Abortion in India: what the MTP Act allows and whose consent counts

Many women believe abortion is illegal in India, or that they need a husband's or family's signature. Neither is true, and these myths push women towards unsafe providers. The Medical Termination of Pregnancy Act, 1971, amended in 2021, says when, where and by whom a pregnancy can be ended. This guide answers the questions women actually ask: up to what week, whose permission, where to go, and what if a hospital refuses.

When abortion is allowed

Under Sec 3 MTP Act, a registered medical practitioner (RMP, a doctor with the training the Rules require) may end a pregnancy if continuing it would risk the woman's life or cause grave injury to her physical or mental health, or if there is a substantial risk that the child would be born with serious physical or mental abnormalities. The Act itself treats the anguish caused by a pregnancy from rape, or from failure of a contraceptive used by a woman or her partner, as a grave injury to mental health. So contraceptive failure is a legal ground.

The number of doctors needed depends on how far the pregnancy has advanced:

• Up to 20 weeks: the opinion of one RMP (Sec 3(2)(a)).
• 20 to 24 weeks: the opinion of two RMPs, for women in the categories listed in Rule 3B, MTP Rules (Sec 3(2)(b)): survivors of sexual assault, rape or incest; minors; women whose marital status changed during the pregnancy (widowed or divorced); women with physical disabilities; women with mental illness; cases of foetal malformation; and women in humanitarian or disaster settings declared by the government.
• Beyond 24 weeks: only where a state Medical Board finds substantial foetal abnormalities (Sec 3(2B)); the Rules ask it to decide within three days.
• Any stage, to save life: one doctor may act at any time if termination is immediately necessary to save the woman's life (Sec 5).

In other situations beyond 24 weeks, women have approached High Courts and the Supreme Court, which have allowed termination in some cases after a medical board report. In May 2026 the Supreme Court, in a minor rape survivor's case, observed that Parliament may consider removing time limits for such cases. As of October 2026, the law has not changed.

Whose consent is needed

An adult woman's own written consent is enough (Sec 3(4)). The Act does not require the consent of a husband, partner, parents or in-laws. Only for a girl below 18, or a woman with mental illness who cannot consent, is a guardian's written consent needed.

In X v. Principal Secretary, Health and Family Welfare Department (2022), the Supreme Court held that the "change of marital status" category cannot be read to exclude unmarried women: a woman in a consensual relationship has the same right to abortion up to 24 weeks as a married woman. The Court also held that, for the MTP Act, "rape" includes forced sex by a husband, so a married woman can seek termination as a survivor. It rooted these rights in reproductive autonomy, dignity and privacy under Art 21.

Where and how it is done

• Abortion must be done by an RMP at a government hospital or a place approved by the government (Sec 4). Ask to see the approval certificate at a private clinic.
• Early abortion with medicines (the "MTP pill") is legal up to nine weeks under the Rules, but only when prescribed by an RMP with access to an approved facility for emergencies.
• Government hospitals and many community health centres provide the service free. Private hospitals charge; ask for the cost in writing first.
• Your name and details are confidential. An RMP who reveals them to anyone not authorised by law commits an offence (Sec 5A).
• Sex-selective abortion is a separate crime under the PC-PNDT Act, 1994.

Step by step

1. Confirm the pregnancy and its stage with a urine test and an ultrasound. Weeks are counted from the first day of your last period, not from when you found out.
2. See the gynaecologist and say clearly that you want to end the pregnancy. If you are within 20 weeks, one doctor's opinion is enough. You sign the consent form yourself; nobody else signs.
3. Choose the method with the doctor: medicines (up to nine weeks) or a short procedure. Ask when to come back and which warning signs need urgent care.
4. If the hospital refuses or delays, ask for the refusal in writing and go to the District Chief Medical Officer the same day. Refusing because you are unmarried, or because your husband has not signed, is unlawful.
5. If you are past 24 weeks, or the Board refuses, call 15100 immediately; a High Court petition can be heard within days, but every week matters.