
An overview of India's Medical Termination of Pregnancy (MTP) Act
The Medical Termination of Pregnancy (MTP) Act was first enacted in 1971 and came into force in 1972 by the Ministry of Health and Family Welfare, Government of India. It wasn’t just a law—it was a lifeline. A response to the growing number of unsafe abortions claiming lives, particularly among poor and vulnerable women. The Act recognized that women needed autonomy. That they deserved safety, dignity, and choice when it came to pregnancy.
The Aim Behind the Law
• Improving maternal health by preventing unsafe abortions
• legalizing abortion services.
• promoting access to safe abortion services for women
Indications:-
• Continuation of pregnancy constituting risk to the life or grave injury to the physical or mental health of the woman.
• any chromosomal defect
• pregnancy caused by rape
• any contraceptive failure
• socio economic condition
Gestational age:
• Can be performed up to 20 weeks gestation under the MTP Act.
• If < 12 weeks gestation opinion of one medical practitioner was required before proceeding.
• If 12-20 weeks ge tation opinion of two medical practitioners was required before proceeding.
Persons qualified to perform MTP:
Only a registered medical practitioner with recognized medical qualification can perform MTP and should had experience given below -
• Up to 12 weeks gestation:
A practitioner who has assisted registered medical practitioner in the performance of a minimum of 25 cases of MTP of which are least 5 have been performed independently in a hospital established or maintained by a government or a training institute approved for this purpose by the government.
• Up to 20 weeks gestation:
•A practitioner who holds a postgraduate diploma or degree in obstetrics and gynaecology.
• A practitioner who has completed 6 months of house surgeoncy in obstetrics and gynaecology.
• A practitioner who has at least 1 year of experience in the practice of obstetrics and gynaecology at any hospital that has all the facilities.
Place where it can performed:
• Hospital established or maintained by the government
• A place that has been approved for this purpose by the district-level committee constituted by the government with the chief medical officer or the district health officer as chair person.
∆ gestation 8 weeks -PHC
∆ gestation 12 weeks - CHC
∆ gestation 20 weeks - District hospital.
Consent:-
∆ Only the consent of the pregnant woman is required.
∆ Consent of the guardian is essential if the girl is a minor or mentally ill.
Procedure preparation:
There’s always a moment before. A pause. A deep breath. For most women walking into an abortion clinic, it’s not just about removing cells—it’s about removing fear, confusion, and sometimes, a sense of failure. But what comes next isn’t chaos. It’s structured. It’s medical. It’s human.
Here’s how it usually goes. No drama. Just real care.
1. The History
The doctor begins with simple questions.
Not casual, but important.
- When was your last period? (LMP)
- Have you been pregnant before? Any complications?
- Do you have diabetes? High BP? Any other health condition?
It’s not just about data. It’s about knowing you—because your body’s story matters in this decision.
2. The Physical Check
A proper abdominal and pelvic examination follows.
It’s clinical. Slightly uncomfortable for some, yes. But necessary.
This aids in the doctor's assessment of the pregnancy's stage and any indications of infection or concern.
3. Assessing the Gestational Age
How many weeks into pregnancy are you? That’s the key question.
They’ll calculate it in three ways:
- Again, using your LMP
- Through a clinical exam
- And often an ultrasound (USG) for clarity
Accuracy here is critical. It determines the method. The dose. The approach.
Not everything can be done after 12 or 20 weeks.
4. Counseling—Because You Deserve to Know Everything
The next part? A conversation.
- The doctor explains the available procedures—both medical and surgical.
- Talks about possible complications. Yes, they’re rare, but honesty matters.
- And if you're interested, discusses future contraception—including sterilization options.
It’s not one-way. You can ask anything. You should.
5. Investigations—The Usual But Important Tests
Blood work follows:
- Hemoglobin & Hematocrit – to check for anemia.
- Blood group and Rh typing – because Rh-negative women need special care.
- HIV test and STI screening – for your safety, and your future health.
It’s basic. Standard. But don’t ignore it.
6. Consent—But Not Just a Signature
Yes, there's a form. But it’s more than paper.
You must understand what’s being done, why, how, and what the risks are.
The doctor will explain. You can take a moment. You can even say no.
If you’re a minor or have mental health challenges, then your guardian’s consent is needed.
Otherwise? Only your permission matters. No one else's.
Method of Termination
Now comes the core. The actual procedure. Two ways. Carefully chosen.
∆ Medical Method
Used early—usually under 9 weeks.
It’s like inducing a natural miscarriage, but in a controlled, safe environment.
- Mifepristone – Blocks the hormone that supports the pregnancy.
- Misoprostol – Taken later, causes the uterus to contract and empty.
It’s not always pleasant. Cramps. Bleeding. Fatigue.
But many prefer it—it feels private, natural.
Some women even go home after the first dose.
∆ Surgical Method
When medical pills aren’t an option—or the pregnancy is more advanced.
- Manual Vacuum Aspiration (MVA) – A hand-held device gently removes the tissue.
- Electric Vacuum Aspiration (EVA) – Same concept, but with machines.
- Dilation and Evacuation (D&E) – Used for later stages. Requires more preparation, often anaesthesia.
Quick. Clean. Safe—when done by trained hands.
Sometimes, all a woman needs is the right information, the right doctor, and the right to decide for herself.
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