MTP AFTER THE AMENDMENT, 2021

Dr. Kajol Kailash Mantri* and Dr. Shamrao Ramji Wakode

ABSTRACT

Introduction: The evolution of abortion laws in India, culminating in the Medical Termination of Pregnancy (MTP) Act, mirrors the global trajectory towards acknowledging women's reproductive rights while grappling with the ethical and medical complexities of abortion. Despite the legislative strides made with the MTP (Amendment) Act of 2021, significant gaps remain in the understanding of the clinical outcomes and broader implications of medical termination of pregnancy beyond 20 weeks. This study aims to fill this gap by systematically examining the maternal outcomes post-amendment, providing evidence-based insights to inform clinical practice and policymaking.
Aims and objectives
1. To study maternal outcomes in various gestational ages beyond 20 weeks in all MTP cases.
2. To study various indications for MTP.
3. To study selection of abortifacient in individual patient for termination of pregnancy.
Materials and Methods: This study follows a prospective cross-sectional design. The study population included all women presenting to the Obstetrics and Gynaecology OPD of Dr. Shankarrao Chavan Government Medical College and hospital, Nanded, with requests for termination of pregnancy beyond 20 weeks. The study was done for 18 months, spanned from October 2022 to April 2024. Complete enumeration was used as the sampling technique.
Results
1. Majority of patients were younger reproductive age group and from rural areas
2. Majority of MTP’s were done for eugenic ground (85.91%), but humanitarian (7.04 %) and social grounds (minors and change in marital status) (5.05 %) were also significant grounds in our study.
3. Misoprostol alone or in combination with dinoprostone was found to be equally effective for termination while mechanical method like intracervical foleys catheter proved to be effective in women with prior history of >/=1 caesarean section.
4. Majority of patients underwent successful and uneventful MTP (success rate 88.02%) with no complications.
Conclusion: MTP in later gestational ages as per the amendment is considered safe when done in a tertiary health care centre, by experts, under proper supervision, monitoring and vigilance with indivisualised and proper selection of abortifacient and prompt management of complications. The amendment of 2021 has proven to be effective in filling the loop holes of initial Act of 1971 taking into account other aspects of female health care along with MTP.

Keywords: Medical termination of pregnancy, Amendment 2021.