Medical Termination of Pregnancy Act, 1971

The Medical Termination of Pregnancy Act, 1971 regulates when and by whom a pregnancy may lawfully be terminated in India. As amended in 2021, it permits termination on specified medical and humanitarian grounds rather than providing abortion on request.

Grounds for termination

A registered medical practitioner may terminate a pregnancy when continuation would risk the pregnant woman’s life, cause grave injury to her physical or mental health, or create a substantial risk of serious fetal abnormality.

• For pregnancies up to 20 weeks, the opinion of one registered medical practitioner is required.
• For pregnancies of 20-24 weeks, opinions of two registered medical practitioners are required, and the woman must belong to a category prescribed by the Rules, such as survivors of rape, minors, women facing specified changes in marital status, women with disabilities, or women in notified disaster or humanitarian settings.
• Beyond 24 weeks, termination for substantial fetal abnormalities may be permitted following diagnosis by a state or Union Territory Medical Board.
• The gestational limits do not apply when a registered medical practitioner considers termination immediately necessary to save the woman’s life.

Mental health and presumed injury

The Act expressly treats grave injury to mental health as a valid ground. In assessing risk, the practitioner may consider the woman’s actual or reasonably foreseeable environment.

• Mental anguish from a pregnancy alleged to have resulted from rape is presumed to constitute grave injury to mental health.
• Mental anguish caused by failure of a contraceptive method used by any woman or her partner is also presumed to constitute grave injury to mental health.

Consent, providers and confidentiality

Termination must be performed by a registered medical practitioner in a government hospital or another place approved for this purpose.

• The written consent of an adult pregnant woman is required; spousal consent is not required.
• For a woman below 18 years, or an adult who is a mentally ill person within the Act, written consent of the guardian is required.
• Under Section 5A, the practitioner must protect the woman’s identity and particulars, except when disclosure is authorised by law.
• Medical Boards include specialists such as a gynaecologist, paediatrician and radiologist or sonologist, along with any other notified members.