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Medical Termination of Pregnancy (MTP)

Medical Termination of Pregnancy is legalized abortion. There are many countries where abortion is yet to be legalized. In India, abortion was legalized through "Medical Termination of Pregnancy Act" of 1971, which came in force from April '72. The provisions of the act have been revised in '75.

WHEN IS MTP REQUIRED?

Since the legalization of abortion in India, deliberate induction of abortion by a Registered Medical Practitioner in the interest of mother’s health and life is protected under the MTP act. The following provisions are laid down:

  • The continuation of pregnancy would involve serious risk of life or grave injury to the physical and mental health of the pregnant woman.

  • There is a substantial risk of the child being born with serious physical and mental abnormalities so as to be handicapped in life.

  • When the pregnancy is caused by rape both in cases of major or minor girl and in mentally unbalanced women.

  • Pregnancy caused as a result of failure of a contraceptive used by any married woman or by her husband.

In practice, the following are the indications for termination under the MTP Act:

  • To save the life of the mother (therapeutic or Medical termination): The indications are limited and scarcely justifiable now a days except in the following cases:

    1. Pulmonary tuberculosis, when superimposed pregnancy deteriorates the conditions.
      Cardiac diseases like abnormalities of the valves with history of complications in the previous pregnancy or in between pregnancies are justifiable indications for termination of the first trimester.
      Chronic glomerulonephritis
      Malignant Hypertension
    2. intractable hyperemesis gravidarum
    3. Epilepsy or psychiatric illness with the advice of a psychiatrist.

  • Social indications: This is almost the sole indication and is covered under the provision "to prevent grave injury to the physical and mental health of the pregnant woman". In about 80%, it is limited to women already having children, with an unplanned pregnancy with low socioeconomic status. Pregnancy caused by rape or unwanted pregnancy caused due to failure of any contraceptive device also falls in this category (20%).

  • Fetal causes: This is done under the provision of "substantial risk of the child being born with serious physical and mental abnormalities so as to be handicapped in life". The indication is rare.

    1. Genetic and other abnormalities of the fetus, which are known to transmit certain inherited disorders.

    2. When the fetus is likely to be deformed due to action of teratogenic drugs or radiation exposure in early pregnancy. Having taken hormones either in form of tablets or injections for delayed periods or accidental pelvic X-ray (having less than 10 rad) is not a justifiable indication for termination, especially in first pregnancy.
  • Rubella, a viral infection affecting in the first trimester, is an indication for termination.
  • History of one or both parents being mentally defective or previous children being malformed can be a reason for termination in consultation with a geneticist.

WHAT YOU SHOULD KNOW

  • In the revised rules, a Registered Medical Practitioner fulfilling the following criteria is qualified to perform a MTP provided:

    1. One who has assisted in at least 25 MTPs in an authorized center and having a certificate.

    2. One who has got six months house surgeon training in Obstetrics and Gynecology.

    3. One who has got diploma or degree in obstetrics and gynecology.

  • Termination can only be performed in hospitals, established or maintained by the government or places approved by the government.

  • Pregnancy can only be terminated on the written consent of the woman. Husband’s consent is not required.

  • Pregnancy in a minor girl (below the age of 18 years) or lunatic cannot be terminated without written consent of the parents or legal guardians.

  • Termination is permitted up to 20 weeks of pregnancy. In cases of pregnancy exceeding 12 weeks, opinion of two medical practitioners is required.

  • The abortion has to be performed confidentially and to be reported to the Director of Health Services of the State in the prescribed form.


METHODS OF TERMINATION

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