Autonomy and Access: A Critical Look at the Medical Termination of Pregnancy Act

Abstract

The medical expiry of the Pregnancy Act (MTP), adopted in India in 1971 and changed in 2021, represents an important legislative structure that balances women's reproductive autonomy with moral and medical views. This paper examines the implications of the actions of women, focusing on their regulations, social influences, and frequent challenges. The MTP Act allows miscarriage under specific conditions, such as the mother's risk of physical or mental health, fetal deviations, or rape or contraceptive failure because of pregnancy. The change in 2021 extended the pregnancy limit to 24 weeks for some of the women's categories and removed the need for the spouse's consent for unmarried women, taking a progressive step toward identifying individual agency. These changes empower women to create a reproductive alternative that aligns with global human rights standards, emphasising physical autonomy. However, the implementation of ACT reveals the gap that reduces efficiency. Social stigma, lack of awareness, and inadequate infrastructure for the health care system often prohibit access to safe abortion services, especially for marginalised women in rural areas. In addition, medical doctors' approval can limit autonomy, as it presents women's decisions for external verification. Judicial interventions and public health campaigns have tried to address these issues, but there are still differences in socio-economic and geographical divisions. The structure of the law also raises moral questions about balancing fetal rights with the mother's autonomy, especially in cases of late miscarriage. Comparative analysis with global abortion laws emphasises the need for further reforms, such as full abortion and ensuring universal access to reproductive health services. This study emphasises that while the MTP law has enhanced women's autonomy by providing legal support for reproductive alternatives, systemic obstacles and cultural biases continue to hinder its full implementation. Future political interventions should be focused on increasing access, reducing stigma, and promoting an environment where women can use their rights without fear or obstacle. By solving these challenges, the MTP law can do better as a foundation stone for gender and reproductive justice in India.