Decisional Autonomy and Abortion Law In India: Evaluating The Medical Termination of Pregnancy(MTP) Act, 1971, and Its 2021 Amendment In The Light Of International Human Rights Standards

Abstract

Although abortion is legally permitted in India under the Medical Termination of Pregnancy Act, 1971, access to safe and timely termination continues to be shaped by procedural and institutional constraints. These regulatory controls significantly affect women’s ability to exercise decisional autonomy in matters of reproduction. This paper examines the extent to which the existing legal framework recognises and enables reproductive decision-making, situating the analysis within the constitutional guarantees of equality, privacy, dignity, and personal liberty under Articles 14 and 21 of the Constitution of India. Using a doctrinal analysis of the MTP Act and its 2021 amendment, along with an examination of key judicial decisions, the study argues that the current regime remains largely medicalised and paternalistic. While constitutional courts have expanded the scope of reproductive rights by recognising abortion as an aspect of bodily autonomy and privacy, access in practice continues to depend on medical authorisation, procedural requirements, and, in certain cases, judicial intervention. These structural barriers disproportionately affect socially and economically marginalised groups. The paper further engages with international human rights standards to demonstrate that restrictive abortion frameworks may amount to gender-based discrimination and undermine the right to health. Drawing on comparative constitutional developments, particularly the recent withdrawal of constitutional protection for abortion rights in the United States, the study highlights the risks associated with weakening rights-based protections. It concludes by arguing for a re-orientation of Indian abortion law towards a framework which centres decisional autonomy while also ensuring safe, accessible and equitable reproductive healthcare.