MTP ACT 2021 Breakdown: 5 important changes Doctors need to know

The new act, seeks to overcome the various shortcomings of the original act that at some points was not just illogical but also unfair to many women who had recently conceived.

By a recent Act of Parliament, the Medical Termination of Pregnancy Act, 1971 was amended to become the MEDICAL TERMINATION OF PREGNANCY (AMENDMENT) ACT, 2021. From the changes in the duration of eligible pregnancies for MTP to the number of RMPs whose opinion is required, the Act sees several changes and draws implications to the practicing doctors particularly Gynaecologists who perform these procedures.

So here are 5 most important changes in the new MTP Act that Doctors should now about.

The Key changes are as follows:

One of the main issues with the MTP Act 1971 was that its terminology focused on only married women. This created an unfair environment for unmarried women who faced contraception failures. The objective of comprehensive abortion care for all was not achieved due to this.

With the earlier act, if termination was required due to a failure in contraceptive device or method, only a married woman was eligible to terminate such pregnancy up to 20 weeks.

However, in the revised act married as well as unmarried women are allowed to terminate their pregnancies in case of a failure in contraceptive device or method.

Earlier as per MPT Act 1971, the opinion of one registered medical practitioner (RMP) was required up till 12 weeks of pregnancy and that of two RMP was needed till 20 weeks of the same.

However, now under the new MPT, 2021; opinion of one RMP can be taken up till 20 weeks of pregnancy and of two RMP can be taken till 24 weeks of pregnancy.

In case there exists a foetal abnormality, termination can be done even after 24 weeks subject to a state-level medical board approval.

The procedures are to be carried out by authorised RMPs only as per under the new rules which are yet to be released.

The earlier MTP Act set an upper limit of 20 weeks for termination of pregnancies. This had indeed created a huge issue for vulnerable women as well as in cases of women who came to know about congenital anomalies in the foetus after 20 weeks. The medical fraternity had also raised its concern pointing out that many cardiac anomalies are only visible after 20 weeks.

The new act extends the upper limit of MTP from 20 weeks to 24 weeks. At the same time, the act specifies the special cases in which pregnancy can be terminated after 20 weeks and before 24 weeks. These Special categories include rape survivors, victims of incest or other vulnerable women like differently abled women or minors, the upper limit is increased to 24 weeks under the new MTP Act. Earlier such a limit was 20 weeks under MTP, 71.

Further, the act lays down that in case of substantial foetal abnormalities, the rules for length of the pregnancy shall NOT apply- implying that in such cases MTP can be carried out anytime. Having said that the new act puts the onus of making the decision to diagnose a substantial foetal abnormality on a special Medical Board that will be set up for this purpose.

Earlier on, in any case of foetal abnormality or grievance for extension of termination period, the court was approached to hear the plea. Such a burden on courts led to an utter chaos and no relief to the patients of such special cases.

The New MTP Act, 2021 makes way for a provision of making specific medical boards in every state to look into matters of extended termination period in special cases such as in case of a foetal anomality or in cases of vulnerable women who have conceived.

The women who are to be included in these special cases are listed in the new Act including rape survivors, differently abled women etc.

The board shall consist of a Gynaecologist, a Paediatrician, a Radiologist or Sonologist and such other number of members as may be notified in the Official Gazette by the State Government or Union territory, as the case may be.

Confidentiality is a huge concern in cases of pregnancy termination, especially in cases of unmarried women. Breach of such confidentiality clauses does more harm than good to the patients. Therefore, in cases of a medical termination of pregnancy, the details of the women whose pregnancy has been terminated like name and other particulars can not be revealed. Such information can only be given to persons having authorisation by any law which might be in force at the time.

If there is breach in confidentiality of women who undergo the process of termination of pregnancy, under MPT, 1971 only a fine up to Rs. 1000 was put on the convict.