Roe vs Wade ruling: Will embolden regressive ideas in India, say activists

Gender rights activists and health experts in India have opposed the decision of the US Supreme Court to overturn the landmark Roe vs Wade ruling that recognised a woman’s constitutional right to abortion and legalised it nationwide. They said the move is of deep concern as it could embolden regressive ideas in society and also stigmatise reproductive health measures in India.

For the last 50 years, abortion has been legal in India under various circumstances, following the enactment of the Medical Termination of Pregnancy (MTP) Act in 1971. In 2003, the Act was amended to allow women access to safe and legal abortion services. On the advice of doctors, all women can terminate their pregnancy up to 20 weeks. Since 2020, special categories such as survivors of sexual abuse, minors, rape victims, incest, and disabled women have been allowed to seek termination up to 24 weeks.

“This is a major setback for the movement to protect women’s sexual and reproductive health rights,” said Poonam Muttreja, executive director of Population of India. “Given the global influence of the US, this is likely to stigmatise reproductive health worldwide. This is a full attack on women’s rights over their own bodies, and women all over the world should be concerned.”

Experts said the decision’s implication that reproductive rights are not a part of fundamental rights could lead to worrying interpretations in different countries. As of now in India, major deformations in the foetus, failed contraception, potential injury to the physical or mental health of the mother are all considered valid grounds to medically terminate a pregnancy

Many doctors however feel the ruling will not have much impact on India.

Gynecologist Swati Singh of Safdarjung Hospital said the debate does not mean much for the country as abortion has always been legal in India. It has never been a political issue and although there have been discussions on fertility rates and population control, there has never been a demand in any state to ban or restrict abortions, she said.

“Yes, the medical termination of a pregnancy is still not provided on request here, but there is no legal opinion sought either. Women are not asked to seek permissions from courts as time runs out on them, like we have seen in other countries,” she said. “What I see here are essential medical safeguards so that a woman's life is not put at risk. A person with a very low heamoglobin count should not undergo an abortion. The new laws also allow no limit for gestational age in case of fetal abnormalities, mainly to address maternal mortality and morbidity arising from unsafe abortions.”

Tripat Choudhary, obstetrician-gynecologist, Fortis La-Femme, New Delhi, said India has liberal abortion laws, and they have only become more so with the most recent amendment.

“The context in India is different. In my long career I have not seen anyone objecting to the laws,” Choudhary said. “The patients and families who go through it certainly suffer through guilt, but at least in most of them, they don't see it as religiously binding to not allow an abortion. Also, abortion is such a private matter in this country. It will perhaps take us a long time to talk about it openly, despite the liberal laws.”

Sana Saiyed, a Lucknow-based social worker said it will embolden regressive ideas and the groups that are pushing them. "Nearly 47% of trafficking victims, any year, are minor girls who are often made to undergo unsafe abortions, given the lack of access to rights.”

While an unmarried woman too can avail of abortion in India, if she’s under 18, a case has to be registered under the Protection of Children from Sexual Offences (POCSO) Act, she said. The registering of the case happens even if the sex was consensual so that those involved (if they are minors) can undergo counselling, which is often why families choose to go for unsafe abortions, she added.

Renu Singh of Young Lives India, a think-tank that works in the area of women's health, said it was tragic that the US had taken such a regressive step as removing the right to safe and legal abortion.

“Illegality of abortion is going to be a major contributor to women’s mortality and the judgement has denied women a fundamental human right,” she said. “It is time we stopped politicising the bodies and lives of girls and women as seen in this case wherein they will be deprived of autonomy in decision making related to their own reproductive health.”l

According to the United Nations Population Fund, 45% of all abortions around the world are unsafe, making them a leading cause of maternal death. Since 1994, four nations--Poland, El Salvador, Nicaragua and now the US--have rolled back or restricted abortion rights.

There is substantial evidence to suggest that restrictive abortion laws can be counterproductive and result in an increase in the absolute number of such procedures taking place, many of them backroom operations that put lives at risk, experts pointed out.

According to a study published in the Lancet, the abortion rate dropped by 43% between 1990-1995 and 2015-2019 in settings where abortion is largely legal, excluding China and India. In contrast, the abortion rate increased by about 12% in countries that highly restrict access to abortion.

Maharashtra-based social activist Varsha Deshpande, who runs Lek-Ladki Abhiyaan, an organisation to save the girl child, told ET she considers abortion a health right that every woman is entitled to. The Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act that was enacted in 1994 to prevent misuse of the MTP Act has to be enforced more strictly, she said.

“We have laws that make abortion up to 20 weeks safe and legal, and we seek only health opinion for the process, but there is a need for a system to implement that properly,” she said. “Unsafe abortions remain the second-highest reason for maternal mortality deaths in our country, which shows laws are not enough.”

When the MTP act was conceived, it was also a measure to control the population at the cost of a woman's reproductive health, she said. “There was a gender bias even when it started because it talked about failed contraception,” Deshpande said. “I see abortion as a health right of every woman and we need a rights-based approach to this matter.”

The right to decide whether to continue a pregnancy rests with the woman in India but it’s important to understand the differences in the social context of the US and India to make sense of the debate and its implications, said Uma Vaidyanathan, senior consultant, obstetrics and gynaecology, Fortis Hospital.

“There are differences in the way the matter is approached socially in the West,” she said. “The Christian sensitivities about ‘life’ or ‘soul’ of the child in the womb are not much of a concern here. Recently, the government raised the right to terminate a pregnancy from 20 to 24 weeks, which is a good move, as a few abnormalities are only picked up only after 20 weeks, or if the woman registers late for some reason. This will most likely bring down the incidences of unsafe abortions here.”