UNIT 2 - Medical Termination of Pregnancy ACT, 1971.pptx

This ppt is about MTP ACT, 1971 and its amendments made in 2021 along with landmark judgments relating to the same.

1. MEDICAL TERMINATION OF PREGNANCY ACT,1971 (MTP ACT) Ms. R.Yuvanaa Priyadharshini SoL , SASTRA

2. HISTORY OF MTP ACT IN INDIA The medical termination of pregnancy act 1971 , does not use the word ‘Abortion ’. The need for an abortion law in India started in 1960s. At that time, abortion were strictly illegal under section 312 of Indian Penal Code 1860, causing miscarriage of women was a crime punishable with imprisonment up to 3 years. The Shantilal Shah committee carried out a review of legal , medical and socio- cultural aspects of abortion and law on comprehensive abortion care in the year 1966. Its recommendations eventually led to passing of act 1971 , which allows for only medical termination of pregnancy.

3. DEFINITION An act to provide for termination of certain pregnancies by registered medical practitioner and for matters connected therewith and incidental thereto.” (Deliberate termination of pregnancy either by medical and surgical method before the viability of the fetus is called induction of abortion ) AIMS OF THE MTP ACT, 1971: - Legalizes abortion services Decriminalizes abortion seekers To improve maternal health by preventing large number of unsafe abortions. It provides opportunity to motivate women for adopting some forms of contraception. Promote access to safe abortion services to women

4. OBJECTIVES of the mtp act To improve the maternal health scenario by preventing large number of unsafe abortion and consequent high incidence of maternal mortality and morbidity. To regulate and ensure access to safe abortion care and defines ‘when’ , ‘where’ , and under ‘what’ condition abortion is permissible. Offers protection to medical practitioners who otherwise would be penalized under Indian Penal code. Health care measures which helps to reduce maternal mortality and morbidity resulting from illegal abortion.

5. CONDITIONS UNDER WHICH PREGNANCY CAN BE TERMINATED: Medical: Grave injury to physical , mental health of mother if pregnancy is continued. Eugenic : Substantial risk to child, serious handicap due to physical or mental abnormality . ( Foetal abnormalities) Humanitarian : Pregnancy as a result of rape. Socio-economic : Risk of health of mother Failure of contraceptive devices.

6. INDICATION FOR EARLY MEDICAL ABORTION: General conditions to be fulfilled ; Frame of mind of the patient and her acceptability of minimum 3 follow up visits. Ready for surgical procedures if failure or excessive bleeding occurs. Family support . Permission of guardian in case of minor as per MTP Act(1971). Easy access to appropriate health care facility. MEDICAL METHOD OF 1 ST TRIMESTER ABORTION: Mifepristone with misoprostol for medical abortion (before 7 weeks) CHOICE BETWEEN MEDICAL AND SURGICAL ABORTION: Vacuum aspiration (suction evacuation) Surgical abortion is preferred if the patient concurrent tubal ligation.

7. PERSON WHO CAN PERFORM SUCH TERMINATION : UPTO 12 WEEKS : Registered medical practitioner (RMP) having experience in obstetric and gynaecology . PG in Obstetrics and gynaecology MBBS trained for MTP 12 - 20 WEEKS : Two registered medical practitioners having experience in obstetrics and gynaecology. PLACE FOR CONDUCTING MTP : A hospital established or maintained by government A place approved for the purpose of this act by a district level committee constituted by the government with the CMHO as chairperson. A clinic ( but doctor need to be attached to government approved MTP centre ).

8. COMPLICATIONS OF MTP: Injury to cervix (cervix laceration) Uterine perforation during D & C (Dilation & curettage) Thrombosis and embolism Hemorrhage and shock due to trauma.

9. MTP ACT AMENDMENTS

10. IMPLICATIONS OF AMENDMENTS Simplifies registration of sites which can be done at district level now Providers can get their sites approved for providing abortions under MTP Act for first trimester only or up to 20 weeks and there by come under protective cover of MTP Act Offers potential to increase number of approved sites , which would enable women to access safe abortion services Effective implementation will help to bring all abortion within legal frame work

11. CASE LAWS X v. Principal Secretary This is a landmark judgment discussing the right of an unmarried woman to exercise her reproductive autonomy. In the case of KS Puttaswamy v. Union of India (2017) the Court held that “woman’s freedom of choice whether to bear a child or abort her pregnancy are areas which fall in the realm of privacy.”  The Court has reiterated in the above-mentioned case that statutory right of a woman to undergo termination of pregnancy under the MTP Act is relatable to the constitutional right to make reproductive choices under Article 21 of the COI. Article 21 of the Constitution recognizes and protects the right of a woman to undergo termination of pregnancy if her mental or physical health is at stake. Importantly, it is the woman alone who has the right over her body and is the ultimate decisionmaker on the question of whether she wants to undergo an abortion. A (Mother of X) v. State of Maharashtra (2023) The case involved a fourteen-year-old minor who was a victim of sexual assault and sought to terminate her pregnancy. The High Court had initially denied the request for termination, relying on the statutory limit of 24 weeks for pregnancy, which was exceeded in this case. The Supreme Court, after forming a fresh medical board, found that continuing the pregnancy would adversely affect the minor's physical and mental health. It therefore set aside the High Court's decision and authorized the termination. The Court also highlighted that no entity, including the State, can usurp the consent of a pregnant person. The decision belongs to the individual, even if there are differences between the minor and her guardian. Finally, in this case court determined the sole and only consideration of the “ court must weigh the safety and welfare of the minor child ” thus the court recalled its earlier order to terminate pregnancy after the minor wanted to continue the same. 

12. Suchita Srivastava v.Chandigarh Administration This is a landmark judgment which lays down that even a woman who is found to be ‘mentally retarded’ should give her consent for termination of pregnancy. It is to be noted that Section 2 (l) of Mental Health Act, 2017 defines “mentally ill person” as a person who is in need of treatment by reason of mental disorder other than mental retardation. Thus, it is apparent from the definition that ‘mental illness’ is different from ‘mental retardation’. Therefore, the persons who are mentally ill must be treated differently from persons who are mentally retarded.  While guardian can make a decision on behalf of a ‘mentally ill person’ as per Section 3 (4) (a), the same cannot be done on behalf of a person who is in a condition of ‘mental retardation’.  The Court observed that the distinction between ‘mentally ill’ and ‘mentally retarded’ cannot be disregarded so as to interfere with the personal autonomy that has been accorded to mentally retarded persons for exercising their reproductive rights. The Court in this case finally held in favor of continuance of pregnancy. This is because the applicable statute clearly contemplates that even a woman who is found to be ‘mentally retarded’ should give her consent for termination of pregnancy. Swati Agarwal v. Union of India (2021) : At present in the case of Swati Agarwal and others vs U.O.I30, which is sub judice in the Apex Court, The Apex Court has issued notice to the centre for decriminalization of abortion and affirmation of the right of absolute independence of women to make decision- related to reproductive right.

13. Devika Biswas v. UOI &Ors, 2012 In this public interest litigation, a health rights activist challenged the State Governments’ practice of subjecting women (and occasionally men) to sterilization procedures in dangerous and unsanitary sterilization camps where informed consent is often not obtained from patients prior to conducting the procedures. The Supreme Court found these practices – focused mainly on poor, rural women – to be in violation of the right to health and more specifically reproductive rights, two key components of the right to life under the Indian Constitution. In its deliberations, the Court referenced General Comment No. 22 on the right to sexual and reproductive health issued by the UN Committee on Economic, Social and Cultural Rights, which observes that reproductive health is an integral part of the right to health. It also drew on the 2004 decision, A.S. v Hungary, by the UN Committee on the Elimination of Discrimination against Women, which held that fully informed consent to sterilization is essential. The Court ordered the Union of India to ensure the discontinuation of the sterilization camps as early as possible but in any case, within three years, emphasizing that such action must be accompanied simultaneously by measures by the Union of India and the State Governments to strengthen Primary Health Centres , both in terms of infrastructure and accessibility of health care to all persons.

14. THANK YOU