The need for flexibility in the upper limit of gestational age for fetal anomalies in the MTP act: A questionnaire survey

To elicit opinion of practicing obstetricians regarding the change required in the existing MTP Act with regard to limit of gestational age for terminating pregnancies with fetal anomalies and to obtain suggestions about formation of a regulatory body, a questionnaire survey was carried out amongst the consultant obstetricians spread across the city. The questionnaire sought opinions on whether or not to terminate a pregnancy beyond 24 weeks based on the kind of fetal anomaly diagnosed, need or otherwise for increasing the gestational age limit for considering MTP, how would one react to the situation of managing a live baby following late pregnancy terminations and requirement of a regulatory body and consequences of such an amendment. The questions were a combination of multiple choice and open ended types with options of adding one's own suggestions. Responses were received from 41obstetricians and 90.2% expressed the need for amending the MTP Act to increase limit of gestational age with 24.3% suggesting delinking the age constraint. If the anomaly were to be of uncertain significance or that incompatible with survival, 12.2 to 19.5% responded in favor of refusal to terminate pregnancy if duration of pregnancy was beyond the legally permissible limit. Majority of respondents opted for terminating pregnancy citing maternal reasons (36.6 to 39%), recording lower legally permissible gestational age (24.3 to 36.6%) or recording it as preterm labor-delivery (9.7 to 73.2%). Mothers wish was the prime consideration by 41.5%. Opinion of 53.7% obstetricians was not to resuscitate if baby was born alive and 19.5% opted to ensure prior feticide. Necessity of ombudsman was felt by 68.3% It is concluded that delinking or at least raising the gestational age from the provisions of MTP Act for fetal anomalies is required. It is necessary to have a regulatory body to concur with decision made for termination of pregnancy.