“Life begins at conception,” Tamil Nadu Assembly Speaker JCD Prabhakar said at a recent anti-abortion event in Chennai. This triggered questions around abortion rights, access, legality, reproductive autonomy, and the role of the State, all of which require a considered and evidence-based response.
This moment warrants an effort to understand how abortion is perceived in a country where reproductive autonomy has been under Article 21 (Protection of life and personal liberty) and where abortion, though broadly criminalised under the Bharatiya Nyaya Sanhita, is legally permitted within the framework of the Medical Termination of Pregnancy (MTP) Act.
At the same time, it also offers an opportunity to reflect on the narratives shaping abortion discourse in India, who gets to define them, and whose experiences are heard. While individuals are entitled to personal religious beliefs, can a constitutional authority invoke theological doctrine to undermine women's legally and constitutionally protected rights?
India has one of the more progressive legal frameworks on abortion globally. Successive amendments to the MTP Act have expanded the circumstances under which abortion can be accessed, increased gestational limits, and strengthened legal protections around confidentiality.
Yet on the ground, this legally permissive framework doesn’t always translate to accessible services for comprehensive abortion care, more so for adolescents and people marginalised by their identities and geographical barriers.
The law still does not recognise abortion “on request”, access continues to be mediated through statutory conditions, gestational limits, and required permission from registered medical practitioners and authorised facilities; the addition of medical boards in the 2021 MTP (Amendment) Act has furthered third party authorisation. In practice, abortion seekers continue to struggle with multiple intersecting barriers such as finding a trained provider, an authorised facility, affordable care, or timely services. Provider discretion, pervasive stigma, lack of information, geographical distances, and fear of disclosure further shape whether and when care can be accessed.
The legal framework also leaves important gaps.
The Act remains deeply cis-normative, using gendered language such as “pregnant woman” and failing to recognise the needs of LGBTQIA+ people who can become pregnant. The criminal law provisions on causing miscarriage and the Transgender Persons (Protection of Rights) Amendment Act, 2026, which replaces self-identification with bureaucratic medical boards for legal gender recognition create a rigid, punitive administrative environment and can further exclude transmasculine, non-binary, and other queer people from accessing abortion care.
Abortion occupies a paradoxical space in India. It is both legally permitted and medically a commonplace pregnancy outcome, with millions of abortions occurring each year. Yet the public conversations tend to frame abortion through stigma, risk, morality, or the need to justify the decision to seek one. This leaves little room for narratives of agency, relief, responsible decision-making, or simple bodily autonomy.
The absence of positive narratives is itself an important dimension of stigma.
When people rarely see abortion represented as a legitimate and ordinary part of reproductive life, secrecy, guilt, and isolation are reinforced. A potent illustration of this negative framing lies in campaigns against sex determination and selection. While addressing the serious and deeply rooted problem of gender discrimination, some campaigns have relied on the language of “foeticide” and grotesque foetal imagery. Such representations have unintentionally reinforced the idea that abortion is inherently violent, immoral, or socially harmful, rather than a form of healthcare that may be necessary for a person’s health, dignity, and life circumstances. Abortion is both life-affirming and choice-affirming healthcare.
These very stigmatising narratives are increasingly exploited by organised anti-choice mobilisation. Such mobilisation often attempts to appropriate the language of gender justice and rights, frame opposition to abortion through moral and constitutional rhetoric, and use educational institutions and social media to influence young people and shape public perceptions.
This brings us back to Tamil Nadu, where moralistic views and pressure from conservative groups led to a regulatory crackdown in 2006 and contributed to the continuing de facto ban on emergency contraceptive pills (ECP). This exemplifies the chilling effects of such anti-choice rhetoric on reproductive autonomy.
When policy and political or institutional actors signal disapproval, whether explicitly or implicitly, it influences not only providers and pharmacies but also individuals’ willingness to seek reproductive health services. The instructions issued by the state’s health and family welfare department did little to address private pharmacy access or the informal rulebook that many chemists follow, creating a grey area where access becomes a matter of individual chemist discretion rather than legal entitlement.
Furthermore, the criminal framework under the Bharatiya Nyaya Sanhita, which still treats abortion as an offence with statutory exceptions, perpetuates ongoing chilling effects and confusion among both providers and seekers. Doctors remain unsure of their legal liabilities and individuals remain unsure of their rights, a state of ambiguity that serves anti-choice interests far more effectively than any direct legal prohibition could.
It is therefore important for the pro-choice and reproductive rights movement to move beyond responding to restrictive narratives of such groups and invest in positive, evidence-based, and rights-affirming public narratives that centre women’s agency, lived experiences, and reproductive autonomy. The framing of abortion must shift from a narrow, medicalised exception to a continuum within reproductive and mental health discourses. Positive and destigmatising representations of abortion are a public health imperative. When abortion is positioned as routine reproductive healthcare within a broader continuum of mental and physical wellbeing, the focus shifts from moral judgement to dignity, safety, and justice for all women, especially the most marginalised.
Finally, decriminalisation, that is, removing abortion entirely from penal codes, would fundamentally transform the landscape. It would enable a rights-based healthcare approach where access is equitable, stigma-free, and grounded in the pregnant person's informed choice rather than being vulnerable to State approval, medical gatekeeping, or the whims of political actors.
Recent developments in Tamil Nadu serve as a stark reminder that legal rights, however progressive on paper, remain fragile in the face of organised political and social resistance. Without narrative change, institutional accountability, and full decriminalisation in the longer term, reproductive autonomy in India will remain a promise only partially kept, a right that exists in the law books but doesn’t extend to clinical realities and lived experience.
Dr Alka Barua is a public health and development professional with experience in sexual and reproductive health and rights, health systems, and policy.
Dr Souvik Pyne is a development professional with interest in youth engagement and sexual and reproductive health and rights.
Ragini Bordoloi is a youth sexual and reproductive health and rights advocate and public policy professional working on the intersection of women's health and gender policy.
Views expressed are the authors' own.