The Medical Termination of Pregnancy Act.pptx

termination of pregnancy

1. The Medical Termination of Pregnancy Act Dr. Abhishek Tiwari, Assistant Professor Department of Community Medicine MLN Medical College, Prayagraj

2. Learning Objectives To understand about the provisions in the ACT To understand about the purpose of the ACT Conditions, Person & Place where such practises can be carried out .

3. Introduction An Act to provide for termination of certain pregnancies by RMP Abortion is defined as termination of pregnancy before the foetus becomes viable. Fixed administratively at 28 weeks , when foetus weighs about 1000g. Abortion is sought by women for various reasons.

4. Introduction Legal abortions exceed live birth in Hungary. Categorized into 2 types S pontaneous abortion – 1/15 pregnancies, Nature’s methods of birth control Induced abortion – deliberately (legal 6.1/1000 or illegal 13.5/1000 pregnancies)

5. Abortion Hazards 2010-2014 – 56 million induced abortions Globally 35 induced abortion per 1000 women (15-44 year) 25% of all pregnancies ended in induced abortion R ate of abortion higher in developing countries than in dveloped world. 25 million unsafe abortion in developing world

6. Purpose of the Act Expanding access of women to safe and legal abortion services on therapeutic, eugenic, humanitarian or social grounds To strengthen access to comprehensive abortion care, under strict conditions, without compromising service & quality of safe abortion.

7. Provisions of theACT 5 Conditions identified to terminate Pregnancy Medical Eugenic Humanitarian Socio-economic Failure of contraceptive devices Written consent of guardian is necessary in women under 18 and in lunatics even if they are > 18 yr.

8. 5 Conditions identified... Medical - might endanger mother’s life or cause grave injury to her physical or mental health Eugenic - substantial risk that born child will be born with physical or mental abnormalities Humanitarian - pregnancy as a result of rape

9. 5 Conditions identified... 4) Socio-economic - social or economic environment could lead to risk of injury to health of mother 5) Failure of contraceptive devices - presumed to constitute grave mental injury. This virtually allows abortion on request, in view of difficulty to prove that pregnancy was not caused by failure of contraception.

10. Person who can perform Only a Registered medical practitioner having experience in obstetrics and gynaecology for pregnancy < 12 weeks For > 12 weeks & < 20 weeks, opinion of 2 RMP is necessary

11. Where it can be done Termination shall only be made at hospital established or maintained by the Government or approved for this purpose by Govt. Services provided in strict confidence, name of abortion seeker is kept confidential.

12. MTP Rules 1975 To eliminate time consuming procedures & make it readily available new rules came in force Approval by board not required - CMO of district empowered to certify that a doctor has required qualifications. Qualifications - RMP who has assisted 25 case of MTP in approved institution

13. MTP Rules 1975 Qualifications - A doctor may also qualify to do MTP if he has one or more of the following. 6 months housemanship in OBG PG qualification in OBG 3 years of OBG practice (reg before 1971) 1 year of OBG practice if registered after date of commencement of Act.

14. The MTP (Amendment) Bill, 2020 Introduced 2 March 2020, passed 17 march 2020 For termination up to 20 weeks, opinion of 1 RMP 20-24 weeks opinion of 2 RMP Upper limit extended from 20 to 24 weeks for special categories of women (vulnerable women including survivors of rape, victims of incest & differentlyabled women, minors etc.)

15. The MTP (Amendment) Bill, 2020 Upper gestation limit not to apply in cases of substantial foetal abnormalities diagnosed by Medical Board. The Board must have a gynaecologist, pediatrician, radiologist & other members as given in Act Name & other particulars of woman shall not be revealed except to a person authorized by law.

16. The MTP (Amendment) Bill, 2020 Non-government Institutions may also take up abortions, after obtaining license from CMO. D ecentralization of power of approval from central to states. A bortion has been greatly liberalized, but still needs focus

17. The MTP (Amendment) Bill, 2020 Non-government Institutions may also take up abortions, after obtaining license from CMO.

18. The community level strategy To spread awareness regarding safe MTP and its availability E nhance access to confidential counselling for safe MTP by frontline health workers AAA. Promote post abortion care

19. The Facility level strategy To provide manual vaccum aspiration facility at all CHC & 50% PHC (24hr deliveries) Comprehensive & high quality MTP at all FRU Encourage private sector & NGO to establish quality MTP services

20. T he Take home Nugget Repeated Abortion is not conducive to the health of the mother W e have to ensure that ABORTION does not replace the traditional methods of Birth control. A bortion can never be as safe as efficient contraception

21. Learning Objectives To understand about the provisions in the ACT To understand about the purpose of the ACT Conditions, Person & Place where such practises can be carried out

22. Post-conceptional methods Termination of Pregnancy Menstrual Regulation Menstrual Induction Oral Abortifacient Contraindications