Even after one year of the amendment to the Medical Termination of Pregnancy Act 2021, 95.5% unaware of changes

• Only 68% of women consider pregnancy termination as women’s health right
• In India, the MTP Act 2021, which enables access to safe abortion services, is unknown to around 95.5% of women
• Every third woman interviewed in the study was either not sure or don’t consider abortion as one of their health rights
• 40% of women are aware the MTP is legal in India
• 24% of women opined MTP is “legal with certain conditions”
• UP & Delhi: majority women are aware of the legality of MTP, only a few knew abortion is allowed “up to 24 weeks of pregnancy”
• Almost a year and a half has passed, only 4% women knew MTP Act 1971 was amended

The largest non-government organization (NGO) provider of clinical family planning services in the nation, Foundation for Reproductive Health Services India (FRHS India) released a study to understand the level of awareness of Medical Termination of Pregnancy (Amendment) Act 2021 and practices related to safe abortion in the country.

The study conducted by FRHS in four Indian states – Delhi, Maharashtra, Rajasthan and Uttar Pradesh, which was officially published on their website, says that one in three women interviewed for the study was either not sure or didn’t consider abortion as a health right. “The Medical Termination of Pregnancy Act was modified 1.5 years ago but abortion seekers are still unaware of the changes brought about in the act. We found that even service providers (doctors) in Rajasthan were unclear about the shift in gestational age from 20 to 24 weeks,” said Debanjana Choudhuri, Primary Researcher & Director-Programmes and Partnerships, FRHS India / MSI Reproductive Choices.

“Even after five decades, approximately 95.5% of Indian women are uninformed of the existence of the MTP Act, which gives access to safe abortion services. The study finds that 99% of women in India didn’t know the laws have changed, which is worrying. Also, the MTP Act 1971 amendment is unknown to 95% of frontline healthcare providers (FLWs) or ASHA workers who are the initial point of contact for women,” she said.

According to the report, in number of states, majority of FLWs are unaware that the act has been amended. The study finds that even frontline healthcare workers (FLWs) were unaware of the upper limit of pregnancy up to which MTP is legal in India.

Ashutosh Kaushik, Chief Executive Officer, FRHS India said, “The MTP Act amendment allows greater autonomy to women but lack of awareness among abortion seekers and healthcare service providers is causing a hindrance in bringing the needed change. Abortion is a basic human right, and FRHS strongly believes in ‘children by choice, not chance.’ For this to be successful, the government needs to deploy mass awareness activities in urban and rural areas.”

The study finds that 99% of women in India didn’t know the laws that allows abortion up to 24 weeks ‘for special categories of women,’ up from the existing 20-week gestation period. Less than one-third of women in every state but Uttar Pradesh (43%) had ever seen, read, or heard a message about a safe abortion. Also, religious views influence one’s decision to use MTP services, according to 56% of married women and 36% of single women.

The study findings also reveal that more than two-thirds of the married women look for Frontline Health Workers (FLWs) like ASHA/AWW/ANM for main source of information for pregnancies/abortion, for unmarried women (50%) mostly rely on social media platforms. Around 33% of unmarried women rely on teachers as a key source of information.

FRHS India recommends creating awareness, sensitization, and capacity-building efforts at district and sub-district levels among abortion seekers and healthcare service providers through FLWs. It can be achieved by introducing the public to the amendment through numerous seminars and orientations, this can be achieved. They may use MTP to share condensed video-audio messages on social media in a variety of local tongues and dialects. Also, a multifaceted strategy can be used that includes the engagement of community and religious leaders to reduce the obstacles to access the services.