RESUMO
Medical abortions have been a national as well as social concern for the society, especially in India. There have been certain laws, acts and amendments that have been designed to promote safe abortions. Despite, the rules in place, there is still need to have more awareness as the women still face difficulties in accessing abortion services. The reasons may include legal hurdles, stigma, financial concerns and many more. Through this article, we would like to emphasize the role of government, medical professionals, health care providers to come together and form more dependable guidelines that may help women to access safer abortions.
RESUMO
Reform of the abortion laws in favour of the well-being of pregnant women is one aspect of the removal of gender discrimination. The Medical Termination of Pregnancy Act (MTP Act) 1971, was a breakthrough legislation in this regard, as it reduced the number of unsafe illegal abortions. With advancements in ultrasonography and genetic technologies, many foetal malformations and genetic disorders were being diagnosed after 20 weeks of gestation. The fact that termination of pregnancy was not legally permitted beyond 20 weeks of gestation caused great distress to such women, and highlighted the need to increase the upper limit of termination of pregnancy. Concurrently, there has been greater awareness around the world on the rights of women to take decisions regarding their own bodies. The MTP Bill, 2020, has come as a breath of fresh air extending the term limit for legal abortions to 24 weeks for certain categories of women, and removing the limit for abortion in the presence of a significant foetal abnormality. The amendments were recently approved by Parliament and the President of India, and have become law as of March 25, 2021. This paper presents the amendments made and their implications for obstetric, ultrasonographic and foetal medical practice. It also presents a critique of the various Acts and suggests further amendments that would enhance the value of the Act.
RESUMO
Background: Unsafe abortions continue to cause maternal morbidity and mortality in developing countries. The practice of unsafe abortions by quacks needs to be checked. Our study aims to emphasize upon the unmet needs of medical termination pregnancies (MTP) services in rural India and to recognize the complications due to it and the efficient management of such cases at tertiary care center.Methods: A two years retrospective study of septic abortions from December 2009 to November 2011.Results: Among 1080 abortions reported, 44 were septic-4.07%. More commonly in the age group of >20years (81.9%). 77.3% of them were multiparous and 22.7% were nulligravidae, with an increased incidence of unmarried nulliparous pregnancies. Greater numbers occurred during 1st trimester (77.2% versus 22.7%), with 54.5%-grade I, 29.5%-grade II, 15.9% grade III in severity. Majority of cases were due to evacuation by quacks (72.7%). Among the 44 cases, emergency laparotomy was done for 5 cases of grade III severity. The mortality rates due to septic abortion were 6.25% (3) among the total of 48 maternal deaths.Conclusions: Septic abortion is totally preventable. Majority of uneducated rural women are not aware of MTP services. The reproductive and child health (RCH) services should effectively reach the underprivileged population like slum dwellers and migrants.
RESUMO
Background: Maternal mortality is an important indicator of women’s health and social well-being. According to the WHO report, each year, an estimated 190 women for every 100,000 live births die due to maternal causes. In India, unsafe abortion and related complications accounts for 9% of all maternal deaths. Abortion was made legal in India by the Medical Termination of Pregnancy (MTP) act, which was enacted by Indian Parliament in the year 1971. But the number of unsafe abortions has not declined. Methods: A present study was conducted by the Department of Obstetrics and Gynaecology of Pondicherry Institute of Medical Sciences, in Puducherry, India. All undergraduate students of VIIth semester MBBS participated in the study. A pre-designed semi-structured questionnaire was used to collect information regarding the awareness and perceptions on abortion care and Medical Termination of Pregnancy Act in India. Data were entered in Microsoft Excel 2007. Averages were calculated and chi square test was applied to find the significant difference. Results: Among a total of 75 participants, 41(54.7%) were female and 34 (45.3%) were male students. Majority of the students (97.3%) were aware of the fact that unsafe abortions are a serious health problem in India and all of the students (100.0%), were aware of the MTP Act of India. But only 36.0% students were aware of the fact, that consent from husband was not required to undergo abortion. To reduce the number of unsafe abortions in India majority of the medical students (45.3%) were of the opinion that easy access to MTP services in the community is an effective measure. Conclusions: Legalization of abortions through the MTP Act in India resulted in a considerable decrease in maternal mortality through the decline in abortions but it has failed to ensure effective implementation and access to medically safe abortion services. Training in basic contraceptive counseling and abortion care should be incorporated in basic medical education in India.