THE LEGAL REQUIREMENTS FOR MEDICAL TERMINATION OF PREGNANCY (MTP) REGISTRATION
AND RELATED CONSENT, RECORDS AND INFORMATION TO BE GIVEN TO GOVERNMENT
BY
Dr. (Prof.) Mahesh Baldwa,
M.D,D.C.H, FIAP
MBA, LL.B,LL.M , Ph. D(law)
SENIOR PEDIATRICIAN & MEDICOLEGAL ADVISOR
Formerly Assistant Professor of Pediatrics at T.N. Medical College and Nair Hospital, Mumbai-400008
Ex. Asst. Professor JJ Hosp, Grant medical college
Professor, paper setter & examiner of law to postgraduate students of University Department of Law, University of Mumbai
Baldwa Hospital, Sumer Nagar,S.V. Road,
Borivali (West)Mumbai 400 092
Cell 09322990138
Introduction:
Abortion itself is aggression to the principles of right to life guaranteed under Article 21 of Constitution of India. Hence Section 312 to 315 of the Indian Penal Code defines the various offences related to causing abortion and miscarriage and punishment for the same.
History :
During the last Fifty years many countries have liberalized their abortion laws. 41% of women live in countries where abortion is available on request of women. In India, Shantilal Shah Committee (1964) recommended liberalization of abortion law in 1966 to reduce maternal morbidity and mortality associated with illegal abortion. On these bases, in 1969 Medical termination of pregnancy bill was introduced in Rajya Sabha and Lok Sabha and passed by Indian Parliament in Aug. 1971. Medical Termination Of Pregnancy Act, 1971 (MTP Act) was implemented from Apr.1972. Implemented rules and regulations were again revised in 1975 to eliminate time consuming procedures for the approval of the place and to make services more readily available. The MTP Act, 1971 preamble states” an Act to provide for the termination of certain pregnancies by registered medical practitioners and for matters connected therewith or incidental thereto”.
Types of Abortion:
Abortion may be classified into various categories depending upon the nature and circumstances under which it occurs. For instance, it may be either
- natural
- accidental
- spontaneous
- artificial or induced abortion
Abortions falling under the first three categories are not punishable, while induced abortion is criminal unless exempted under the law.
MTP act legalized artificial or induced abortion only for conditions mentioned in MTP act
Pre-requisite under MTP act
- PLACE
MTP place should be equipped as per requirements authorized by appropriate government authority
- PERSON
The person should be a registered Medical Practitioner having training in performing MTP as per the requirements authorized by appropriate government authority
- CONSENT, RECORD KEEPING AND INFORMATION
MTP consent, record keeping and information should be as per the requirements authorized by appropriate government authority
PROCEDURE OF APPLICATION FOR GETTING A LICENSE OF MTP
- Apply to civil surgeon of district in the format of “Form A“obtained from office of civil surgeon
- In metropolitan cities apply to designated authority by municipality in the format obtained from office of designated authority
- In Mumbai metropolitan area the designated authority has office at F south ward of MCGM
The form along with Following certified Xeroxed or original documents [as the case may be ] are required for MTP up to 12 weeks
- certified Xerox of Nursing Home Registration / in case of no system of registration in existence then submit original “No objection certificate” from local authority i.e. panchayat, talukdar, tehsildar / designated authority of municipality
- Doctor’s recognized medical council qualification MBBS and above and registration with medical council – all certified Xerox certificates
- Certified Xerox certificates for “20 MTP done certificate” for civil surgeon/ designated authority or government recognized authority if person applying for registration is plain simple MBBS. It is not required for medical council recognized DGO and medical council recognized MD in obs,gynec– all certified Xerox certificates
- Anesthetist medical council recognized DA or MD degree and registration with medical council certificate consent/no objection along with degree and registration– certified Xerox certificates
- No objection from FDA Blood bank and its letter of approval that it shall supply blood in emergency arising out of MTP along with certified Xerox registration/ licence from FDA required for Blood bank
- Boyles machine open or closed type
- Minimum two oxygen filled ready to use cylinders of capacity of 1300 liters
- Electrical Suction machine with suitable tubing’s
- of minimum 10 feet by 10 feet size Fully equipped OT with shadow less light ,OT table and all surgical instruments required for LSCS and emergency laparotomy
- emergency medicines and IV fluids and plasma expanders
- gas/ electrical autoclave and
- gas/ electrical sterilizer
- suitable linen clothes , gowns, face masks
- mayo’s trolley
- Patient shifting trolley
- Indoor bed
- Adult Resuscitation kit
- OT should have clean air
- free flowing water supply for washing
- proper drainage system
- OT fumigation system
- Proper Inverter/Genset for running all equipments of OT in case of electricity load shedding
- foot operated suction machine and stand alone emergency light running on cells for bridging gap between electricity failure and Inverter/Genset operation
- spare adult ambubag and required attachments
- Nurses and ayahs and other supporting staff
- Maintain registers in Form I,II & III along with Form A,B & C for consent
REQUIREMENT FOR MTP REGISTRATION UPTO 20 WEEKS
Additional requirements for 20 weeks centre in addition to 12 weeks
- Additional gynecologist other than one approved for 12 weeks duly qualified
- either fill still birth form or death certificate for disposal of baby
- Do not throw away foetus / baby in garbage, give it to bio waste facility or crematorium
THE LAWS YOU MUST KNOW
YOU NEED TO FILL FORM ‘A’ ND SUBMIT TO PROPER AUTHORITY AND APPROPRIATE AUTHORITY WILL GRANT YOU MTP LICENSE IN FORM ‘B’. AND YOU NEED TO TAKE CONSENT IN FORM ‘C’
CUSTODY OF FORMS
Regulation 4 under MTP act says
(l) The consent given by a pregnant woman for the termination of her pregnancy, together with the certified opinion and intimation of termination of pregnancy shall be placed in an envelope sealed & kept in the safe custody of registered medical practitioner
(2) every sealed envelope be serial numbered assigned to the pregnant woman & marked “SECRET” by RMP
(3) Every envelope shall be sent immediately to the head of the hospital
(4) head of the hospital shall keep the envelop in safe custody.
(5) Every head of the hospital send to the Chief Medical Officer a weekly statement of cases in Form II.
(6) On every envelope marked “SECRET” to bear name and the address of RMP date Of TOP
Explanation.- The columns pertaining to the hospital or approved place and the serial number assigned to the pregnant woman in the Admission Register shall be left blank in Form I in the case of TOP under Section 5.
(7) Where the pregnancy is not terminated in an approved place or hospital, every envelope referred to in sub-regulation (6) shall be sent by registered post to the Chief Medical Officer of the State on the same day on which the pregnancy was, terminated or on the working day next following the day on which the pregnancy was terminated: ,
FORM I
(See Regulation 3)
(Full address of the Registered Medical Practitioner).
I, (Name and qualifications of the Registered Medical Practitioner in block letter
(Full address of the Registered Medical Practitioner).
hereby certify that *I/we am/are of opinion, formed in the good faith, that it is necessary to terminate the pregnancy of.~”
(Full name of pregnant woman in block letters).
Resident of ………………for the reasons given below. “
(Full address of woman in block letters).
I/We her by give intimation that I/We terminated the pregnancy of the woman referred to above who bears the serial No. in the Admission Register of the Hospital/approved place.
Signature of Registered Medical Practitioner
Place
Date
FORM II
See Regulation 4(5)
MONTHLY STATEMENT TO C.M.O.
[IN COMPLIANCE TO THE M.T.P. RULES, 2003 & REGULATION 4(5)]
Name of the State .
Name of the Hospital/approved place .
Duration of pregnancy (give total No. only)
(a) Up to 12 weeks – Total numbers of pregnancy terminated ………………………………………………. .
(b) Between 12-20 weeks – Total numbers of pregnancy terminated ………………………………………………. .
Religion of woman (specify total numbers of women)
(a) Hindu ( ______ )
(b) Muslim ( ______ )
(c) Christian ( ______ )
(d) Others ( ______ )
(e) Total: ( ______ )
Termination with acceptance of contraception (specify total numbers only).
(a) Sterilization ( ____ )
(b) I.U.D. ( _________ )
Reasons for termination: (give total number under each sub-head)
(a) Danger to life of the pregnant woman ( )
(b) Grave injury to the physical health of the pregnant woman ( )
(c) Grave injury to the mental health of the pregnant woman ( )
(d) Pregnancy caused by rape ( )
(e) Substantial risk that if the child was born, it would suffer from such physical or mental abnormalities as to be seriously handicapped ( )
(f) Failure of any contraceptive device or method ( )
Date signature
Name of Hospital
FORM III
(See Regulation 5)
MTP ADMISSION REGISTER
(To be destroyed on the expiry of five years from the date of the last entry in the Register)
Fill For each patient in the Register all 14 columns as below:-
| 1 | Sr. No. | |
| 2 | Date of Admission | |
| 3 | Religion | |
| 4 | Name of Patient | |
| 5 | Wife/daughter | |
| 6 | Age | |
| 7 | Address | |
| 8 | Duration of pregnancy | |
| 9 | Reason on which pregnancy is terminated | A/B/C/D/E/F |
| 10 | Date of termination of pregnancy | |
| 11 | Date of discharge of patient | |
| 12 | Result and remark | |
| 13 | Name of Registered Medical Practitioner(s) by whom the Opinion is formed | |
| 14 | Name of Registered Medical Practitioner(s) by whom pregnancy is terminated |
A) Danger to life,
B) Grave injury to physical health of pregnant women,
C) Grave injury to mental health of pregnant women,
D) Pregnancy caused by rape,
E) Substantial risk that if the child was born, it would suffer From such physical or mental abnormalities so as to be seriously handicapped,
F) Failure of Contraceptives
Note:-
- Monthly statement of the MTP cases, furnished by every head of the hospital or owner of approved MTP Center shall be sent to the C.M.O. of the District/State, where MTP has been done.
- Monthly Statement shall be sent in a sealed envelope marked as “SECRET”.
- Where the pregnancy is not terminated in an approved MTP Centre or hospital, every envelope referred to the CMO, shall be sent by Registered Post on the same day on which the Pregnancy was terminated or on the next working day.
- No entry shall De made in any case-sheet, operation theater register, follow-up card or any other document Of register other than the Admission Register maintained at any hospital or approved place indicating. therein the name of the pregnant woman and reference to the pregnant woman shall be made therein by the serial number assigned to the woman in the Admission Register.
- Keep office copy of this statement for your record purpose.
APPLICATION FORM FOR SEEKING LICNESE FOR MTP
FORM A
[See sub-rule (2) of rule 4]
Form of application for the approval of a place under Cl.(b) of Sec.4
1. Name of the place (in capital letters)………………………………………………………………………..
2. Address in full …………………………………………………………………………………………………….
3. Non-Governmental/Private Nursing home/Other Institutions ………………………………………..
4. State, if the following facilities are available at the place ………………………………………………
(i) An operation table and instruments for performing abdominal or gynaecological surgery
(ii) Drugs and parenteral fluid in sufficient supply for emergency cases.
(iii) Anaesthetic equipment, resuscitation equipment and sterization equipment.
Signature of the owner of the place.
Place :
Date :
* Strike out whichever is not applicable.
LICENSE FOR MTP
FORM B
[See sub-rule (6) of rule 4]
Certificate of approval
The place described below is hereby approved for the purpose of the Medical Termination of Pregnancy Act, 1971 (34 of 1971).
Name of the Place, Address and other descriptions
Name of the owner
Place :
Date :
To the Government of the …………………………….
APPLICATION FORM FOR SEEKING CONSENT OF PATIENT FOR MTP
FORM C
(See rule 8)
I……………………………………………………daughter/wife of…………………………………………………………… aged about…………………………………………………………………………………………………………………..years of………………………………………………………………………………………………………………………………..(here state the permanent address)………….at present residing at…………………….do hereby give my consent of the termination of my pregnancy at…………………………………………………………………………. (State the name of a place where the pregnancy is to be terminated).
Signature.
Place :
Date :
(To be filled in by guardian where the woman is lunatic or minor)
I…………………………………………………….son/daughter/wife of…………………………………………..aged about………………………………….of………………………………at present residing at………………………………( permanent address)………………………………………do hereby give my ward……………………………………………………………………………………………………who is a minor/lunatic at…………………………………………….(place of termination of pregnancy).
Signature.
Place :
Date :
