Social Implications of The MTP, 1971 Act:

Govt. of India has enacted much social legislation since independence. In practice we discover that these very good social legislation have remained in the books and the govt. isn't able to implement these laws. The anti dowry bill or the Child marriage bill or the anti sati bill are few instances. Child marriages still takes place. The MTPA is that the only social legislation that has found wide acceptance without any resentment. Unwanted pregnancy may be a social stress in all societies. Before the MTP act, unwanted pregnancy was managed by resorting to illegal abortion, infanticide or deserting the new born in lonely places. Now with the MTP act, the social fears are considerably reduced and therefore the urban and the rural community have taken advantage of the Act. Patterns of sexual and reproductive behaviour have changed significantly over the years. Most vital change is the increase in the premarital sex in all societies. there's also an increase in the out of wedlock births. there's increasing freedom enjoyed by the teenagers in social life. This often leads to increased teenage pregnancy. The tragedy is that physiologically and anatomically there's a trend towards earlier maturation while process of social development is lagging behind.

 

The impact of the MTP act should be judged within the context of changing social values and attitudes. The social implications of MTP in unmarried girls and MTP in wife are different. MTP in wife is not considered as a social stigma, whereas MTP in unmarried girls isn't easily accepted and hence girls are taken to other distant places for MTP, and hence the girl's social future isn't destroyed. This social legislation has certainly reduced incidence of suicide in these women because they will seek safe abortion under the law. The health of the lady has also shown improvement because of the MTP facilities. The acceptance of the birth control methods after MTP has also increased.  It's paradoxical that though the community is taking the advantage of MTP services, they need to maintain secrecy and not let the neighbour about it.

           
Here negative aspects of the MTP Act have also to be considered. Though the MTP services are now available in rural areas, we aren't sure of its effectiveness and safety. The high-risk cases aren't recognized and MTP is performed in such cases without adequate back-up services. This leads to immediate complications and long-term morbidity in term of infertility, menstrual disturbances and pelvic disease (PID). These long-term complications may have social implications in sort of broken marriages, divorce, and promiscuity. Mehlar, Director General of WHO has said, "because of great effects of legalized abortion on the health and reproductive capacity of women, upon the steadiness of family and upon the morality of country specially its youth, it should be administered only in a hospital and that to by a           gynaecologist.

How true are the words in context of this situation in India? The Govt. must see that MTP is completed by trained surgeons only and that to in a hospital set-up. Gynecologist must also share some blame for MTP complications. The young girls and ladies come to the gynecologist at any time for MTP. this is often because they do not want to inform the parents or other family members about it. Some deaths on operation table are reported because of the practice of performing quick MTP without proper checkup. it's necessary that gynecologist do not perform MTP at unearthly hours and without proper facilities to fight complications if they do arise. The Indian MTP act is most liberal in practice, it almost amount to "abortion on demand”.                                                                                             

It is said that termination of pregnancy is performed on flimsy ground such as 'approaching examination'. 'Marriage within the family', 'going on a tour or vacations', etc. it's said that medical fraternity encourages such unnecessary terminations more often for financial reasons. it's necessary to check this trend of pregnancy termination on flimsy grounds. it's often not realized that to frequent and unnecessary pregnancy termination can result in infertility and PID. Though the MTP act was never thought to be used as a way of family planning it is unfortunately used as an alternative to regular methods of family planning by many women. it's the social responsibility of obstetricians to counsel all patients coming for MTP about the use of some contraception. It should be emphasized that contraception use is far safer than MTP.

 Mr. NeeravKhare