Leading the way in reproductive rights

In a move seen as a shot in the arm for women’s rights, the Supreme Court had recently upheld safe abortion rights for all women, whether married or not. The apex court said the marital status of a woman cannot be a reason to deprive her of access to abortion of an undesired pregnancy. An SC bench while pronouncing a judgement in a medical termination of pregnancy (MTP) case, ruled that unmarried or single women cannot be excluded from seeking safe and legal abortion of pregnancies — up to 24 weeks under the MTP Act and its rules. In case of sexual assault-led pregnancies, marital rape will also be considered.

The ruling is indicative of India’s legal system opening up to ideas that are not based on narrow patriarchal stereotypes of what has traditionally constituted as ‘permissible sex’. The ruling recognises women can be sexually active outside the construct of a marital relationship, without being bound by the dogmas and biases perpetuated by either social or religious beliefs. Under Article 21’s rights of reproductive autonomy, dignity and privacy, an unmarried woman has the liberty to choose whether or not to bear a child, just like a married woman.

The development should be viewed in a global context considering how even developed nations are running afoul of honouring such fundamental human rights. This year, the US Supreme Court overturned 50 years of progress in reproductive agency for women when it knocked off the constitutional right of women to seek an abortion in the nation. The ruling was viewed as a symbol of America’s descent into regressive ideology propagated by members of the Republican party that has floundered in separating the Church from the State.

While individual states in the US are allowed to draft abortion laws as per local mandates, critical intervention will remain unavailable to thousands of women, especially economically challenged individuals, who might be unable to afford the cost of travelling to a different state for such procedures. Annually, 121 mn cases of unplanned pregnancies are recorded globally. The WHO says the average maternal mortality rate is thrice as high in nations with restrictive abortion laws (223 maternal deaths per 1 lakh live births) compared to states with liberal laws (77 maternal deaths per 1 lakh live births).

In India, unsafe abortions emerged as the third leading cause of maternal mortality. Close to 67% abortions carried out in India were unsafe, and they caused up to eight deaths every day, as per the United Nations Population Fund (UNFPA) State of the World Population Report 2022, which analysed data between 2006-2011. The Health Ministry’s 2019-20 Rural Health Statistics Report, says a deterrent to access to safe and legal abortion is the lack of qualified medical personnel — obstetrician-gynaecologists in rural India, which is home to 66% of the country’s population.

The restrictive cost of abortions in private hospitals has been underscored by the 2015-16 National Family​​ Health Survey (NFHS). It says just 20% of abortions took place in public healthcare institutions as against 52% of the procedures carried out in private clinics/hospitals, which are chock-a-block in urban India. Add to this, the social stigma and the absence of adequate data pertaining to reproductive wellness and sex education among citizens. The government must expend more resources on creating awareness as well as focus on beefing up healthcare infrastructure in rural India, in the absence of which such historic judgments might only make for lip service.