Medical termination of peregnancy mtp act 1971

3. INDUCTION OF ABORTION
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• INDUCED
ABORTION
• SPONTANEOUS ABORTION
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4. BEFORE 1971 (INDIAN PENAL CODE, 1860)
Before 1971, abortion was criminalized
under Section 312 of the Indian Penal
Code, 1860, describing it as
"causing miscarriage". Except in cases
where abortion was carried out to save
the life of the woman, it was a
punishable offense and criminalized
women/providers, with whoever
voluntarily caused a woman with child
miscarry facing three years in prison
and/or a fine, and the woman availing
the service facing seven years in prison
and/or a fine.
It was in the 1960s, when abortion was
legal in 15 countries, that deliberations
on a legal framework for induced
abortion in India was initiated. The
alarmingly increased number of
abortions taking place put the Ministry
Health and Family Welfare (MoHFW)
alert. To address this, the Government
India instated a Committee in 1964 to
come up with suggestions to draft the
abortion law for India. The
recommendations of this Committee
were accepted in 1970 and
the Parliament as the Medical
Termination of Pregnancy Bill. This bill
was passed in August 1971 as
the Medical Termination of Pregnancy
Act.

5. ABORTION INCIDENCE IN INDIA
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7. THE MEDICAL
TERMINATION
OF
PREGNANCY
ACT, 1971
• THE MEDICAL TERMINATION OF PREGNANCY (MTP) ACT, 1971
PROVIDES THE LEGAL FRAMEWORK FOR MAKING CAC SERVICES
AVAILABLE IN INDIA. TERMINATION OF PREGNANCY IS PERMITTED FOR A
BROAD RANGE OF CONDITIONS UP TO 20 WEEKS OF GESTATION AS
DETAILED BELOW :-
• WHEN CONTINUATION OF PREGNANCY IS A RISK TO THE LIFE OF A
PREGNANT WOMAN OR COULD CAUSE GRAVE INJURY TO HER PHYSICAL
OR MENTAL HEALTH;
• WHEN THERE IS SUBSTANTIAL RISK THAT THE CHILD, IF BORN, WOULD
BE SERIOUSLY HANDICAPPED DUE TO PHYSICAL OR MENTAL
ABNORMALITIES;
• WHEN PREGNANCY IS CAUSED DUE TO RAPE (PRESUMED TO CAUSE
GRAVE INJURY TO THE MENTAL HEALTH OF THE WOMAN);
• WHEN PREGNANCY IS CAUSED DUE TO FAILURE OF CONTRACEPTIVES
USED BY A MARRIED WOMAN OR HER HUSBAND (PRESUMED TO
CONSTITUTE GRAVE INJURY TO MENTAL HEALTH OF THE WOMAN).

8. THE MTP ACT SPECIFIES
(i) Who can
terminate a
pregnancy
(ii) Till when a
pregnancy can
be terminated
(iii) where can
a pregnancy
be terminated.

9. WHO CAN TERMINATE A PREGNANCY ?
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10. WHERE CAN A PREGNANCY BE
TERMINATED ?
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DISTRICT LEVEL
COMMITTEE
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13. WHOSE CONSENT IS REQUIRED FOR
TERMINATION OF PREGNANCY ?
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15. METHODS OF TERMINATION OF
PREGNANCY

16. FIRST TRIMESTER TERMINATION OF
PREGNANCY
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19. SURGICAL METHODS OF FIRST
TRIMESTER ABORTION
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21. Done up to 12 weeks with minimal cervical dilatation.
Performed as an outpatient procedure using a plastic disposable
cannula (up to 12 mm size) and a 60 mL plastic (double valve)
It is quicker (15 minutes), effective (98–100%)
Less traumatic and safer than dilatation, evacuation and curettage.

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1)
2)
3)
4)
5)
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1)
2)

24. RAPID METHOD
SLOW METHOD
1. RAPID METHOD: DONE AS AN OUTDOOR
PROCEDURE WITH DIAZEPAM SEDATION AND
PARACERVICAL BLOCK .
• ADVANTAGES
I. DONE AS AN OUTDOOR PROCEDURE.
II. CHANCE OF SEPSIS IS MINIMAL.
• DRAWBACKS
I. CHANCE OF CERVICAL INJURY IS MORE.
II. UTERUS SHOULD NOT BE MORE THAN 6–8
WEEKS OF PREGNANCY. ALL THE DRAWBACKS OF
D&E.

25. 
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II.
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II.
III.

26. 
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27. 
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28. 
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30. HYSTEROTOMY
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31. 
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II.
III.
IV.
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II.
III.
IV.

32. There is no universally
safe and effective
method which is
applicable to all cases.
Complications are
much less (5%) if
termination is done
before 8 weeks by
or suction
evacuation/curette.
The complications are
about five times more
in midtrimester
termination.
The complications are
either related to the
methods employed or
to the abortion

33. IMMEDIATE COMPLICATIONS
(1) Injury to the cervix (cervical lacerations).
(2) Uterine perforation during D&E.
(3) Hemorrhage and shock due to trauma, incomplete abortion, atonic uterus or
rarely coagulation failure.
(4) Thrombosis or embolism.
(5) Postabortal triad of pain, bleeding and low-grade fever due to retained clots or
products.

34. (6) Related to the methods employed:
Prostaglandins—intractable vomiting, diarrhea, fever, uterine pain and cervicouterine
injury. Oxytocin—water intoxication and rarely convulsions
 Hysterotomy :
1) Uterine bleeding.
2) Peritonitis.
3) Intestinal obstruction.
 Anesthetic hazards. Saline—hypernatremia, pulmonary edema, endotoxic shock,
Disseminated intravascular coagulation (DIC), renal failure, cerebral hemorrhag

36. PROPOSED AMENDMENTS TO THE MTP ACT, 2014
•
NATIONAL
CONSULTATION
MEDICAL TERMINATION OF
PREGNANCY AMENDMENT BILL 2014
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37. •

38. •

39. • SAFE ABORTION: TECHNICAL AND POLICY GUIDANCE FOR HEALTH
SYSTEMS
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40. It has been recommended to replace the term "registered medical
practitioner" with "registered health care provider". This would
the expanded provider base being suggested, by bringing in
and ANMs as well as Ayurveda, Unani, Siddha and Homoeopath
practitioners as legitimate providers of abortion service.
The MTP Act does not have a definition of termination of
For this purpose, it has been recommended to include a definition
for termination of pregnancy.

42. AMENDMENT TO MTP ACT WILL ALIGN THE REPRODUCTIVE
RIGHTS OF WOMEN WITH 21ST CENTURY MEDICINE
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

43.  A 2015 study in the Indian Journal of Medical Ethics has observed that 10-13% of maternal
deaths in India can be attributed to unsafe abortions. It roughly translates into at least six to
seven women losing their life due to unsafe abortions every day. Many of those who survive
such methods are compelled to live a life of pain compounded by infertility, sepsis and other
internal injuries. Studies have shown that the 20 week limit on abortion is based on outdated
medical concepts from the 1970s. Developments in medical science which include medical
abortion pills and vacuum aspiration which allow for safer abortions in advanced stages of
pregnancy have found no legal resonance in the MTP Act.
 By contrast Wednesday’s Cabinet decision to approve the MTP (Amendment) Bill, 2020, will truly
address the needs of gender justice through the prism of reproductive rights, providing a
which women in our country have sought for decades. The bill allows abortion up to 24 weeks of
gestational age for vulnerable categories of women and there is no limit of gestational age in
pregnancies with substantial foetal abnormalities, diagnosed by a medical board. This will
access of women to safe medico legal services and will thus reduce maternal mortality and
arising out of unsafe abortions.

44.  Worldwide, abortion is acknowledged as an important aspect of reproductive health of women. At
present, 26 countries including Egypt, Angola, Thailand, the Philippines, Madagascar and Iraq do not
permit abortion and 39 countries including Brazil, Mexico, Sudan, Indonesia and Sri Lanka permit
abortion when the woman’s life is at risk. Only some countries like China, Russia, Canada, Australia,
South Africa permit abortion on request mostly up to 12 weeks. India will now stand amongst nations
with a highly progressive law which allows legal abortions on a broad range of therapeutic,
humanitarian and social grounds. The new MTP (Amendment) Bill, 2020, is a milestone which will
further empower women, especially those who are vulnerable and victims of rape.

45. THANK YOU