MTP and AIDS

MTP and AIDS:

Though some authorities advise termination of pregnancies in every HIV positive case it is a debatable issue. Various studies show that percentage of transmission from other to baby varies from 12 to 15 % (in European collaboration studies) to 45% in African countries.

Ethical issues leading to legal issues:

Legal problem may arise in the following issue:

1. Termination done without proper counseling and consent.
2. Continuation of pregnancy following MTP. It is an ethical problem where pregnancy is continued in spite of attempted termination both in respect of mother and fetus. If the baby in later life comes to know that he/she was an unwanted one a serious psychological set back leading to hatred to the parent might be imparted upon. From legal point of view, it may be stamped as act of negligence.
3. Among many reasons of failed MTP 'faulty techniques' is one.
4. Improper diagnosis and MTP. It is unethical to attempt MTP without confirming the pregnancy. Often ectopic pregnancy is missed. This might endanger the woman's life and consequently invite litigation.
5. Morbidity and even mortality following the procedure attributable to negligence and improper care given to her in follow-up.
6. MTP in Primigravide is of grave ethical concern. The first pregnancy is the most welcome one to a family, so the physical and mental trauma imparted to her cannot be replaced. Moreover there is a chance of infection leading to morbidity and even in future, secondary infertility- a cure to womanhood in our society.

Psychosocial Aspects Of Mtp:

"No woman can call herself free until she can choose consciously whether she will or will not be a mother"

Margaret Sanger

Women have come a long way since the day of Margaret Sanger when abortion was an illegal, secretive and socially unacceptable procedure, hidden from family members. Today with MTP legally available in most countries of the World, the physiological trauma and social isolation are considerable less. Most studies report psychologically favorable outcomes following MTP in the majority of women. In a landmark study, Osfosky and Osofsky reported psychologically favorable outcomes in 64.6% of 250 women undergoing legal abortions in New York State. On the other hand, there is no denying that MTP can be an emotionally disturbing procedure in many women. However in the socially favorable circumstances following legalized abortion, the patient's relief of getting rid of the unwanted pregnancy outshadows and feeling of guilt that either used to accompany an illegal and socially unsanctioned procedure. In a minority of patients, we see major psychological disturbances in the form of major psychoses or depression.