A week after the ministry of health and family welfare's maternal health division proposed to amend the existing Medical Termination of Pregnancy Act, 1971, several associations of doctors strongly opposed the government's decision to allow ayurveds, homoeopaths and midwives to perform abortion as well.

The Indian Medical Association (IMA) had on Thursday opposed the proposed amendments to the new MTP Act.

A step backwards, say doctorsDr Sudhir Naik, gynaecologist and president-elect of the Association of Medical Counsultants (AMC), said, "The draft bill comes across as one of the most liberal abortion documents but we strongly oppose allowing midwives and ayurveds, homeopaths to perform abortions."The draft bill, put up on the union health ministry's website for suggestions on Thursday, proposes an increase in cut-off period for abortion from the present 20 weeks to 24 weeks. While doctors praise this move, they say allowing midwives and unqualified doctors to perform abortions legally is a step backwards. In a letter to the health ministry, the doctors have pointed out how the amendment will risk the life of a woman.

Risk to a woman's life"The procedure of first trimester abortions is a blind procedure with an inherent risk of puncturing the uterus and causing incomplete abortions or massive bleeding and sepsis. The long-term complications in the form of pelvic inflammatory disease causing subsequent infertility are also too real to ignore. Some of these complications could also result in the young woman requiring hysterectomy as a life-saving measure. We shudder at the thought of this dreaded outcome of one simple procedure carried out by semi-qualified personnel," said Dr Sangeeta Pikale, gynaecologist and president of AMC.The IMA, the umbrella body of allopathy medicine practising doctors, has also written to health minister Dr Harsh Vardhan, saying that the amendment is retrogressive and will increase maternal mortality. "MTP involves alopathy drugs, anaesthesia, the person has to interpret sonography, blood tests, which is not taught in AYUSH or to midwives. IMA is the largest body of doctors and we have not been taken in to confidence before the amendment was made," said Dr KK Aggarwal, present senior national vice president of IMA.

Focus should be on contraceptionThe doctors said that the health ministry should promote and emphasize on contraceptive methods to prevent unwanted pregnancies and not medical termination. "The focus of the family planning program has to be contraception and permanent methods of sterilization after completing the family, rather than abortions. Involving these AYUSH doctors and trained midwives after proper training in methods of contraception should be the focus of the government," said Dr Naik.Advocate Varsha Deshpande, who runs 'Lek Ladki Abhiyan', a Satara-based NGO which has been working against pre-natal sex determination said, "Abortion should be done only by a registered medical practitioner. This amendment will encourage sex-selective abortions in the country. It will also reverse our efforts made so far to improve child sex ratio. The government needs to rethink the amendment. Repeated pregnancies and deliveries bring risk to the life of women. Abortions by non-MBBS person will be like cruelty against women," said Deshpande.While IMA and AMC has openly come out against the amendment, FOGSI is tight-lipped and divided. While most members are against allowing non-MBBS doctors practising MTP, few are for it.The proposed act that will be called 'The Medical Termination of Pregnancy (Amendment) Bill, 2014' is up for people's review on the health ministry's website till November 10, after which the draft will be finalised.