MEDICAL TERMINATION OF PREGNANCY - MTP

Medical Termination of Pregnancy refers to abortion which is done without any surgery and strictly by sticking to medication. The Medical Termination Pregnancy Act (MTP Act) came into being in 1972. Before this, abortion in India was illegal irrespective of methods and causes.The MTP Act has a particular set of conditions under which a woman is allowed to her child aborted. But this abortion is performed strictly by the usage of medicines alone. One or two doctors can perform it and those having an MBBS are well aware of the procedure and methods.

Conditions for allowance

• If a woman’s health is under danger because of pregnancy.
• If a woman is pregnant because of rape.
• If it is known that the fetus will be unwell or handicapped after birth.
• Pregnancies that happen despite contraception.
• If a girl under the age of eighteen or a ‘lunatic’ (a person who is not in his/her senses) is pregnant.

Conditions for MTP to be illegal

• If it is found that either of the parents has been involved in knowing the sex of the child and decided to terminate the pregnancy out of dissatisfaction, the MTP is considered illegal. A strict punishment follows after this.
• MTP is only permitted up to the first 20 weeks of the gestation period. It is said that during the first trimester, it has better chances of succeeding. It is safer, less complicated and involves lesser pain.

Choice between Medical Abortion and Surgical Abortion

• If pregnancy is <= 7 weeks; medical Method with Mifepristone with misoprostol is favourable as success rate is as high as 97%.
• If pregnancy is between 7-12 weeks; surgical abortion is the only option.
• If pregnancy is beyond 12 weeks – 20 weeks, then woman needs to be hopsitalized and will be given either Mifepristone followed by Misoprostol tablet or only misoprostol tablets and woman will then abort like a miscarriage in the Hospital. If any products are remaining then it will be evacuated surgically.
• Surgical abortion is preferred if patient desires concurrent tubal ligation or IUCD (CuT) insertion.
• If a woman fulfills the criteria for selecting either method i.e. Before 7 weeks), final choice to be given to the woman.

Summary of Choice between Medical abortion and Surgical abortion in India

<= 7 weeks - Medical method or Surgical method7-12 weeks - Surgical abortion 12 – 20 weeks – Medicines with or without surgical procedure in Hospital.

Places where MTP can be performed

It is considered illegal to perform MTP unless it is conducted in either of the following places.

• A hospital which is under the government.
• Any other place which is approved by the government to work according to the MTP Act.
• Medical abortion can be performed at a clinic, but the doctor needs to be attached to the government approved MTP center.

Advantages for doctors

• If there is any sort of damage or harm caused to the woman who is being provided with the medication and the act was done under good faith, then the doctors would not be responsible for it at all.

Complications involved during MTP

• Is always carried out under anesthesia and thus, risk is increased.
• Lot of bleeding can occur before or after the procedure.
• If there is an infection, patient loses the chance of conceiving again in the future.
• The chance of having miscarriages and abortions increases after performing MTP for the first time.

"Authored By Dr.Niraj Mahajan"