

seeking permission to abort their disabled foetus that was over 20 weeks old. (The Act

allows termination of pregnancy only up to 20 weeks of pregnancy.) The high court

refused to grant permission, honouring the limits set in the law.

The Medical Termination of Pregnancy (MTP) Act allows termination of pregnancy on

medical grounds including abnormalities in the foetus, contraceptive failure and risk to

social and mental health. Earlier, abortions under it could be performed only till 12

weeks of the pregnancy. In 1971, this was raised to 20 weeks and if the Union Ministry

of Health has its way the limit could be further raised to 24 weeks which will make it

possible for a six-month-old foetus to be aborted legally.

In a country where abortion clinics operate overtime to provide services to people,

without bothering much about time limits or other conditions prescribed by law, the

Mehtas' attempt to get a direction from the court was widely perceived as an attempt to

start a debate on abortion rights in the country, a debate that has never taken place.

But any hopes of women's groups joining such a debate have now begun to evaporate.

There are other relaxations too on the anvil. The health ministry is in the process of

finalising several amendments to the Medical Termination of Pregnancy Act in the light

of upgrades in technology.

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Now that the abortion pill Metoprosal is available, the MTP law may allow ayurvedic

and homoeopathic physicians to administer the pill. The MTP Act was passed, among

other things, to regulate abortions and minimise unsafe practices. Therefore, under the

law, other practitioners like midwives and homeopathic doctors are not allowed to carry

out abortions. Similarly, only those allopathic doctors registered under the Act can

perform an abortion. Doctors admit, however, that many of these regulations are not

strictly enforced.

Many have welcomed the proposed changes. Eminent south Delhi gynaecologist, Dr

Puneet Bedi, calls the imposition of a time limit "arbitrary" and asserts that when

performed by a specialist, an abortion, even a late one, is as safe as a normal delivery.

But that brings us uncomfortably close to the foetus being almost a child. Seven-month-

olds have been known to survive. We then have to confront the difference between

foeticide and infanticide.

Several doctors, including Bedi, assert that abnormalities often manifest themselves

late and that many tests will have to be carried out before it is confirmed that the

unborn child is indeed abnormal. Parents then need time to think about what they want

to do. The imposition of a 20-week limit only puts pressure on doctors and technicians

to hasten the diagnostic procedure, and that might not be good. It could lead to many

wrong decisions.

Then there's the question: Are these changes the natural response to technology

upgrades? Or are they a response to growing demands for a relaxed abortion regime?

In the public space there is hardly any evidence of campaigning by women's groups for

a more relaxed abortion law. Even after the health ministry began its recent moves,

women's groups chose to be silent or engage only in small group discussions. There

was never any concerted attempt to enter into the debate.

"It must have been done under pressure from the gynaecologists lobby that wanted to

extend the period of abortion. They will continue to do tests till late into the pregnancy,

and then get a chance to abort too," says Dr Mira Shiva from the Initiative for Health

Equity and Society. That makes good business sense. The industry has put a lot of

money into developing diagnostic techniques; it should earn some profits now!

Not everybody agrees with this viewpoint though. Dr Bedi argues that a State that

cannot provide public funds to children with special needs does not have the right to

dictate to individuals what kind of children they should or should not have.

There are many who are disturbed by the extremely clinical tone of the debate; they

believe there are several moral and social questions that have to be addressed first.



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"The plane of the debate shifts if you agree to accept the extended period for MTP,

because you can now abort a foetus that is viable or close to viable," says public health

specialist Dr Imrana Qadeer. "If you have this right and you exercise it, what does it

essentially mean? That you are getting rid of a foetus that you cannot look after. It can

apply to the old and sick too. Do you get rid of them because you can't look after

them? What is the moral position of the movement here?" Dr Qadeer also cautions

against the tendency to extend choice limitlessly. "Despite everything, it is a fact that

sometimes during delivery things go wrong and a child can get cerebral palsy. This

whole thing must be debated at length and a stand evolved," she says.

The women's movement must take a stand on this important moral question. To have

or not to have a disabled child, or a child with special needs if one is to use politically

correct language. It is not an easy decision. Whatever language you use, the facts stay

the same. In cases of severe abnormalities it is not easy to look away from the

situation. To have a child with special needs in the family means that one adult at leasthas to be totally devoted to that child and must give up his/her 'normal' life, aspirations

and ambitions to look after the child. The responsibility generally falls on the woman,

the mother, or the sister. Sometimes men too shoulder it.

These issues must be taken into consideration before arriving at a standpoint. Why do

you want to get rid of such a foetus? For your own convenience? Is this not a form of

discrimination?

The moment the debate enters this area other related questions start to arise. If

discrimination against the disabled is to be allowed, why is discrimination againstfemale foeticide not allowed? If parental convenience can be a legitimate reason for

aborting an abnormal foetus, why can the argument not legitimately be applied to

female foetuses? After all, parents do cite dowry and other future expenses as reasons

for wanting to get rid of a female foetus...

Questions are being asked about whether a relaxation in the time period during which

MTP can be performed can be misused for female foeticide. "I don't think so," says

Kalpana Mehta of Saheli. "The sex of the child is diagnosed by the 16th week. I don't

think people will wait long after that. They will abort much before the 20th week. Theydon't need to go up to the 24th week."

"If there is any possibility of misuse it should be taken care of by the PNDT (Pre-Natal

Diagnostic Techniques [Regulation and Prevention of Misuse] Act," says Kirti Singh, a

high court lawyer and president of the Delhi unit of AIDWA (All-India Democratic

Women's Association). "In case of abnormalities, two doctors have to certify. If the law

is enforced properly, the chances of misuse can be minimised. We must look at the



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regulatory mechanisms."

Questions are also being raised about the safety of the procedure for pregnant women,

the need for it and the pressures operating behind it. Dr Mira Shiva sees the industry

that produces all gadgets and chemicals as being behind the pressure to relax the

limits. "They first allowed MTPs only up to 12 weeks. Then they said it can be done till20 weeks; beyond that it was supposed to be risky for the mother. The more

technology you have, the further the relaxation. The industry is producing diagnostic

equipment; they need people to use it on. And why will people use it if they don't have

the option of carrying the child or not," she asks.

Dr Shiva adds: "There has been tremendous trivialisation of abortion in this country.

When it comes to female foeticide, doctors were happily doing it in the second

trimester. Who bothered what the law said? Many Acts are never implemented. What

we need is proper implementation and checks."

Dr Bedi asserts that the MTP Act now gives the discretion to doctors. When women go

to doctors seeking an abortion they cite some grounds allowed under the Act, like

contraceptive failure or risk to social health, to carry out the abortion. Most doctors do

this for financial gain. However, in principle, women do not have the right to walk up to

a registered practitioner and seek an abortion. "Women do not have the choice.

Doctors have the choice. And doctors can refuse to oblige a woman," he says.

The time has come to make a distinction between rights in principle and rights in

practice. In principle, women have no right to abortion. The MTP Act, passed mainlywith an eye on keeping family size small, gave many women access to abortion

services. With prosperity, and private nursing homes springing up in practically every

third alley in cities and small towns, the scene, at least in urban areas, has changed

dramatically. There is hardly any girl or woman who is denied an abortion in the city.

Doctors claim that, by and large, even government facilities do not refuse abortions to

women who come to their MTP clinics.

In practice, however, women do have the right and that is what we need to guard right

now. Dr Ritu Priya, faculty, Centre of Social Medicine and Community Health, JNU,

agrees that in practice women can get an abortion done quite easily. "Some areas

should remain grey. Why do we have to paint them black or white? What difference

does it make that women do not have the right to an abortion? They have the service

available, and that is enough."

She also says the PNDT Act must guard against possible misuse. This Act is not linked

to the MTP Act, she says, it only diagnoses. The patient follows it up elsewhere. "Even

if women had the legal right to demand an abortion, any doctor can refuse her the



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service on grounds of conscience. So what we have here is a situation in which if a

doctor refuses to provide the service to a woman she can go to another. In practice we

have the right. Let it be like that."

(Anjali Deshpande is a freelance journalist and an activist with an interest in

many issues especially those concerned with women, dalits and theenvironment)

InfoChange News & Features, November 2008


why is the women's movement silent on abortion-

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