Medical Termination of Pregnancy Act (MTP)

MTP Act – 1971 with amendments in 2002 is an enabling act

Aims to improve the maternal health scenario by preventing large number of unsafe abortions and consequent high incidence of maternal mortality & morbidity
Legalizes abortion services
Promotes access to safe abortion services to women
De-criminalizes the abortion seeker
Offers protection to medical practitioners who otherwise would be penalized under the Indian Penal Code (sections 315-316).

MTP Act amendment 2002

Decentralizes site registration to a 3-5 member district level committee chaired by the CMO/DHO
Approval of sites that can perform MTPs under the act can now be done at the district level
Stricter penalties for MTPs being done in an un-approved site or by a person not permitted by the act.

Abortions are termed legal only when all the following conditions are met:

Continuation of pregnancy constitutes risk to the life or grave injury to the physical or mental health of woman
Substantial risk of physical or mental abnormalities in the fetus as to render it seriously handicapped
Pregnancy caused by rape (presumed grave injury to mental health)
Contraceptive failure in married couple (presumed grave injury to mental health)

When can pregnancies be terminated?

Up to 20 weeks gestation

With the consent of the women alone who is above 18 years, If the women is below 18 years or is mentally ill, then with consent of a guardian
With the opinion of a registered medical practitioner, formed in good faith, under certain circumstances

Opinion of two RMPs required for termination of pregnancy between 12 and 20 weeks

A medical practitioner (RMP)

who has a recognized medical qualification as defined in clause (h) of section 2 of Indian Medical Council Act, 1956
Whose name has been entered in a State Medical Register and
Who has such experience or training in Gynecology and Obstetrics as prescribed by Rules made under the Act

Training requirement

For termination up to 12 weeks:

A practitioner who has assisted a registered medical practitioner in performing 25 cases of MTP of which at least 5 were performed independently in a hospital established or maintained or a training institute approved for this purpose by the Government

For termination up to 20 weeks

A practitioner who holds a post-graduate degree or diploma in Obstetrics and Gynecology
A practitioner who has completed six months house job in Obstetrics and Gynecology
A practitioner who has at least one-year experience in practice of Obstetrics and Gynecology at a hospital which has all facilities
A practitioner registered in state medical register immediately before commencement of the Act, experience in practice of Obstetrics and Gynecology for a period not less than three years.

A hospital established or maintained by Government or

A place approved for the purpose of this Act by a District-level Committee constituted by the government with the CMHO as Chairperson

Facilities that do MTP upto 12 weeks (1^st trimester) should have

Facilities that do MTP upto 20 weeks (1^st and 2^nd trimester) should have

All requirements for up to 12 weeks, plus
Operation table and instruments for performing abdominal or gynecological surgery
Anesthetic equipment, resuscitation equipment and sterilization equipment
Drugs & parental fluids notified for emergency use, notified by Government of India from time to time

MTP using Mifepristone & Misoprostol approved for up to 7 weeks termination
Only an RMP (as defined by the MTP Act) can prescribe the drugs
Has to follow MTP Act, Rules & Regulations
Can prescribe in his/her clinic, provided he/she has access to an approved place
Should display a certificate from owner of approved place agreeing to provide access