Beyond the Womb: Analyzing the MTP Amendment of 2021 and the Evolving Jurisprudence on Bodily Autonomy in India

Published On: October 7th 2025

Authored By: Dheepshika M

Chennai Dr Ambedkar Government Law College, Pudupakkam

Abstract

Reproductive rights, a cornerstone of personal liberty and bodily autonomy, have been a complex and evolving legal and social issue in India. While these rights encompass both men and women, the legal framework in India, particularly through the Medical Termination of Pregnancy (MTP) Act, 1971, has focused predominantly on women’s right to control their own reproductive choices, including the right to procreation and safe abortion. The enactment of the MTP Act by the Indian Parliament marked a significant departure from the criminalization of abortion under the Indian Penal Code, a reform largely prompted by the recommendations of the Shantilal Shah Committee in 1966.^[1]

The MTP Act has since been amended, with the most recent and significant changes coming through the Medical Termination of Pregnancy (Amendment) Act, 2021. Passed by Parliament in March 2021 and brought into effect on September 24, 2021, this amendment expanded the termination period and, critically, extended the right to seek an abortion to unmarried women, dismantling a long-standing discriminatory provision.This landmark legislation expanded the gestational limits for termination and, critically, extended the right to seek an abortion to unmarried women, dismantling a long-standing discriminatory provision. This legislative progress has been further championed by the judiciary. In a landmark 2022 ruling, the Supreme Court of India affirmed that any distinction between married and unmarried women regarding abortion access was unconstitutional, cementing the right to reproductive autonomy as intrinsic to the right to life and personal liberty under Article 21 of the Constitution.

This article will evaluate the transformative impact of the 2021 MTP Amendment, analyze the judiciary’s expanding role in protecting bodily autonomy, and critically examine the persistent challenges that hinder the effective implementation of these rights on the ground.

Medical Termination of Pregnancy Act,1971

The Medical Termination of Pregnancy (MTP) Act of 1971 legalizes abortion in India under specific circumstances, providing women with the right to bodily autonomy. Previously considered an offense under the Indian Penal Code, abortion is now permissible for various reasons, including risks to the mother’s health, fetal abnormalities, and social, economic, or personal situations. The act covers both medical and surgical abortions.^[2]

Types of MTP

Medical abortion uses medications like Mifepristone and Misoprostol and is highly effective (95-98% success rate) for pregnancies up to nine weeks.

Surgical abortion has a nearly 100% success rate when performed by trained professionals. It includes two main procedures:

Manual Vacuum Aspiration (MVA): Used in the first trimester, this procedure removes the pregnancy using suction.
Dilation and Evacuation (D&E): This is used for later pregnancies and involves dilating the cervix before removing the pregnancy tissue.

Both surgical methods are quick and safe, with minimal recovery time.^[3]

Legal and Procedural Requirements

The MTP (Amendment) Act of 2021 extended the legal limit for pregnancy termination from 20 to 24 weeks. The process for seeking an abortion depends on the length of the pregnancy:

Up to 12 weeks: Requires the approval of a single registered medical practitioner (RMP).
12 to 20 weeks: Requires the approval of two RMPs.
Beyond 20 weeks: Requires approval from a medical board.

This act ensures that women can make informed decisions about their reproductive health while adhering to proper medical and legal guidance.

Consent for Termination of Pregnancy

Consent for a pregnancy termination must be obtained from the woman, provided she has not been subjected to sexual assault, either physical or mental, such as rape. If the woman is a minor or has a mental illness, consent from her legal guardian is required.

Grounds for termination include:

Medical reasons: This is the primary reason and includes situations where the fetus has abnormalities or the pregnancy poses a risk to the mother’s health.
Socio-economic reasons: This is a secondary reason and includes financial instability of the couple, lack of interest in having children due to personal issues, or other social reasons.
Special circumstances: Termination is also permitted in cases of rape or sexual assault. Additionally, if the woman is a minor or has a mental illness, she may not be able to carry the pregnancy to term.^[4]

Medical Termination of Pregnancy Amendment Act (2021)

The Medical Termination of Pregnancy (MTP) Amendment Act of 2021 extended the upper gestational limit for abortion in India from 20 to 24 weeks for certain categories of women. This extension was made to accommodate women who may face unique challenges that delay their awareness of pregnancy or their ability to access timely abortion services.^[5]

The special categories of women eligible for the 24-week limit include:

Survivors of sexual assault, rape, or incest.
Women whose marital status has changed during the pregnancy (such as due to widowhood or divorce).
Women with physical disabilities or mental illness.
Women carrying a fetus with a substantial risk of serious abnormalities.
Women in humanitarian, disaster, or emergency situations.

The reasons for this extension are rooted in the understanding that these women often experience delays. For example, survivors of sexual assault may not realize they are pregnant until later, minors may face difficulties accessing services due to a lack of parental consent, and the diagnosis of fetal abnormalities can be a time-consuming process. Additionally, social and economic factors can create systemic barriers to healthcare for women in marginalized communities.

The Medical Termination of Pregnancy (Amendment) Act, 2021: A Step Towards Women’s Autonomy

The Medical Termination of Pregnancy (Amendment) Act, 2021, represents a significant evolution in India’s legal framework for reproductive rights. By centering women’s autonomy and dignity, the legislation modernizes the approach to abortion, expanding access and providing critical protections. The amendment addresses several key areas, from consent and gestational limits to privacy and the role of healthcare providers, marking a progressive shift in the nation’s healthcare policy.

Emphasis on Consent and Autonomy

The 2021 amendment makes crucial changes to empower women by expanding their choices and recognizing a broader range of personal circumstances.

Expanded Gestational Limits: A major change is the increase in the gestational limit for abortion. The act allows for termination up to 20 weeks with the opinion of one Registered Medical Practitioner (RMP). For specific categories of women, the limit is extended to 24 weeks, requiring the opinion of two RMPs. This adjustment acknowledges medical advancements and the complex realities that can lead to a late-term decision, such as a change in a woman’s health or the detection of fetal abnormalities.
Recognition Beyond Marriage: The amendment’s language is more inclusive, using “any woman or her partner” instead of the previous “married woman or her husband.” This change legally affirms the reproductive rights of unmarried women and those in non-traditional relationships, dismantling a long-standing discriminatory barrier.
Conditional Consent: While the amendment is a positive step, it stops short of granting unconditional abortion rights. The final decision remains with the RMP, meaning a woman’s consent alone is not sufficient. Critics argue that this requirement, while intended to ensure medical safety, could still be seen as undermining full reproductive autonomy by making a woman’s body subject to medical gatekeeping.

Confidentiality and Privacy Protections

To protect women from social stigma and discrimination, the amendment introduces a robust privacy clause.

Section 5A – Privacy Clause: This newly added section makes it illegal for an RMP to disclose the identity or personal details of a woman who has undergone an abortion. Exceptions are only made for individuals legally authorized to receive such information. Violations are punishable by imprisonment, fines, or both, providing a strong legal safeguard against breaches of privacy.
Legal Safeguards: This confidentiality provision is particularly impactful in a country where social stigma surrounding abortion can be severe. It aims to protect women’s reputations and prevent potential discrimination, especially in conservative or rural communities, thereby encouraging safer, legal abortions over unsafe alternatives.

The Role of the “Registered Medical Practitioner” (RMP)

The amendment also refines the definition of who can legally perform an abortion, thereby improving accessibility.

Terminological Shift: The Act replaces the term “doctor” with “Registered Medical Practitioner” (RMP). This broadens the scope of qualified providers to include not only MBBS doctors but also others with recognized qualifications in gynecology and obstetrics, as specified by the Act’s rules.
Practical Implications: This change is crucial for improving access to abortion services, especially in rural or underserved areas where specialists may not be readily available. By allowing a wider range of qualified healthcare professionals to perform abortions, the amendment helps ensure that more women can access safe, legal care without compromising on medical standards.^[6]

Criticism of MTP Act

Critics of India’s MTP Act argue that it still doesn’t grant women complete bodily autonomy. The law remains doctor-centric, meaning a medical professional’s opinion can override a woman’s personal choice. Although the law expands the gestational limit to 24 weeks, this is only for specific categories of women and requires judicial approval in later cases, creating stressful bottlenecks. The Act is also criticized for its lack of consideration for mental health and socio-economic distress. Furthermore, there’s a significant urban-rural divide in access to safe facilities and trained doctors. The law’s use of gendered language also excludes transgender and non-binary people who may become pregnant.

Key difference between MTP Act 1971 and 2021^[7]

Basis	MTP Act 1971	MTP Amendment Act 2021
Termination due to Contraceptive failure	Applicable only to married women	Unmarried women are also covered up to 20 weeks
Upper Gestation limit for special categories	20 weeks for all indications	Increase from 20 to 24 weeks for rape survivors, victims of incest and other vulnerable women
Opinion needed for termination of pregnancy	● 1 RMP till 12 weeks ● 2 RMPs till 20 weeks	● 1 RMP till 20 weeks ● 2 RMPs 20-24 weeks ● Abortion beyond 24 weeks only in situations where a medical board certifies significant foetal abnormalities and authorizes abortion.
Invasion of the woman’s privacy	Up to Rs 1000 fine	Fine and/or imprisonment of 1 year

Conclusion

The Medical Termination of Pregnancy (Amendment) Act, 2021, is a landmark piece of legislation that moves India’s reproductive rights framework closer to international standards. By expanding access, ensuring privacy, and embracing a more inclusive approach, the Act signifies a progressive step toward recognizing and protecting the autonomy and dignity of all women.