The Ministry of Health and Family Welfare (MOHFW) has announced an amendment to the Medical Termination of Pregnancy (MTP) Rules, 2003. This amendment introduces inclusive language in respect of women with mental infirmities. This amendment was published on June 18, 2024.
Focus on Person-Centered Language
The amendment replaces the term “mental retardation” with “women with intellectual disability“. This change is effected, both, in the rules and the related application Form E.
Change in Rules
It may be recalled that on October 12, 2021, the MOHFW had published the Medical Termination of Pregnancy (Amendment) Rules, 2021. These rules introduced sweeping changes in permitting women to obtain medical termination of pregnancy. One such change was the introduction of Rule 3B. Rule 3B permits specified categories of women to obtain termination of pregnancy up to twenty-four weeks of gestation.
(a) survivors of sexual assault or rape or incest;
Rule 3B of Medical Termination of Pregnancy Rules, 2003
(b) minors;
(c) change of marital status during the ongoing pregnancy (widowhood and divorce);
(d) women with physical disabilities
(e) mentally ill women including mental retardation;
(f) the foetal malformation that has substantial risk of being incompatible with life or if the child is born it may suffer from such physical or mental abnormalities to be seriously handicapped; and
(g) women with pregnancy in humanitarian settings or disaster or emergency situations as may be declared by the Government.”
Now, therefore, the present amendment notification has modified the term “mental retardation” in the above category (e) for a more inclusive term of “women with intellectual disability“. Therefore, the category of mentally ill women would now include women with intellectual disabilities. This change permits women with intellectual disabilities to obtain termination of pregnancy up to twenty-four weeks of gestation.
Change in Form E
The amendment rules have also reflected this update in terminology in the Form E that was first introduced by MTP (Amendment) Rules, 2021. Form E is called the Opinion Form of Registered Medical Practitioners.
It specifically applies to cases where the gestation age is beyond twenty weeks and up to twenty-four weeks. The form lists the same above-stated categories of women as circumstances appropriate for termination of pregnancy beyond twenty weeks till twenty-four weeks. The Registered Medical Practitioners (RMPs) are required to specify any of the relevant circumstances for carrying out the termination of pregnancy.
Hence, the same change in terminology of “mental retardation” for a more inclusive term of ““women with intellectual disability” is also reflected in this form.
It is therefore pertinent to understand the definition of intellectual disability in the light of Rights of Persons with Disabilities Act, 2016. The Act defines intellectual disability as a condition characterised by significant limitation both in intellectual functioning (reasoning, learning, problem solving) and in adaptive behaviour which covers a range of every day, social and practical skills.
These include:
(a) specific learning disabilities. This means a heterogeneous group of conditions wherein there is a deficit in processing language, spoken or written, that may manifest itself as a difficulty to comprehend, speak, read, write, spell, or to do mathematical calculations and includes such conditions as perceptual disabilities, dyslexia, dysgraphia, dyscalculia, dyspraxia and developmental aphasia and
(b) autism spectrum disorder. This refers to a neuro-developmental condition typically appearing in the first three years of life that significantly affects a person’s ability to communicate, understand relationships and relate to others, and is frequently associated with unusal or stereotypical rituals or behaviours.
Reason for Change
The updated terminology aligns with the Rights of Persons with Disabilities Act, 2016, promoting person-centered language that respects the dignity of individuals with intellectual disabilities.
This change in terminology aims to reduce stigma associated with intellectual disability and promote respectful language within the medical termination of pregnancy process.
