Abortion in India:

That abortion laws in India are governed by The Medical Termination of Pregnancy [MTP] Act, 1973 which allows for termination of pregnancy up to 20 weeks for all the women in India under certain conditions. The sole aim & object of the law is to ensure safe abortions to all the women in India & reduce maternal mortality rate due to unsafe abortion. And hence to achieve the said object, the Government of India made an important amendment in the MTP Act in the year 2021 & extended gestational period for abortion from 20 to 24 weeks for vulnerable class of women like rape survivors, minors, physically or mentally disable women, Divorcee & Widow etc.

Landmark Judgment on Abortion passed by the Hon’ble Supreme Court of India:

That the Hon’ble Supreme Court of India in the landmark Judgment X v. The Principal Secretary Govt. NCT of Delhi on 29.09.2022 covered unmarried or single women in Rule 3B MTP & allowed them for abortion up to 24 weeks without any consent of partner or parents. Also, the Hon’ble Supreme Court declared abortion as a fundamental right for all the unmarried or single women up to 24 weeks in India. But it is very sad & unfortunate that despite above positive developments, the Maternal Mortality Rate [MMR] has not yet improved & still eight women die daily due to unsafe abortions in India. The main reason behind is lack of awareness among people about the MTP Act and non-regulation of abortion pills. That the abortion pills are sold by local medical shop over the counter to anyone without any medical prescription or ultrasound scan & hence bring severe health complications & even death caused to them due to intake of abortion pills. At present, there is no regulation over the abortion pills and it can be sold by local medical shops to any women or girls included minors without any medical prescription of the doctor. Hence, it’s a major grey area in the law to be strictly implemented by the health officials.

Types of Abortions:

There are basically two types of Abortions depending upon the gestational period & weeks namely as Medical Abortion & Suction Abortion. Both methods are safe & effective for terminating a pregnancy but before opting any method, it is mandatory to have a Doctor Consultation & Ultrasound Scan to confirm the pregnancy & to rule out the Ectopic Pregnancy. That only the consent of the pregnant women is required for both the methods and no one else like husband/spouse/partner or parents. Only in the case of minors or physically disable or mentally challenged women, the consent of the parents or local guardian is required for termination of the pregnancy.

Medical Abortion:

The Medical Abortion is non-invasive & commonly used for up to 9 weeks of gestational period by using Tablets Mifepristone & Misoprostol but it must be taken only at approved medical facility registered by State Government under supervision of a qualified doctor. Medical Abortion is easy to take but have severe side effects like severe abdominal cramps, heavy bleeding, nausea, vomiting, chances of incomplete abortion, RPOC remaining intact or sometimes G-Sac remaining intact in few cases. It is highly unsafe to take abortion pills over the counter without doctor consultation or ultrasound scan as if there is ectopic pregnancy, then it can endanger the life and severe health complications may occur. Before taking abortion pills, it is necessary to check through an ultrasound scan whether the pregnancy is confirmed & sac is visible in the uterus and not any other place. It is also necessary to ascertain from the blood test of the patient whether the patient is neither anaemic nor having other medical history of ailments as the abortion pills cannot be given to patient who are anaemic or suffering from chronic ailments. If the patient after intake of medical abortion is unable to bear the pain or having profuse bleeding, then she must immediately contact her doctor. And in the case of medical abortion, it is always necessary to have a final doctor consultation & follow-up ultrasound after three weeks to check whether the pregnancy is clear or not.

Suction Abortion:

The Suction Abortion on the other hand is the safest & highly effective method for termination of the pregnancy up to 12 weeks. It is also known as Vacuum Aspiration & a surgical method of terminating a pregnancy. This procedure generally takes 5 to 10 minutes in Operation Theatre [OT] done under IV Anaesthesia. A thin, flexible tube (Cannula) is inserted through the Cervix into the Uterus. The Cannula is attached to a Suction Machine, which creates a gentle vacuum. The Suction Machine is activated & the Gestational Sac/RPOC Tissue is gently suctioned out of the Uterus & finally the Ultrasound Scan is done to assure that uterus is clear. This procedure is basically day care and the patient gets discharged same day. There are no major side effects of this procedure except one to two weeks controlled procedural bleeding & that gets settled down by itself. In this procedure, same day rest required & normal activities can be resumed from the next day. The next menstrual cycle gets resume after 6 to 8 weeks and the next pregnancy can be planned after a gap of 4 months. A follow-up doctor consultation & ultrasound scan is required after 3 weeks to ensure that the abortion is complete & no retained products of conception or blood clots are there in the uterus.

Pros & Cons of both Methods of Abortion:

Both methods of abortion have their pros and cons. A women may prefer one method over the other based on their individual needs & preferences. If she needs a procedure without any pain, then second method Suction abortion is advisable. Some women prefer a suction abortion for its quickness & certainty, while others may prefer a medical abortion for more control & privacy. Certain medical conditions may make one method more suitable than the other. For example, women with bleeding disorders or having low Hb or Anaemic advised for suction abortion. It is always essential to consult with a qualified healthcare provider to determine the best option for each individual.

It is noticed that now-a-days, most of the women prefer suction procedure over the medical abortion to avoid pain and down-time in the procedure. Moreover, the suction abortion is good for the women who are working and have to resume work from the next day. And on the other hand, medical abortion is good for the women who have given birth to babies through normal delivery & they are adapted to pain. Ultimately, the choice between medical abortion & suction procedure depends on various factors, including gestational age, medical & health conditions of the patient & personal preferences and the final call have to be taken by the qualified doctors at the medical facility registered by the Government.