MTP AND

PCPNDT
ACT
Sonali Jugran
MTP ACT
 PRE-MTP ERA
• (1860) IPC section 312-316: “inducing an abortion amounted to culpable homicide, and that any
person performing it would be subject to imprisonment for three or more years and/or payment of a
fine.”
• Exception- if performed to save the life of woman.
• Not changed until 1971, resulting deaths due to unsafe illegal abortions.
• Unsafe abortion, third leading cause of maternal deaths in the country, contributes 8% of such deaths
annually.
• Before MTP act, around 5 million terminations were carried out per year, out of which 3 million were
illegal.
• Induced termination of pregnancy whether in hands of skilled or unskilled
persons leads to increased incidence of maternal mortality and morbidity
especially when performed in unsafe and unhygienic conditions.
• Act needed - High mortality and also pressure of an increasing population
• Law recognises foetus as a special aggregation of cells with a potential for
independent life and protects its rights.
 MTP ACT
Passed in 1971 and came into force from 1st April 1972

Revised in 1975

Amended in 2002 (MTP amendment act 2002)

Further amended in 2003 (Medical Termination of Pregnancy Rules and Regulations)

Latest revised on 25 march 2021

COMPRISE OF

Indications for which termination of pregnancy can be done

Who can perform
Where can it be performed
Higher limit of period of gestation
 WHEN?

The continuation of the pregnancy would involve a risk to the life of the pregnant
woman
Risk of grave injury to her physical or mental health
If child were born, it would suffer from such physical or mental abnormalities as to
be seriously handicapped
 INDICATIONS
MEDICAL
 Heart disease grade III and IV
 Severe hypertension
 Chronic glomerulonephritis
 Diabetic retinopathy
 Epilepsy
 Severe psychiatric illness
 Uncontrolled hyperemesis gravidarum
 Cervical or breast malignancy
SOCIAL

Pregnancy caused by rape

Pregnancy due to contraceptive failure
Unplanned pregnancy
EUGENIC
Anencephaly
Down syndrome
Uncorrectable multiple anomalies
Malformation due to teratogenesis
Rubella in first trimester
 PERIOD OF GESTATION

MTP can be done upto 20 weeks of gestation

Duration < 12 weeks- single medical practitioner can take the decision
 Duration >12 weeks and < 20 weeks, opinion of two registered medical
practitioners is needed.
WHERE ?

• Government hospitals

• Non governmental establishment approved by the

government
 2003 AMENDMENT- REQUIREMENTS FOR
APPROVAL
First trimester abortions Second trimester abortions

 Gynaecology examination/labour table  Operation table and instruments for performing

abdominal or gynaecological surgery
 Resuscitation and sterilization equipment
 Anaesthetic, resuscitation and sterilization
 Drugs and parental fluid required equipment

 Back up facilities for treatment of shock  Drugs and parental fluids for emergency use.

 Facilities for transportation

PROCEDURE FOR APPROVAL
Form A application addressed to CMO

CMO verify/inspect

Recommend the approval to the district committee

Certificate of approval in form B

 WHO CAN PERFORM?

Any medical practitioner registered in state medical register and

• He/she has completed 6 months of house surgency in gynaecology and obstetrics
• He/she had experience at any hospital for a period of not less than 1 year in the
practice of obs and gynae
• He/she has assisted a registered medical practitioner in at least 25 cases of MTP
(at least 5 have been performed independently) in an authorized center
• He/ she holds a post graduate degree or diploma in gynaecology and obstetrics
WHO CAN GIVE CONSENT?

• Written consent of the woman concerned

• If minor or mentally ill, written consent of legal guardian
(2002 amendment- “mentally ill” to be used in place of lunatic; any person who
is in need of treatment by reason of any mental disorder other than mental
retardation)
PRE REQUISITES

• Approach by the woman for termination with genuine indication

• Counselling
• Consent
• Physical examination- general and gynaecological
• Investigations
MTP AMENDEMENT ACT 2021

• “A procedure to terminate a pregnancy by using medical or surgical methods”

• Revises the gestational age limits
• GA< 20 weeks, opinion of a single registered medical practitioner is required
• GA > 20 weeks and < 24 weeks , opinion of two registered medical practitioners
required
• If diagnosed as “substantial foetal abnormalities” by medical board , provisions
relating to length of pregnancy will not apply.
 CONT….

• Substituted “married woman or her husband” with “any woman or her partner” in
the part dealing with pregnancy due to contraceptive failure.
• A new section introduced (5A) to protects the privacy of women seeking termination
of pregnancy
• Discard the proposal of incorporating AYUSH health care providers and nurses.
 PENALTIES

• No legal proceeding lie against any RMP for any damaged caused by
anything which is done in good faith under this act
• Pregnancy termination by a non-RMP is a punishable offence- rigorous
imprisonment for a term not less than 2 years and extend to 7 years.
• Termination in a place other than mentioned- whoever performs is subjected to
rigorous imprisonment for a term not less than 2 years and extend to 7 years and
also for the owner
• Violation of privacy- imprisonment extending to one year or with fine or both.
CASE 1

• PANCHKULA-2020- Gynaecologist accused of conducting an abortion of

the female foetus and demanding 20,000 rupees. The accused doctor was
approached by a couple for termination of third pregnancy of female
foetus. She was accused of performing illegal MTPs for monetary gains
and also performing MTPs at her house.
Case was registered and her Suspension was ordered.
 CASE 2

• GWALIOR- 2012 : on receiving information of an illegal MTP, a team of magistrate

and CMHO inspected a nursing home and found 28 year old pregnant female
admitted for MTP. The consulting doctor was not able to produce any consent form,
USG report for confirming gestational age, or any other form in accordance with the
act. During check up no cause for MTP to be done was found. Patient was shifted and
evacuation was done as medicine was already inserted for abortion. Postmortem
revealed 16 weeks female foetus. The nursing home was registered for first trimester
MTP only.
• FIR registered and Registration of nursing home cancelled with immediate effect.
 CASE 3
PUNJAB; 2011: A husband filed a suit against her wife, her parents, brother and
doctors for conducting termination of pregnancy at 6 weeks without his consent.
He argued that termination cannot be done unless it harms the physical health of
the woman.

Judgement- only the woman undergoing termination needs to provide consent.

The doctors conducted the procedure in a safe and legal setting in “good faith”
under the act, so exempted.
PCPNDT ACT
 ORIGIN

• Pre natal diagnostic techniques (regulation and prevention of misuse) act

1994 PNDT was passed and came into effect on 1 January 1996.
• Amended in 2003 to pre conception and pre natal diagnostic techniques
(prohibition of sex selection ) PCPNDT Act
• Improve the regulation of the technology used in sex selection
 NEED

• To prevent female foeticide

• Concern of decreased female-male ratio
• National child sex ratio- in 1991 was 945 girls for every 1000 boys aged 0 to 6, by
2011 it has fallen to 918.
• Census conducted in 2011- Uttarakhand’s child sex ratio fell from 908 in 2001 to 890
ten years later.
PCPNDT ACT

“An Act to provide for the prohibition of sex selection, before or

after conception, and for regulation of prenatal diagnostic
techniques for the purposes of detecting genetic abnormalities or
metabolic disorders or chromosomal abnormalities or certain
congenital malformations or sex-linked disorders and for the
prevention of their misuse for sex determination leading to female
foeticide.”
 DEFINITIONS ACCORDING TO ACT

• “PRE-NATAL DIAGNOSTIC PROCEDURES” means all gynaecological or obstetrical or medical

procedures such as ultrasonography, foetoscopy, taking or removing samples of amniotic fluid,
chorionic villi, blood or any other tissue or fluid of a man, or of a woman for being sent to a Genetic
Laboratory or Genetic Clinic for conducting any type of analysis or pre-natal diagnostic tests for
selection of sex before or after conception;

• “PRE-NATAL DIAGNOSTIC TEST” means ultrasonography or any test or analysis of amniotic fluid,
chorionic villi, blood or any tissue or fluid of a pregnant woman or conceptus conducted to detect
genetic or metabolic disorders or chromosomal abnormalities or congenital anomalies or
haemoglobinopathies or sex-linked diseases
• “SEX SELECTION” includes any procedure, technique, test or
administration or prescription or provision of anything for the
purpose of ensuring or increasing the probability that an embryo
will be of a particular sex;
 PROVISIONS
No Genetic Counselling Centre/Laboratory/Clinic unless registered under this Act, shall
conduct or associate with, or help in, conducting activities relating to prenatal
diagnostic techniques;
No Genetic Counselling Centre/Laboratory/Clinic shall employ or take services of any
person who does not possess qualifications as may be prescribed;
No medical geneticist, gynaecologist, paediatrician, registered medical practitioner or
any other person shall conduct or aid in conducting any pre-natal diagnostic techniques
at a place other than a place registered under this Act.
 CONT…..
PROHIBITION OF SEX-SELECTION- No person, including a specialist or a team of
specialists in the field of infertility, shall conduct sex selection on a woman or a man or
on both or on any tissue, embryo, conceptus, fluid or gametes derived from either or
both of them.

DETERMINATION OF SEX PROHIBITED-No Genetic Counselling Centre

/Laboratory /Clinic shall conduct or cause to be conducted in its Centre, Laboratory or
Clinic, pre-natal diagnostic techniques including ultrasonography, for the purpose of
determining the sex of a foetus.
 No communication can be made about the sex of the foetus in any
manner
Prohibition on sale of ultrasound machines, etc., to persons,
laboratories, clinics, etc. not registered under the Act
• No person or organization Shall advertise in any manner regarding
pre-natal determination or preconception selection of sex by any
means.
• Must display a notice delineating that sex determination/selection is
prohibited under law.
REGISTRATION: applications sent to appropriate authority by filling
form A with application fee,
Receive form B as a certificate to be displayed and valid for 5 years.
Pre-natal diagnostic techniques shall be conducted for the purposes of detection of
any of the following abnormalities—
• chromosomal abnormalities;
• genetic metabolic diseases;
• haemoglobinopathies;
• sex-linked genetic diseases;
• congenital anomalies;
• any other abnormalities or diseases as may be specified by the Central Supervisory
Board;
Pre-natal diagnostic techniques shall be used or conducted for any of the
following conditions
• age of the pregnant woman is above thirty-five years;
• the pregnant woman has undergone of two or more spontaneous abortions or
foetal loss;
• the pregnant woman had been exposed to potentially teratogenic agents such as
drugs, radiation, infection or chemicals;
• the pregnant woman or her spouse has a family history of mental retardation or
physical deformities or any other genetic disease;
• any other condition as may be specified by the Central Supervisory Board;
• MAINTENANCE OF RECORDS

• Before conducting a test, form F to be filled (details, indication and

declaration);
• Records to be maintained for 2 years
• Or till the final disposal of any legal proceedings
 PUNISHMENT

• Doctor performing the test- Rigorous imprisonment upto 3 years and fine of 10,000;
Registration suspension/ cancellation
• Family members demanding test : 3 years of rigorous imprisonment and fine of rs
50000;
5 years imprisonment and 1 lakh fine on subsequent offence
• Pregnant woman will not be charged.
CASE 1

• CHANDIGARH-2009: PIL filed directing state government to conduct an

enquiry into illegal elimination of 250 female foetuses leading to recovery
of large quantity of fetal remains from a 20 feet deep septic tank from a
nursing home in Gurgaon district.
• Administrative enquiry done, , 4 medical officers found guilty and
appropriate actions taken.
 CASE 2
BOMBAY-2005: A married couple filed a petition having 2 female children
and were desirous of a male child; on basis that couple who already have
children of one sex should be allowed to make use of diagnostic techniques to
have a child of opposite sex and to balance the family.
Plea was rejected on discriminatory grounds as techniques cannot be used for
sex selection.
CASE 3: 2012- An applicant published an article in the local newspaper on
how to conceive a male child through naturopathy.
Prosecution initiated against the applicant.
TO CONCLUDE……

• These acts are implemented to ensure safe abortion services to women and
to regulate diagnostic techniques.
• These also serve to prevent female discrimination
• To be followed by professionals for avoiding legal proceedings.
THANK YOU