Medical Termination of Pregnancy Act and Rules (MTP Act and Rules)–basic understanding, salient features, and Amendments.

Medical Termination of Pregnancy Act 1971

Aim: Terminate Pregnancy for Bonafide Medical Reasons

Definitions

• Guardian: "Guardian" means a person who takes care of a minor individual or a lunatic;

• Lunatics: "Lunatic" means a person having a severe disorder of mind who behaves in a stupid way or dangerously to do things. In act has the meaning assigned to it in Sec.3 of the Indian Lunacy Act, 1912 (4 of 1912) ;

• Minor: "Minor" means a person who, under the provisions of the Indian Majority Act, 1875 (9 of 1875), is to be deemed not to have attained his majority,

• Registered Medical Practioner: "Registered Medical Practitioner" means a medical practitioner who possesses any recognized medical qualification as defined in Clause.(h) of Section 2 of the Indian Medical Council Act, 1956 (102 of 1956), whose name has been entered in a State Medical Register and who has such experience or training in gynecology and obstetrics as may be prescribed by rules made under this Act

Conditions to Terminate Pregnancy

Pregnancy can be terminated under the following conditions by Registered Medical Practitioners

• 1. A pregnancy duration of not more than 12 weeks can be terminated by a registered medical practitioner. He should of any one of the following opinions to terminate this pregnancy

  • a. Continuation of pregnancy may be life-threatening for pregnant women or

  • b. Continuation of pregnancy may cause grave injury to the health of the pregnant woman. or

  • c. There is a high risk that a child will born with physical or mental abnormalities.

  • d. Pregnancy is due to the failure of contraceptive devices used by married women or by their husbands to limit the number of children in the family. This pregnancy may cause grave injury to the mental health of the pregnant lady.

  • e. Pregnancy is due to rape. Pregnancy causes grave injury to the mental health of pregnant women. This pregnancy may cause grave injury to the mental health of the pregnant lady.

• 2. Pregnancy of a duration of more than 12 weeks and less than 20 weeks shall be terminated upon the opinion of two registered medical practitioners. They should have any one of the following opinions to terminate pregnancy

  • a. Continuation of pregnancy may be life-threatening for pregnant women or

  • b. Continuation of pregnancy may cause grave injury to the health of pregnant women. or

  • c. There is a high risk that a child will born with physical or mental abnormalities.

  • d. Pregnancy is due to rape. Pregnancy causes grave injury to the mental health of pregnant women. This pregnancy may cause grave injury to the mental health of the pregnant lady.

  • e. Pregnancy is due to the failure of contraceptive devices used by married women or by their husbands to limit the number of children in the family. This pregnancy may cause grave injury to the mental health of the pregnant lady.

• 3. Pregnancy of any duration can be terminated if a registered medical practitioner thinks that immediate termination of pregnancy is a must to save the life of a pregnant woman. In this condition opinion of only one registered medical practitioner shall be required to terminate the pregnancy.

Pregnancy shall be terminated by a registered medical practitioner with written consent from the pregnant lady if she has attained 18 years of age or more. If the age of a pregnant lady is less than 18 years or she is a minor then the consent of her legal guardian is a must to terminate pregnancy. If a pregnant lady is a lunatic then consent of her guardian is a must to terminate the pregnancy.

The registered medical practitioner shall not be guilty of any offense under the Indian Penal Code or any other law to terminate pregnancy under this Medical Termination of Pregnancy Act 1971. Termination of pregnancy other than registered medical practitioner shall be a punishable offense under the Indian Penal Code.

Pregnancy can be terminated under MTP Act 1971 at the following places

• 1. Hospital Established or Maintained by the Government

• 2. A place approved by the government to terminate pregnancy under MTP Act 1971

Power to make Rules

Central Government Power: The central government has the power to make rules related to the following matters. Central government makes rules and publishes it in official gazette notifications

• 1. Experience or training or both for registered medical practitioners to terminate any pregnancy under the Medical Termination of Pregnancy Act 1971.

• 2. Any other matters related to rules made under the Medical Termination of Pregnancy Act 1971.

The central government shall submit every rule made under this act to be passed by both parliaments. The rule shall be considered as passed from both houses if both houses agree with such rules. Otherwise, it shall not be considered a rule under this act.

State government Power: State governments have the power to make regulations regarding the following matters

• 1. Certification of opinions of registered medical practitioners under this act. Preservation and disposal of such certificates.

• 2. Regarding intimation from registered medical practitioners to terminate pregnancy under this act and any other information to be submitted by registered medical practitioners

• 3. Prohibition to disclose information regarding termination of pregnancy under this act. and disclosure of information to the person required in regulation.

• 4. Information regarding termination of pregnancy to the chief medical officer of the state.

• 5. Any person who wilfully contravenes or wilfully fails to comply with regulation shall be liable to punishment with a fine. A fine may extend up to Rs 1000/-.

Protection of Action Taken in Good Faith: No legal action can be taken against a registered medical practitioner if any damage occurs in good faith of treatment advised under this act.

Medical Termination of Pregnancy (Amendment) Bill 2020

The Medical Termination of Pregnancy (Amendment) Bill, 2020 was introduced in Lok Sabha by the Minister of Health and Family Welfare. This Bill amends the Medical Termination of Pregnancy Act, of 1971. MTP 1971 has provisions for the termination of certain pregnancies by registered medical practitioners. This Bill introduces the definition of termination of pregnancy. Termination of pregnancy means a procedure undertaken to terminate a pregnancy by using medical or surgical methods. Medical Termination of Pregnancy (Amendment) Bill 2020 was introduced to provide legal services to women to abort on grounds of therapeutic, eugenic, humanitarian, or social. This amendment bill proposes to increase the upper limit of pregnancy duration to terminate pregnancy. Bill increases the duration of pregnancy without compromising the safety and quality of abortion. MTP (Amendment) Bill 2020 was introduced due to several litigations in court for permission to terminate pregnancy beyond the permissible limit in MTP Act 1971. It is to be noted that most countries do not allow pregnancy termination beyond 20 weeks duration except Canada, the United States, China, Singapore, North Korea, the Netherlands, and Vietnam. Termination of pregnancy beyond 20 weeks may cause survival of the fetus beyond the womb. This may put the lives of pregnant women in danger. This will be an unsafe abortion and delayed abortion.

The following provisions of MTP 1971 have been amended in the Medical Termination of Pregnancy (Amendment) Bill:

This bill amends that pregnancy of a duration less than 20 weeks shall be terminated upon the opinion of one registered medical practitioner. The opinion of two registered medical practitioners shall be required to terminate the pregnancy for a duration between 20 weeks and 24 weeks. Termination of pregnancy of a duration of more than 24 weeks shall be allowed in special conditions. These special conditions shall be announced by the central government. The central government shall also notify norm-registered medical practitioners whose opinion shall be required to terminate the pregnancy. Termination of pregnancy due to rape can be terminated up to 20 weeks of pregnancy. This bill extended 20 weeks duration of pregnancy to 24 weeks duration of pregnancy that can be terminated

Pregnancy may occur due to the failure of contraceptive devices or methods used by a married woman or her husband to limit the number of children (family planning) or to stop unwanted pregnancies. MTP 1971 states if this pregnancy causes grave injury to the mental health of pregnant women then it can be terminated by a registered medical practitioner. Here word “married woman or her husband” is replaced by the word “Woman or her partner”.

Constitution of Medical Board: The Bill states that every state shall constitute a Medical Board. These Medical Boards shall have the following members

• 1. A Gynaecologist,

• 2. A paediatrician,

• 3. A radiologist or sonologist, and

• 4. Any other number of members, as may be notified by the state government.

The central government shall decide the power and function of this Medical Board by notification. Pregnancy of any duration can be terminated by the opinion of this Medical Board. The Medical Board shall have diagnosed that there is substantial fetal abnormality. The medical board thinks to terminate the pregnancy. This medical termination of pregnancy has no time limit on pregnancy duration.

Protection of privacy of a woman: The bill states that registered medical practitioners shall not be allowed to disclose names and any other information of women undergone a terminated pregnancy. Disclosure of any information is a punishable offense. Punishment shall be imprisonment for up to one year or a fine or both. Registered medical practitioners can disclose their names and any other information on demand of a court of law.

Alok Bains