Respectful Abortion Care: Comprehensive Abortion Care (CAC) Refresher Trainings

An initiative led by Prof Dr S Shantha Kumari, President, The Federation of Obstetrics and Gynaecological Societies of India (FOGSI), WHO and GOI.

India first legalized abortion in 1971 to provide legal and safe abortion services to women. However, with the passage of time and advancements of medical technology for safe abortion, there was a need for increasing gestational limit for terminating pregnancies, especially for vulnerable women and for pregnancies with substantial fetal abnormalities detected late in the pregnancy.

In a historic move India amended the Medical Termination of Pregnancy (MTP) Act 1971 to increase access to comprehensive abortion care for all. The new Medical Termination of Pregnancy (Amendment) Act 2021 which came into force from 25 March 2021, aims to contribute significantly towards ending preventable maternal mortality to help in meeting the Sustainable Development Goals (SDGs) 3.1, 3.7 and 5.6 and expand access to safe and legal abortion services on therapeutic, eugenic, humanitarian and social grounds.

Key Amendments: 

• Gestational limit increased from 20 to 24 weeks for special categories of women, including the survivors of rape, victims of incest and other vulnerable women (like differently abled women, minors etc.)
• Non-applicability of the provisions relating to the length of pregnancy in cases where the termination of pregnancy is necessitated by the diagnosis of any of the substantial fetal abnormalities diagnosed by a Medical Board.
• Requirement of the opinion of only one provider for abortions up to 20 weeks and two providers for abortions between 20-24 weeks
• Name and other particulars of a woman whose pregnancy has been terminated shall not be revealed except to a person authorized in any law for the time being in force.
• The ground of failure of contraceptive has been extended to women and her partner.

FOGSI, WHO and GOI are working together to ensure all Obstetricians-Gynecologists in the FOGSI network across India are updated on the 2021 MTP Amendment and its corresponding rules through competency-based trainings to reduce conscientious bias in abortion care and provide dignity, quality, and respectful services to all women.

List of topics being covered in the trainings

1. Medical Termination of Pregnancy (MTP) Amendment 2021- key changes and implications
2. Methods of Abortion (MMA) – updates in technology, availability, and quality
3. Cross the line Game - WHO SAVER Toolkit- Safe Abortion Values, Evidence and Rights
4. Pre-post Abortion FP Counselling – need for online consultations