Medical Termination of Pregnancy (MTP) Unveiled: What Every Individual Needs to Know

Host:  Hello and welcome to Pace Hospitals podcast. Today we are diving into the sensitive yet crucial topic of medical termination of pregnancy or MTP.

Joining us today, Doctor Rupa Pandra - obstetrician, gynecologist, laparoscopic surgeon and infertility consultant, having wide expertise in treating and managing gynecologic related problems.

Today she would like to delve into a topic of medical termination of pregnancy or MTP, thats often surrounded by controversy, yet profoundly impact the lives of individuals and families worldwide.

Thank you Doctor Roopa for joining us at Peace Hospitals High tech city.

Host:  Can you please explain what should be done in case of a missed period and what could be the reason for it?

Doctor: Today I want to discuss a very delicate topic which if we are very ignorant about and we are neglecting a lot women of this generation, and especially the women of this generation, I would like to advise you all and listen to me properly about what I'm talking.

So whenever you have a miss period, there are so many, so many reasons for a missed period. First thing we have to rule out is pregnancy, so whether you're married, unmarried or so by taking your historyor you know, like some people, they do the pregnancy test at home and come to us.

So people don't know, they come to the gynecologist or to the hospital to do the pregnancy, so first thing we have to do when any woman comes with a missed period is a to rule out pregnancy.

Wherever, depending on the history of the patient, if pregnancy is ruled out, then we rule out the other reasons like so many other reasons would be there, like hormonal reason, hormonal issues, obesity and hormonal issues, obesity, stress factors and so many others which would be discussed with you and you come to the doctor.

 Host:  So doctor, could you please shed some light on the preventive measures and medical termination of pregnancy guidelines in case of confirmed early pregnancythrough the urine pregnancy test?

Doctor:  Today I want to mainly speak on patients who miss their period and who at home get their UPT i,e. urine pregnancy test done at home. They come to know it is positive and it is an early pregnancy, either they google or they get knowledge from other friends and relatives and then they take their own medication without consulting a gynecologist, which is very dangerous.

So I will explain to you why it is dangerous see, the problem is whenever you have an early pregnancy, you think that, you know, you can just take medicine and you know, it is a process which goes on at home, but there are certain rules and regulations which you have to follow before taking the medication and it is not legal to take medication over the counter and whoever is supplying you with medications.

Over the counter is supposed to explain to you about the medicine, complications of the medicine, what happens after taking the medicine, why you're supposed to do investigations before taking the medication, during the process of abortion, what can happen to you? All that can be explained only by a gynecologist or a medical staff but this is not being followed these days.

People are free making unwanted pills or medication for medical termination of pregnancy freely available in the shops or we don't know where the patients are getting there. No. Basically I want to tell you this is very dangerous because when you meet a gynecologist, why does the gynaecologist tell you that you should take the medicine only after doing certain investigations like basic test, like what is your hemoglobin, what is your blood group, are you a hypothyroid and a early pregnancy scan?

So many patients ask us why should we do a scan? This is only early pregnancy it is only one week. It is only two weeks I have missed it's only ten days. I agree to that, you can just take the medicine and it will be expelled but there are conditions where you cannot take the medicine even if your urine pregnancy test is positive.

That is, whenever you do a urine pregnancy test it just tells you that there is pregnancy but it doesn't tell you whether it is in the uterus or in the fallopian tube. So the pregnancy has to grow in the uterus, so whenever it grows outside uterus, it is a complication. It is not supposed to grow either in the tube or in the ovary or elsewhere wherever it is.

So we do a scan to rule out that it is not in the fallopian tube because if it occurs in the fallopian tube there is a condition called ectopic pregnancy which is a life threatening situation to the patient and other than the gynecologist, nobody is authorized to give the medical termination pill, that is the unwanted pill to a patient.

So this should be remembered by every woman and every patient that the medication has. The only the gynecologist has the right and there are some formalities written by the government according to the medical termination that is the MDP act. The latest Amended Act 2021 says that any woman above 18 years old can go for a medical termination of pregnancy without anybody's consent. She has the right. Okay and up to first trimester. First trimester of pregnancy she can go for a medical termination.

If it is in the second trimester, she can go for a medical termination but other complications like failed induction. Failed induction means where the medicine does not work, or incomplete abortion, or retained placenta. Incomplete abortion means only part of the products come and the part of the products remain inside and then the patient starts bleeding then failed induction, that means the medicine doesn't work at all and then you have to put a nick on the uterus and remove the baby.

Then the third is the baby comes out and the placenta remains that is called retained placenta, which is also dangerous she may start bleeding. So the second trimester abortion cannot occur. It cannot be happening at home. So anything more than twelve weeks has to be monitored and supervised by the doctors and the paramedical staff.

So please remember this and there was a case today why I'm especially discussing about this, uh, and telling all the women there who do not want their pregnancy, please go. Don't take directly over the counter medication, it is illegal and there is a process for it.

The people who supply the medicine and who take the medicine without authority of the gynecologist and there are forms which have to be signed and submitted to the government. This is very strict rule and why this is being done and all the patients question the doctors.

Why should we sign this form? Why are you charging so much? Why are you doing all these tests unnecessarily? When the problem arises?

We are answerable for that and we need to answer everybody for any complication which arise, so we have an answer for everything and one more reason why the government has implemented this. This rule was implemented, this NTP act was implemented in 1971.

Now the Amended Act, Amendment Act 2021, so this is basically to avoid all illegal abortions, abortions which are done by quacks and where many women have died in the past because of septic abortion, that is, untrained staff in villages and quacks have done dilatation and curator d and c procedures to clean the uterus. Many women have died because of this, so to decrease the mortality rate, that is the death rate, morbidity rate, that means a complication rate because of abortion and to decrease fetal feticide, many women are going for gender discrimination, gender determin, sex determination, and then going for a fetal feticide.

So these are the reasons why the government has implemented this act and it is mandatory and even if patients go take medicine over the counter, nobody questions the person who is supplying the medicine or the patient who has taken it. But if the same patient comes to the hospital with a complication and she dies, then we are questioned, doctors are questioned why this is why the patient died, why didn't you all attend? But everybody forgets about what is happening outside the hospital.

So please my dear friends, follow this, recently we had a patient who has done the same mistake, she has taken medicine over the counter after a missed period and her urine pregnancy test was positive and she came in shock with in euctopic pregnancy where she bled to death and by the time she was taken for surgery, we advised her for surgery.

She was not willing and some friends who came, she was an unmarried lady, she went outside, she went to some other hospital maybe due to so many reasons and she passed away before she was taken for surgery. So these one or two complications which can occur are very dangerous for women. So don't take any risk.

Please be open with your gynecologist, they're always there to help you and I'm not blaming, I'm not complaining about people who are supplying the medicine. It is just that the patient should be guided properly and the rules implemented by the government should be followed. So I wish all of you would do this and take this piece of my advice sincerely. Thank you.

Host:  Thank you Doctor Rupa for joining us and sharing crucial information on sensitive and important topic regarding MTP to our listeners. If any of you have any further questions regarding MTP, please don't hesitate to consult a gynecologist and remember, understanding and compassion are essential as we navigate this complex issue.

Thank you for tuning. We will be back soon with another episode on Pace Hospitals podcast. Until next time, take care, be well and be compassionate. Thank you. Bye.