This document provides information on India's Medical Termination of Pregnancy (MTP) Act of 1971, including the legal framework, indications for termination, qualifications of medical practitioners, and facility requirements. Key points covered include: the MTP Act provides legal protection for termination if requirements are met; termination is allowed up to 12 weeks for various medical reasons and up to 20 weeks with additional approvals; practitioners must have proper training and facilities must be approved; violations can result in imprisonment; and amendments aim to simplify procedures while upholding safety.

1. DR. SHARDA JAIN
DR. JYOTI AGARWAL
DR. JYOTI BHASKAR
Understanding the
MTP act & MTP

2. country wide Uproar by Doctors
forced
FOGSI & GOVT. of India
to take a step back
Proposed MTP Amendments
2014

3. Lets know the LAW of the land

4. 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

5. MTP ACT
1972

6. 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

7. 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

8. 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
3 Things

9. Legal Framework
1. MTP Act
2. Rules
3. Regulation

10. MTP Act, Rules & Regulations

11. 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

12. 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

13. Who Can Terminate a Pregnancy?

14. 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

15. 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

16. 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

17. 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

18. 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

20. 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

21. 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 ….

22. …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

23. 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

24. 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

26. 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

28. 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

29. 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

30. 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

31. MTP Regulations
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 )

33. 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

35. Recommendations to Overcome Shortcomings
Requirement of 2 opinions for second trimester
termination is now a formality and could be
dispensed – but doctors want no change.
A qualified extension of up to 24 weeks to
accommodate terminations after prenatal diagnosis of
birth defects

36. Recommendations
to Overcome Shortcomings
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

37. 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
Recommendations
to Overcome Shortcomings

38. 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

39. 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

40. Pre Abortion Information
for Patients & GP
Medical termination usually leads to vaginal
bleeding for 10 – 14 days – more like having a
heavy prolonged period.
 there may be a risk of congenital
malformation in your baby in case of
continuation of pregnancy
In case of heavy bleeding please report to
emergency immediately.

41. Pre Abortion Information
for Patients & GP
Next period may be delayed by one or two
weeks but subsequent periods should be
regularized as earlier.
Maintain a menstrual dairy.
Avoid intercourse during treatment and
preferably till the next menstrual periods

42. Pre Abortion Information
for Patients & GP
Please sign on the consent from after
being satisfied with information provided
and clarifying any doubts that you may
have
Note that you have the full option of
choosing suction evacuation for
termination of pregnancy.

43. Pre Abortion Information
for Patients & GP
Women desiring concurrent tubal
ligation should realize that surgical
abortion is preferable since it can be
combined with the tubal ligation
Any method of termination of
pregnancy may lead to future
INFERTILITY or pregnancy
mishaps!

44. Anti – D in Rh Negative patients
Take injection anti – D 50 mg of Rh D
on day one

45. “Absolute contraindication to
medical abortion”
Previous ALLERGIC reaction to mifepristone /
misoprostol inherited porphyria
Chronic adrenal failure
Known or suspected ECTOPIC or heterotopic
pregnancy

46. Caution is required in a range of
circumstances including
Long term use of corticosteroids such as
for bronchial asthma
Coagulopathy
Severe anamia (must be treated at time of
abortion),
 Pre- existing heart disease or
cardiovascular risk factor (e.g
hypertension and smoking)

47. No contraindicatio to medical
abortion
Adolescence age or >35 ,
anemia ,
insulin dependent diabetes mellitus,
thyroid disorders,
multiple pregnancies,
obesity, previous caesarean section,
smoking,
uterine malformation – congenital and acquired
and previous cervical surgeries

48. Medical Abortion is Not Advised
if
No quick access to 24 hrs emergency
service
Patents unable to take responsibility
excessive anxiety wanting quick abortion
language or comprehensive barrier not
willing for surgical abortion in case of
failure living alone

49. 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 .
• Medical Abortion is safe & public awareness to be
created

50. In matters of style, swim with the current; in
matters of principle, stand like a rock.
Be LAW abider

51. ADDRESS
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Flyover, Delhi - 51
CONTACT US
9650588339, 011-22414049,
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