Union government has introduced a draft of the Medical Termination of Pregnancy (Amendment) Bill, 2014.The salient features of the proposed amendment are abortion can be performed by those practicing Ayurveda, Homoeopathy and also by midwives. The abortion time limit has also been raised to 24 weeks from the existing 20 weeks.
But experts in the field of maternal healthcare have exhorted the need for strengthening the rules by engaging the stakeholders concerned through more consultation meetings and extensive deliberations. They call for the inclusion of Medical Abortion pills for early termination but exercise caution in expanding base of healthcare providers.
The maternal healthcare sector suggest that a comprehensive approach is required to tackle the issues at a macro level. Though the amendment was long overdue, it cannot be done in haste.
“As of now, we apprehend a few shortcomings, as the amendment has to be properly worded. Both these proposals are revolutionary and long awaited. However, we see a lack of cohesive approach here. The time frame (November 10) specified by the Union Ministry of Health & Family Welfare for experts to submit their suggestions/advise is too short. We need a serious thinking, involving all the stakeholders concerned, before any decision is taken,” said Dr. Hema Divakar, Medical Director, Divakars Specialty Hospital, Bengaluru and past president of Federation of Obstetric and Gynaecological Societies of India (FOGSI).
“The Draft Bill in its present form is open for misinterpretation, as people are reading these amendments in isolation without examining the MTP Act and Rules which continue to stand these are additions or selective changes. Many changes we have been part of have brought down the unsafe abortion share of maternal mortality in India from 12 per cent to 8 per cent and we need to go much further which we believe these amendments could do for us, she added.
According to FOGSI, while due attention needs to be paid to the use of contraceptive methods to prevent unwanted pregnancies, there is a need for introducing medical abortion pills on a priority basis for early termination of pregnancies. This will not only help curb maternal mortality rate, but also help women, particularly those in rural areas, in approaching quacks for abortion.
Many members in the Federation are apprehensive about expanding the pool of providers to include those practicing Ayurveda, Homeopathy and also by midwives. Right now in a responsible way by using medical abortion pills in the right manner with right instructions by registered medical practitioners, the women will be safe and stand to benefit. Due training of MBBS doctors is the need of the hour.
Dr. Hema also emphasized the need for more clarity on empowering those practicing Ayurveda, Homoeopathy and midwives to perform abortion. “The issue of 20 to 24 weeks for terminating for fetal abnormalities lacks clarity. The rules for this stay the same with respect to the provision by the specialists and non-specialists should never be allowed to perform,” she observed.
The maternal health fraternity opined that it was high time that the government takes into confidence all the stake-holders from the medical profession before finalising the Draft Medical Termination of Pregnancy (Amendment) Bill 2014.