INTRODUCTION
In a country where legal landscapes often reflect a complex interplay of cultural, ethical and medical terrain, abortion law in India has evolved into one of the most congested areas of reproductive rights jurisprudence. India’s abortion law was conceived in 1971, a time when colour television had not reached most Indian homes, yet the very word ‘reproductive rights’ had already entered the legal vocabulary. At its core, the law sits at the intersection of personal choice, medical regulation, and constitutional values, requiring courts to continuously balance legal intent with lived realities.
Women have constantly faced oppression and abuse for centuries, whether in the form of rape, sexual assault, forced sex work or domestic abuse. Yet in the midst of all this, India’s abortion law has provided them with a choice. , an opportunity to actually live their lives despite what they might have faced. But is the choice actually a woman’s? India’s abortion law is guided by the Medical Termination of Pregnancy (MTP) Act, 1971.[1] Under the Act, access to abortion is shaped by the opinion of registered medical practitioners, meaning that while a woman’s consent is essential, it operates within a framework where medical approval plays a decisive role. This reflects a model where reproductive choice is recognised, but not entirely autonomous, as it remains mediated through clinical assessment and statutory conditions. By vesting the power of primary consent with the doctor and not the woman, the Act retains a regressive legal position vis-à-vis reproductive autonomy for women.”[2]
This blog examines the historical development of the abortion framework in India, the current framework governing abortion and the challenges faced by it.
HISTORICAL ROOTS
Abortion in India has evolved from a strict criminal offence to a regulated framework over the last century. Before 1971, abortion was strictly criminalised under Section 312 of the Indian Penal Code[3], punishable by up to 7 years in prison, except when done in good faith to save the woman’s life. This, in turn, led to an increase in maternal mortality. The limits of this approach made it clear that treating abortion purely as a crime was neither practical nor humane, and that it needed to be addressed as a matter of healthcare and public well-being. This shift, however, also meant that control over abortion moved largely into the hands of medical professionals rather than women themselves, a dynamic that still influences current challenges around access, autonomy, and procedural hurdles.
It was in the mid-1960s that the government set up the Shantilal Shah Committee and asked the group, headed by Dr Shantilal Shah, to look into the matter of abortions and decide if India needed a law for the same. Based on the report of the Shantilal Shah Committee, a medical termination bill was introduced in the Lok Sabha and Rajya Sabha and was passed by Parliament in August 1971.[4]
The Medical Termination of Pregnancy Act, 1971 marked India as a pioneer in liberalising abortion, originally, allowing termination up to 12 weeks on a single doctor’s opinion if it posed risks to the woman’s health or resulted from contraceptive failure, rape, or fetal anomalies. Amended in 2002 and significantly in 2021, it extended limits to a single doctor up to 20 weeks and two doctors for 20-24 weeks in specific cases like rape survivors or fetal issues, and beyond 24 weeks via medical boards for life threats or severe anomalies.[5]
MEDICAL TERMINATION OF PREGNANCY ACT 1971
The Medical Termination of Pregnancy Act, 1971, was enacted to provide a legal framework for terminating certain pregnancies by registered medical practitioners and to regulate matters incidental to it. This Act applies throughout India, except Jammu and Kashmir.[6] [7] It defines key terms such as ‘guardian’[8], ‘minor’[9], and ‘registered medical practitioner’[10], emphasising required medical qualifications and training.
It lays down conditions under which pregnancy may be terminated. The requirement of medical opinion, i.e. one practitioner up to 12 weeks and two between 12 and 20 weeks, places decision-making authority primarily with doctors rather than the pregnant woman.[11] While the grounds for termination, including risk to life, grave injury to physical or mental health, and foetal abnormalities,[12] appear broad, their interpretation is mediated through medical judgement. Even progressive inclusions like the presumption of mental injury in cases of rape or contraceptive failure in married women[13] reflect a framework that validates access indirectly rather than recognising abortion as an unconditional right.
Consent provisions further reveal this duality. While adult women must consent to termination, the requirement of guardian consent for minors and mentally ill persons reinforces a protective yet controlling approach.[14] Similarly, restrictions on places of termination[15] aim to ensure safety but also result in access barriers, especially across rural or under-resourced areas.
The rule-making powers under Sections 6 and 7, along with the good faith protection under Section 8, strengthen administrative and professional control but also reinforce the medicalised nature of law. Consequently, the Act represents a progressive yet limited model that facilitates access within boundaries that continue to shape debates on accessibility, autonomy, and reproductive rights.
KEY LANDMARK JUDGEMENTS
X v. Principal Secretary, Health and Family Welfare Department,[16] the Supreme Court transformed Indian abortion law by overturning the Delhi High Court’s exclusion of unmarried women from the MTP Rules. The Court held that marital status is constitutionally irrelevant to reproductive autonomy, and denying unmarried women access to abortion violates Article 14 by perpetuating arbitrary and discriminatory assumptions about legitimate pregnancies.
In Suchita Srivastava v. Chandigarh Administration,[17] the Supreme Court affirmed that reproductive choices are integral to Article 21’s right to life and dignity, rejecting forced abortion for a mentally challenged woman who wished to continue her pregnancy. The bench emphasised, “A woman’s right to make reproductive choices is a fundamental right”. It affirmed that reproductive choice, including the decision to carry a pregnancy to term or to terminate it form an integral dimension of personal liberty.
In Devika Biswas v. Union of India,[18] the Court struck down coercive sterilisation drives that violated women’s bodily integrity. The Court made clear that the State has no license to command a woman’s body, whether to compel continuation or forcible termination of pregnancy.
THE PERSISTING CHALLENGES
Women seeking an abortion in India often navigate a complex legal and moral maze where competing considerations of foetal rights and women’s autonomy arise. While Indian law does not recognise the foetus as a rights-bearing person, social attitudes frequently treat it as such, placing women under moral suspicion rather than treating abortion as a matter of healthcare. This tension reflects an imbalance that may undermine the effective exercise of women’s constitutional rights to privacy, bodily integrity, and decisional autonomy.
Access barriers exist. Rural women trek to urban clinics, facing costs and delays. Abortion law remains largely cisgender-centric, failing to account for transgender and gender-diverse persons capable of pregnancy, despite the recognition of gender identity, and sex selective abortion persists. In a place where abortion is legalized there are still instances that leave us shocked. For instance, reports of village midwives in Bihar admitting to the killing of newborn girls[19] underscore how restricted access, socio-cultural son preference, and regulatory gaps can lead to such practices outside the formal legal framework, thereby revealing the failure of abortion law to effectively prevent unsafe or illegal alternatives and to ensure safe, lawful access.
Despite recognising mental health as an integral part of well-being[20], the abortion law remains paternalistic, especially for minors, disregarding psychological trauma. For rape survivors, pregnancy itself is a continuation of violence. Mandatory reporting requirements under POCSO[21] can deter access to seek safe abortion services by raising concerns about breaching confidentiality and trust. This creates a legal conflict wherein healthcare providers are obligated to report under POCSO, while patients’ reproductive autonomy and privacy rights, grounded in constitutional protections, require confidentiality, thereby discouraging timely medical intervention and undermining access to safe abortion services.
CONCLUSION
India’s abortion law occupies a fascinating and unresolved space. The MTP Act and its 2021 amendment represent genuine legislative progress. Further, the Supreme Court’s decisions in Suchita Srivastava and X v. Principal Secretary have strengthened reproductive autonomy in the constitutional sphere. Yet the law remains medicalised, access-constrained and unevenly implemented.
The question ‘whose body, whose choice?’ is not merely rhetorical. It defines that the State ultimately holds power over the most intimate terrain of a woman’s life. While the Indian courts have repeatedly answered with clarity that the choice belongs to the women, challenges pertain. The law has taken several long strides, but the journey is not yet over.
Author’s Name: Ojaswini Jaswal (Shoolini University)
References:
[1] Medical Termination of Pregnancy Act, 1971, No. 34, Acts of Parliament, 1971
[2] Pragya Singh, MTP(Amendment) Act 2021:A Missed Opportunity for Women’s Reproductive Autonomy in India? (https://www.gprf.org.in/post/mtp-amendment-act-2021-a-missed-opportunity-for-women-s-reproductive-autonomy-in-india, April 27, 2021) accessed 16 February 2026
[3] Indian Penal Code, 1860, Sec 312
[4] Abortion Law in India (https://www.drishtiias.com/daily-updates/daily-news-analysis/abortion-law-in-india, July 25, 2022) accessed 17 February 2026
[5] Medical Termination of Pregnancy Act, 1971, No. 34, Acts of Parliament, 1971
[6] Removed by Jammu and Kashmir Reorganisation Act, 2019, effective from October 31, 2019
[7] Medical Termination of Pregnancy Act, 1971, Sec 1
[8] ibid s 2(a)
[9] ibid s2(b)
[10]ibid s2(d)
[11] ibid s 3(2)
[12] ibid s 3(2)(i)-(ii)
[13] ibid. Explanation 1 and 2 to s 3
[14] ibid s 3(4)
[15] ibid s 4
[16] X v. Principal Secretary, Health and Family Welfare Department, Govt. of NCT of Delhi, (2022)14 SCC 1. Hereinafter referred to as ‘X v. Principal Secretary’
[17] Suchita Srivastava v. Chandigarh Administration (2009) 9 SCC 1
[18] Devika Biswas v. Union of India, (2016) 10 SCC 726
[19] BBC News India, In an Indian village, midwives make a shocking confession- BBC World Service Documentaries (September 11, 2024) https://youtu.be/3rIS5kgZVsQ?si=iOMZPw1gcAE-1lv6 accessed on February 17, 2026
[20] Mental Healthcare Act, 2017, s 2, 18
[21] Protection of Children from Sexual Offences Act, 2012, s 19
