Sanjeev Kumar Patro

Bhubaneswar: With the Union Cabinet on Friday having vetted the Medical Termination of Pregnancy (Amendment) Bill 2020, India has joined a select group of 67 countries across the world where the upper gestation limit for medical terminated pregnancy is 24 weeks.

At present the length of pregnancy termination period is restricted to 20 weeks under the Section 3(2)(b) of the MTP Act 1971. The section has also stipulated requirement of opinion of two medical practitioners regarding whether continuance of pregnancy would subject the foetus or the mother to considerable risk. The section is applicable to cases of pregnancies exceeding 12 weeks but not 20 weeks.

Similarly, another section, 3(2)(a), requires that in case of pregnancy not exceeding 12 weeks, abortion can be performed only if a medical practitioner forms an opinion that continuance of pregnancy would endanger the mother or the foetus’ life.

As per the amendment vetted in the Cabinet today, the amendments haven't completely done away with the medical opinion on MTP, but has tweaked somewhat and proposed a requirement for opinion of one provider for termination of pregnancy up to 20 weeks of gestation and introducing the requirement of opinion of two providers for termination of pregnancy of 20-24 weeks.

The Centre has raised the upper limit period for 'vulnerable women' including survivors of rape, victims of incest , differently-abled women, Minors, or the foetus having high abnormality/deformity  etc.

However, the other side of the story is reports show the facility of MTPs are being misused in the State to carry out sex selection. Sex selection is usually done in between 18 and 22 weeks.

Therefore, to check  and balance MTP Act, Union government inserted the requirement of medical opinion before going for induced abortion.

Also, as unsafe abortion is the third cause of maternal mortality in India, the Union Health Ministry has liberalised certain sections to create a climate of safe abortion in the country.

The data available with the State Health department shows Odisha has recorded a massive 34,712 spontaneous abortions for the period April - December 2019.  Besides, a high of another 9,797 MTPs were conducted during the same period. The total MTPs in 2018-19 were 12,316. MTPs account for a high over 30 per cent of total abortions in Odisha, reveals the data.

The noteworthy mention is the above numbers belong to government health/MTPs centres only. And MTPs at public health institutions account for only around 86 per cent of total MTPs in the State.

Moreover, though late abortions in Odisha stood at only 3.5 per cent of the total MTPs conducted in the State. There is no uniformity in late MTP cases in the State.

Two districts - Balasore and Khurda -account for over 13 per cent of late MTPs in the State. As many as 10 districts in State report proportion of late abortions higher than the State average. The ithr districts are: Balasore, Sundargarh, Ganjam, Keonjhar, Malkangiri, Sambalpur, Nuapada and Nayagarh.

Though Khurda report higher MTP in numbers, when seen proportionately, it's below the state average,

An analysis also showed that except Sundergarh, all other districts that have reported higher late MTPs, coincidentally have a poor sex ratio at live birth - means sex ratio (girls per 1000 boys) of newborn.

However, a study done by Gynecology Department of  Capital Hospital reasons that the high rate of MTPs in Khurda district is attributed to reasons like environmental factors, injury to physical health and failure of contraceptives.

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