Medical Termination of Pregnancy

1. The Medical Termination of Pregnancy
Act, Rules, Amendments
-by
Dr Sayan Das
DMCHO, South 24 parganas

2. Background (1/2)
• IPC 312: Any one voluntarily causing miscarriage to woman with child, other
than in good faith for purpose of saving her life is punishable by imprisonment
(simple or rigorous) up to 3 years, with /without fine. Women who caused her
self to miscarry are also counted.
• IPC 313 (Abortion without consent): Punishable by life imprisonment
or up to 10 years with fine
• IPC 314 (death due to procedure): Imprisonment up to 10 years with
fine, may be extended to life imprisonment if with out consent.

3. Background (2/2)
• In 1964: Maternal mortality increases
• Married women under no socio-cultural pressure – seeking
abortion service
• Abortion is illegal- opted for unsafe method- maternal mortality
• The Shah Committee appointed by GOI-recommended
legislation in 1966- some state wants it to decrease population
• Committee denies it
• In 1971, The Medical Termination of Pregnancy (MTP) Act
passed- applied all over India except Jammu & Kashmir in 1972
• Jammu & Kashmir and Mizoram adopted in 1980
GOI: Government of India

4. The MTP Act, Rules, Amendments
• The Medical Termination of Pregnancy Act, 1971 (Act No. 34 of
1971)
• The Medical Termination of Pregnancy Rules, 1975
• The Medical Termination of Pregnancy (Amendment) Act, 2002
(Act No. 64 of 2002)
• The Medical Termination of Pregnancy Rules, 2003
• The Medical Termination of Pregnancy (Amendment) Act 2021
(Act No. 8 of 2021)

5. The MTP Act (no 34 of 1971)
• Can be terminated up to 20 weeks of pregnancy
• Requires a second doctor’s approval- if beyond 12 weeks
• When Conducted -
o To save the life of mother or it cause grave physical or mental
illness
o When pregnancy is due to rape
o Contraceptive failure in married women
o Substantial risk that if child born, would be seriously affected with
mental and/or physical disability
o Written Consent:
 By the woman
 By legal guardian, if women is lunatic or minor

6. The MTP Act (no 34 of 1971)
• Who can Conduct-
o Registered Medical Practitioner with recognize medical
qualification in Clause(b) Section 2 of The Indian Medical
Council Act, 1956
o Registered in any State Medical Register
o Have training experience as per MTP rules

7. Experience required as per the MTP rules,1975
o Up to 12 weeks
 1 years experience in G&O department
 6 months of House Surgeon ship in G&O
Worked with an RMP- 25 cases done 5 of which by own
Before commencement of act- minimum 3 years of
experience
o From 12 weeks to 20 weeks
PG degree or diploma in G&O
Completed 6 months of House staff ship in G&O
At least one year experience in G&O at any Government
Hospital have all facilities
RMP: Registered Medical Practitioner, G&O: Gynecology & Obstetrics

8. Abortion in 1970-2000
• 1972 to 1986: 10% increase in abortion
• In 90s: shows decline trends
• 2/3rd facilities are urban
• Less than 10% of estimated abortion reported
• 2-11 illegal abortion performed per single legal case
• Thus all are not unsafe, when done at unapproved place
• In most states: less 20% PHC provide abortion services
• Both public & private: poor technique, counselling, privacy
• Dilatation & Curettage preferred than vacuum aspiration

9. Abortion law reform since 2000
• Act amended - 2002, Rules and Regulation amended – 2003
• Power shift to district level from state level
• Provision of punishment 2-7 year for provider & owner of
unapproved place
• Approval with in 60 days with inspection by CMO/DLC or with in
60 days after rectification of any deficiency found
• Facilities dose not requires onsite management of emergency
• Allow medical abortion facility (up to 7 weeks)
 RMP dose not need approval from DLC for place
 Only registered doctor can prescribe
 Need to follow all rules and regulation under MTP Act
Rules and Regulations formed in 1975 previously, CMO: chief Medical Officer, DLC: District Level Committee

10. The MTP (Amendment) Act, 2021 (1/2)
• Allows abortion for up to 20 weeks based on the judgement of
one medical practitioner.
• 2 doctor’s consent required - pregnancies between 20-24 weeks.
• The District Level Medical Board - evaluate whether abortions
after 24 weeks are permissible based on significant foetal
abnormalities only
• The writ petition has to be filed - rape and a gestation period of
more than 24 weeks.
• Up to a period of 20 weeks by a married woman if a
contraceptive method or device fails. The amended act has also
allowed unmarried women to terminate a pregnancy under such
circumstances.

11. The MTP (Amendment) Act, 2021 (2/2)
• No registered medical practitioner shall reveal the name and
other particulars of a woman whose pregnancy has been
terminated under this Act except to a person authorized by any
law for the time being in force
• No registered medical practitioner shall reveal the name and
other particulars of a woman whose pregnancy has been
terminated under this Act except to a person authorized by any
law for the time being in force

12. How to apply for MTP License & Reporting
• Pre-requisite: CE License
• Apply in Form No A
• Inspection from CMOH Office
• District Level License committee meeting
• Issuance of License in Form No B
• Quarterly reporting to RCH section of CMOH Office
Note: Mandatory consent from mother
to be taken in Form C for each case

13. Safer abortion – Better reproductive health
Thank You