MTP Act, 1971

1. The Medical Termination of Pregnancy Act (MTP Rules)Act No. 34 of 1971 Prajakta V. Mayekar PR No: 10040141073 Health Regulatory Environment. MBA – HHC (2010-2012)

3. Lunatic

4. Minor

5. Registered Medical PractitionerPrajakta V. Mayekar

7. Legalizes abortion services

8. Promotes access to safe abortion services to women

9. De-criminalizes the abortion seeker

10. Offers protection to medical practitioners who otherwise would be penalized under the Indian Penal Code (sections 315-316)Prajakta V. Mayekar

11. Legal abortions Termination done by a medical practitioner approved by the Act. Termination done at a place approved under the Act. Termination done for conditions and within the gestation prescribed by the Act. Other requirements of the rules & regulations are complied with the act Prajakta V. Mayekar

13. MTP Rules

14. MTP RegulationsPrajakta V. Mayekar

15. MTP Act: When can pregnancies be terminated? Up to 20 weeks of gestation, with the consent of the woman. If the woman is below 18 years or is mentally ill, then with consent of a guardian With the opinion of a RMP, formed in good faith, under certain circumstances Opinion of two RMPs required for termination of pregnancy between 12 and 20 weeks Prajakta V. Mayekar

17. Substantial risk of physical or mental abnormalities in the fetus.

18. Pregnancy caused by rape (presumed grave injury to mental health)

19. Contraceptive failure in married couple (presumed grave injury to mental health)Prajakta V. Mayekar

20. MTP rules: what are they for? Enable proper implementation of the provisions of the Act Ensure that MTP services are provided by qualified persons in safe and hygienic settings Help to monitor quality of services Prajakta V. Mayekar

21. MTP rules: what do they cover? Experience & training required for providers Approval of a place for terminating pregnancy under the Act Composition & tenure of District Level Committee Inspection; Cancellation or suspension of approval; Review Consent form. Prajakta V. Mayekar

22. Experience: clause (d) of section 2 Experience in the practice of Gynaecology and obstetrics for a period of not less than three years. Completed six months of house surgery in Gynaecology and obstetrics or assisted a RMP in the performance of twenty five cases of Medical termination of pregnancy in a hospital established or maintained or a training institute approved for this purpose by the Government. Prajakta V. Mayekar

23. MTP rules: Who can perform? A medical practitioner (RMP) who has a recognized medical qualification as defined in clause (h) of section 2 of Indian Medical Council Act, 1956 Whose name has been entered in a State Medical Register and Who has such experience or training in Gynecology and Obstetrics as prescribed by Rules made under the Act Prajakta V. Mayekar

24. Approval of a place : clause (b) of section – 4 For sites up to 12 weeks (1st trimester) Gynecology examination / labor table Resuscitation and sterilization equipment Drugs & parental fluids Back up facilities for treatment of shock Facilities for transportation For sites up to 20 weeks (1st & 2nd trimester) All requirements for up to 12 weeks + Operation table and instruments for performing abdominal or gynecological surgery & anesthetic equipment.

25. Approval Process Application in Form A to be addressed to CMHO by place seeking approval Verification by CMHO CMHO recommends approval to the committee Committee considers application & recommendation and approve and issue certificate of approval in Form B Prajakta V. Mayekar

26. Approval Process Place to be inspected within 2 months of receiving application Certificate to be issued within 2 months of inspection If deficiency found, within 2 months of deficiency having been rectified Prajakta V. Mayekar

27. Application form for Approval (Form A)

28. Certificate for Approval ( Form B )

29. Inspection CMHOs to inspect to ensure safe & hygienic conditions for conduction of MTPs. Call for information and seize in case found otherwise Prajakta V. Mayekar

30. Cancellation/ Suspension CMHO can report for unsafe and unhygienic conditions. Committee can suspend or cancel approval after giving the owner an opportunity for representation Owner can reapply to the committee after making additions and improvements. During suspension the place be deemed as non-approved Prajakta V. Mayekar

31. Review :- (1) The owner of a place who is aggrieved by an order made under rule 6 may make an application for review of the order to the Government within a period of sixty days from the date of such order. (2) The Government may after giving the owner an opportunity of being heard, confirm, modify or reverse the order. Prajakta V. Mayekar

32. Form of consent The Consent referred to in sub-section (4) of section 3 shall be given in Form C. Prajakta V. Mayekar

33. MTP regulations:- Power to states to make regulations regarding MTP services Regulations for Union Territories by Central Govt. Application of central govt. regulations in the absence of state regulations. Prevention of disclosure of information Prajakta V. Mayekar

34. Penalties Penalty of two to seven years in prison if termination performed by a non- registered medical practitioner. Same penalty applies to those who perform abortions outside of hospitals or other approved locations. Prajakta V. Mayekar

35. Name: Harish and Nikita Mehta's Case Date: 5th August, 2008 Court: The Bombay High Court Facts: They were pleading the case on the basis that the child is suffering from a congenital heart block that would require a permanent pace-maker, meaning that the child would have a disabled life and would also hurt them financially which they would not be able to afford in the long run. They were also citing doctor’s report that asserts that the child will suffer critical problems even with a pace-maker. Prajakta V. Mayekar

36. Judgment: The Mumbai high court held that no categorical opinion of experts had emerged to state that the child would be born with serious handicaps. The court thus denied recourse to medical termination of the pregnancy after 20 weeks and an opinion emerged that terminating the life of a viable unborn on grounds of possible handicap is akin to mercy killing. Prajakta V. Mayekar