On women’s rights, West takes a backward step, and India shows the way

Smriti Zubin Irani
At a time of distressing furore on social media and on streets against near-total bans on abortion in the West, India’s generous stance on the termination of pregnancy is a comforting sanctum. Coupled with the moratorium on commercial surrogacy and the proposal to equalise men and women’s age at marriage, India is positioned securely in the highest echelons of countries that safeguard reproductive autonomy.
India’s Constitutional ethos commits to the protection of personal liberty through Article 21. Abortion or termination of pregnancy is a woman’s prerogative to self- determine. While women are exclusively fated to withstand child-bearing -purely on account of their biological predisposition- socio-cultural constructs also subject women to a disproportionate share of child-rearing.
The Medical Termination of Pregnancy (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. Under the aegis of the Act, abortions may be performed up to 24 gestational weeks on grounds of risk to the mother’s life, mental anguish, rape, incest, contraception failure or the diagnosis of foetal abnormalities. The 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. It is a liberal achievement over countries where abortions are disallowed since conception, even in the most traumatising of circumstances of sexual abuse or incest.
The MTP Act, 2021 attests to the intuition and farsightedness of its crafters. Readiness for and desirability of children decisively shape the life trajectories of mothers, families and children alike. 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, WHO links the likelihood of children being born ‘wanted’ to greater parental investments in their education. The recent MTP Act therefore relieves mothers from the emotional and financial albatross of unwanted pregnancies.
Incumbent law and policy-makers have skilfully given reproductive choice a lifecycle twist. Since fertility, child-bearing and child-rearing are unmistakably associated with marriage, by proposing to raise the legal marriageable age for women, policy-makers are heralding welcome changes that delay pregnancy.
The Prohibition of Child Marriage (Amendment) Bill, 2021 seeks to push the marriage age for women from 18 years to 21 years. The Bill is well founded in the face of scholarship and evidence cited by 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. Children born to such mothers additionally face higher risks of low birth weight, preterm delivery and severe neonatal conditions.
It is worthy to note that the unmet need for family planning in terms of limiting or spacing of child-bearing decreased from 12.9% to 9.4% between NFHS-4 (2014-15) to NFHS-5 (2019-21). However, on a stand alone basis, nearly 7% 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%. Such young mothers are poorly aware about feeding practices and baby-care, making them more likely to have stunted or wasted children. 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.
Another underrated policy innovation that the Government curated was the decimation of surrogacy bazaars that allowed ‘renting a womb’. 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 a commercialisation of motherhood, commodification of women and their reduction to their reproductive capacity. India came to condescendingly be dubbed as a ‘baby factory’, with babies abandoned, exploitation of surrogates and non-payment of compensation. 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. The Act prohibits couples who are not of Indian origin to avail surrogacy in the country and allows only locals with certified, medical reasons necessitating gestational surrogacy to avail it. The MTP Act, the Surrogacy Act and the PCM (Amendment) Bill, 2021, collectively give new meaning to narishakti.
Within this enabling politico-legal apparatus, the Government has framed policies that readily coalesce to respect the choices and decisions made by women. Under the aegis of Ayushman Bharat- Jan ArogyaYojana (PM-JAY), 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. While Pradhan Mantri Matru Vandana Yojana (PMMVY) partially compensates wage loss before and after pregnancy, Pradhan Mantri Surakshit Matritva Abhiyaan (PMSMA) provides free of cost antenatal care to pregnant women on every 9th day of the month, easing the financial burden of pregnant women.
Not only is the Government making a concerted effort for reproductive choices to be easier on the pockets of women, it is also promoting safe motherhood through institutional deliveries under Janani Suraksha Yojana and quality, respectful care in labour rooms during deliveries under schemes like LaQshya. These efforts have culminated in a manifold increase in institutional deliveries from 79% in NFHS-4 to nearly 89% in NFHS-5. The ultimate reward to the Nation is the greater longevity of mothers as evidenced by declining Maternal Mortality Ratio (MMR) 167 per lakh live births in 2011-13 to 103 per lakh live births as of 2019.
(To be contd)