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CONTRIBUTORS
Dr. Archana Verma
Dr. Sharda Jain
Dr. Ila Gupta
Indian Penal Code (IPC, 1860)
Section 312
Any one voluntarily causing miscarriage to a woman with
child, other than in go...
MTP ACT
A Protective Umbrella
The MTP Act if adhered to completely offers
complete protection to the medical practitioner from
an...
The MTP Act (Act No. 34 of 1971)
“ An Act to provide for the Termination of certain
pregnancies by registered medical pra...
MTP Act, Rules, Regulations
MTP Act Is an Act of Parliament providing an
Overview of Safe abortions and delegating author...
Legal framework
1. MTP Act
2. Rules
3. Regulation
MTP Act, Rules & Regulations
MTP Act Specifies:
 1  The Indications for legal Terminations
 2  Who can Terminate
 3  The Place where it can be te...
When pregnancy can be terminated.. ???
1--continuation of pregnancy is a risk to the life of
pregnant woman
or
it can cau...
Who Can Terminate a Pregnancy?
Who can perform MTP ?
A Registered Medical practitioner (RMP )who has a
recognized Medical qualification as defined in cl...
Experience of RMP-
Up to 12 weeks Gestation only
Before the commencement of act experience
minimum 3yrs
Who is regst in ...
Experience and Training Required by a
RMP-upto 20 wks
PG Degree or Diploma in OB & Gynae
Completed 6 months as House Sur...
Where pregnancy can be Terminated --
PLACE
Hospitals established or maintained by the Govt
A Place approved by the Gover...
Consent ----- Form C
1-- Only the
consent of a
women is
required
2-- If Age <18 yrs
or a mentally ill
patient consent of
g...
MTP Rules
A- Appointed by Govt n responsible for approval and
suspension of Place
Chaired by CMO
B 3-5 members
C - one...
Up to 12 wks --
FACILITIES -
1-Gynecological examination /labor table
2-Resuscitation and sterilization Equipments
3-...
…For approval
For Terminating 12 to 20 weeks of Pregnancy
 FACILITIES 
1-An operation table and instruments for perform...
For Medical Abortion
1-up to 7 wks 
An RMP does not need approval of place , can display 
a certificate  from owner of a...
MTP rules…..
Approval is applied - FORM A Annexure 1
Addressed to CMO 
CMO does -- verification
                       ...
Inspection of Place
Place should be inspected within 60 days of receipt 
of approval 
    and approval within next 2 mont...
Cancellation / Suspension
 CMO can suspend or cancel the approval , if he 
suspects unsafe and unhygienic conditions .
 
...
MTP rules….
Already 
discussed 
4-- Registered medical practitioner  -- 
Requirements 
Amendments to MTP rules 2003
Key features :-
1. Detailed the composition and tenure of the DLC 
2.Abortion sites approved...
MTP Regulations
MTP Act empowers the state govt to form regulations , 
maintain records , reports 
Salient features
1-F...
Maintenance Of Admission
Register
Maintain records As per Form III ( Annexure -4 )
Record the detail
Keep in secret cus...
Recommendations to Overcome Shortcomings
Requirement of 2 opinions for second trimester
termination is now a formality an...
Recommendations to Overcome Shortcomings
With medical methods administered on an outpatient
basis, the act needs to be up...
Violation of The ACT
Any person doing MTP and not a RMP can be
punished with rigorous imprisonment for 2-7 yrs
If termin...
Legal abortion means
Termination done at a place approved under the Act
Termination done for conditions and within the
g...
Take home message
• It is necessary to do register your nursing home
under the MTP act, if you are going to do MTP
• Must ...
In matters of style, swim with the current;
in matters of principle, stand like a rock.
Understanding the MTP Act Interpretation & implications dr. Sharda Jain & Team
Understanding the MTP Act Interpretation & implications dr. Sharda Jain & Team
Understanding the MTP Act Interpretation & implications dr. Sharda Jain & Team
Understanding the MTP Act Interpretation & implications dr. Sharda Jain & Team
Understanding the MTP Act Interpretation & implications dr. Sharda Jain & Team
Understanding the MTP Act Interpretation & implications dr. Sharda Jain & Team
Understanding the MTP Act Interpretation & implications dr. Sharda Jain & Team
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Understanding the MTP Act Interpretation & implications dr. Sharda Jain & Team

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Understanding the MTP Act Interpretation & implications dr. Sharda Jain & Team

  1. 1. CONTRIBUTORS Dr. Archana Verma Dr. Sharda Jain Dr. Ila Gupta
  2. 2. Indian Penal Code (IPC, 1860) Section 312 Any one voluntarily causing miscarriage to a woman with child, other than in good faith for the purpose of saving her life is punishable by imprisonment (simple or rigorous) &/or a fine Sections 313 - 316 (for death due to procedure) Up to 10 years imprisonment and fine, extending up to life imprisonment where the abortion was conducted without consent
  3. 3. MTP ACT
  4. 4. A Protective Umbrella The MTP Act if adhered to completely offers complete protection to the medical practitioner from any of the consequences of the IPC However legal protection is only available conditional to every requirement of the Act being fulfilled Sheriar, J Obs Gyn India, 51(6):25, 2002
  5. 5. The MTP Act (Act No. 34 of 1971) “ An Act to provide for the Termination of certain pregnancies by registered medical practioners & for matters connected therewith & incidental thereto” Legislated by the Parliament on August 10th , 1971 And the Act was enforced Nationwide from April 1st , 1972 Adopted by Kashmir & Mizoram- 1980
  6. 6. MTP Act, Rules, Regulations MTP Act Is an Act of Parliament providing an Overview of Safe abortions and delegating authority to Central & State government Rules are framed by the Central Government BUT must be ratified by each house of Parliament Regulations are framed by the State Government & relate to issues involving Opinions , reporting and maintaining secrecy
  7. 7. Legal framework 1. MTP Act 2. Rules 3. Regulation
  8. 8. MTP Act, Rules & Regulations
  9. 9. MTP Act Specifies:  1  The Indications for legal Terminations  2  Who can Terminate  3  The Place where it can be terminated  4  Last but most imp. Consent requirement
  10. 10. When pregnancy can be terminated.. ??? 1--continuation of pregnancy is a risk to the life of pregnant woman or it can cause grave injury to her physical and mental health 2--Substantial risk that the child , if born ,would be seriously handicapped due to physical or mental abnormalities 3--pregnancy caused by rape 4--failure of contraceptive in married woman
  11. 11. Who Can Terminate a Pregnancy?
  12. 12. Who can perform MTP ? A Registered Medical practitioner (RMP )who has a recognized Medical qualification as defined in clause ( b) of Sec 2 of indian Medical Counsel Act, 1956 Whose name is registered in a state Medical register Who has training experience as per MTP rules
  13. 13. Experience of RMP- Up to 12 weeks Gestation only Before the commencement of act experience minimum 3yrs Who is regst in state medical register ---6months of house surgeon ship in gynae Or experience of working in dept of gynae –1yr 1-- A Practitioner who has assisted RMP in 25 cases of Medical termination of pregnancies ,at least 5 of which have been performed independently in a hospital established or maintained by govt or a training institute approved for this purpose by the Govt
  14. 14. Experience and Training Required by a RMP-upto 20 wks PG Degree or Diploma in OB & Gynae Completed 6 months as House Surgeon in OB & Gynae At least one yr experience in dept of ob & Gynae at any hospital that has all facilities
  15. 15. Where pregnancy can be Terminated -- PLACE Hospitals established or maintained by the Govt A Place approved by the Government or DLC constituted by the Govt
  16. 16. Consent ----- Form C 1-- Only the consent of a women is required 2-- If Age <18 yrs or a mentally ill patient consent of guardian is reqd
  17. 17. MTP Rules A- Appointed by Govt n responsible for approval and suspension of Place Chaired by CMO B 3-5 members C - one member shd be Gynecologist , surgeon , Anesthetist D -other members are from local drs , NGO, Panchayat Raj E -at least one should be woman 1---Composition and tenure of DLC Which is
  18. 18. Up to 12 wks -- FACILITIES - 1-Gynecological examination /labor table 2-Resuscitation and sterilization Equipments 3-Drugs and Parenteral fluids 4- Backup facilities for treatment of shock 2- REQUIREMENT FOR APPROVAL OF A PLACE MTP rules ….
  19. 19. …For approval For Terminating 12 to 20 weeks of Pregnancy  FACILITIES  1-An operation table and instruments for performing  abdominal or gynecological surgery  2-Anesthetic Equipments, resuscitation and  sterilization equipments  3- Drugs and Parentral fluids for any emergency ,  notified by GOI from time to time 
  20. 20. For Medical Abortion 1-up to 7 wks  An RMP does not need approval of place , can display  a certificate  from owner of a approved place  Only Registered doctor can prescribe  One needs to follow all rules and regulation under  MTP Act
  21. 21. MTP rules….. Approval is applied - FORM A Annexure 1 Addressed to CMO  CMO does -- verification                           inquiry or inspection                            then recommends for approval of place to                              DLC   issues a certificate of approval  in FORM B (annexure -1 ) 3---APRROVAL PROCESS 
  22. 22. Inspection of Place Place should be inspected within 60 days of receipt  of approval      and approval within next 2 months or within 2 month  of any deficiency being rectified by applicant to  ensure safe and hygienic conditions  CMO may inspect the approved place  any time if  necessary to reconfirm  You have to show and give all information's to CMO  anytime 
  23. 23. Cancellation / Suspension  CMO can suspend or cancel the approval , if he  suspects unsafe and unhygienic conditions .   After suspension can apply again after making  improvement within 60 days of order , during  suspension place is deemed as not approved govt can  modify or reverse the orders 
  24. 24. MTP rules…. Already  discussed  4-- Registered medical practitioner  --  Requirements 
  25. 25. Amendments to MTP rules 2003 Key features :- 1. Detailed the composition and tenure of the DLC  2.Abortion sites approved for  A-   up to 12 weeks  B-   12-20 weeks, facilities and equipments required for  two types were detailed 3.Allowed medical abortion using RU-486 and  misoprostol by RMP even from site not approved  provided  the RMP has referral linkage access to an  approved place  4.A non OB gynae provider who is trained and certified  can provide first trimester abortion
  26. 26. MTP Regulations MTP Act empowers the state govt to form regulations ,  maintain records , reports  Salient features 1-Form of certifying opinion or opinions         Form 1 Annexure - 2  RMP who terminate s, should certify it in Form 1  2- Custody of forms      Form c the consent form + Form 1 for intimation of  termination  , shall be sealed n kept in safe custody & given  to head or owner of approved place  A serial number is assigned to the pregnant pat in the  admission register ,name of the RMP, & shall write SECRET  3- Head or Owner has to send monthly statement of the  MTP cases to the CMO on FORM II  ( Annexure -3 )   
  27. 27. Maintenance Of Admission Register Maintain records As per Form III ( Annexure -4 ) Record the detail Keep in secret custody for 5 years from the end of calendar year it relates to; It is not disclosed to anyone except under authority of law
  28. 28. Recommendations to Overcome Shortcomings Requirement of 2 opinions for second trimester termination is now a formality and could be dispensed A qualified extension of up to 22 weeks to accommodate terminations after prenatal diagnosis of birth defects Scope to simplify and streamline bureaucratic procedures by amending MTP Rules and Regulations. Registration of centres by meticulous application & persistent follow up Valid case for bifurcating recognition requirements for performing first & second trimester MTPs, in view of the documented safety & simplicity of early abortions
  29. 29. Recommendations to Overcome Shortcomings With medical methods administered on an outpatient basis, the act needs to be updated to keep abreast with future medical advances Revisit documentation required. Admission register could be replaced by MTP Register Increase the number of trained persons performing induced abortions by multiplying training facilities
  30. 30. Violation of The ACT Any person doing MTP and not a RMP can be punished with rigorous imprisonment for 2-7 yrs If terminating at a place which is not approved can be punished 2--7 yrs rigorous imprisonment The owner of unapproved place , performing termination can also be punished with rigorous imprisonment 2--7 yrs
  31. 31. Legal abortion means Termination done at a place approved under the Act Termination done for conditions and within the gestation prescribed the Act Termination done by a medical practitioner approved by the act Other requirements of the rules and regulations are complied with
  32. 32. Take home message • It is necessary to do register your nursing home under the MTP act, if you are going to do MTP • Must follow all the rules and regulations under MTP strictly and correctly • All paper work must be complete before you start an MTP ,one never knows when an emergency arises • Cultivate good habits like keeping and preparing documents well in time .
  33. 33. In matters of style, swim with the current; in matters of principle, stand like a rock.

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