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).
- 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:
- Termination done by a medical practitioner approved by the Act
- Termination done at a place approved under the Act
- Termination done for conditions and within the gestation prescribed by the Act
- Other requirements of the rules & regulations are complied with
What are the conditions for terminating a pregnancy?
- 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
Who can perform an MTP?
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
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.
Where can MTP be conducted?
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 (1st trimester) should have
- Gynecology examination/ labor table
- Resuscitation and sterilization equipment
- Drugs & parental fluids
- Back up facilities for treatment of shock
- Facilities for transportation
Facilities that do MTP upto 20 weeks (1st and 2nd 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