MTP

A medical termination ends a pregnancy using medicines instead of an operation. Two different medicines are used, taken a day or two apart. The first blocks the hormone the pregnancy needs in order to continue, and the second makes the uterus contract and empty itself. The medicines are prescribed and supervised by a doctor, and the interval, the route and the dose are all decided by them.

This method is used in early pregnancy. How early depends on the assessment, and your doctor will confirm the number of weeks with a scan before anything is given, because beyond a certain point in pregnancy these medicines are not the right approach and a different one is offered.

In India this is governed by the Medical Termination of Pregnancy Act. Care is provided by a registered medical practitioner at an approved facility, within the gestational limits and the grounds the Act sets out, and the opinion of one or two doctors is required depending on the stage of pregnancy. The consent that matters is yours: for a woman over eighteen, the consent of a husband, partner or parent is not required. For someone under eighteen, a guardian's consent is needed. Your identity is protected under the Act.

No anaesthetic is used and there is no operation, so you are awake and aware throughout. The first medicine is given at the clinic and most women feel nothing at all after it, occasionally some nausea or light bleeding. You go about your day normally in the interval before the second.

The second medicine is what starts the process, and your doctor will tell you whether you take it at the clinic or at home and exactly when. Cramping begins within a few hours and can be strong, coming in waves, and bleeding starts with it and is heavier than a period, with clots and the passage of the pregnancy tissue over several hours. The heaviest part is usually over within four to six hours. Plan to be somewhere private and comfortable with a responsible adult who can reach help, with thick pads, pain relief and a hot water bottle to hand.

This is arranged as a Day Care attendance. You will be given a contact number to use at any hour, and a follow-up visit is arranged for one to two weeks later, usually with a scan or a hormone test, to confirm the uterus is empty. That visit is not optional, because it is the only way to know the treatment worked.

Bleeding continues for one to two weeks and then tails into spotting that can last three to four weeks in total. Cramping eases over the first day or two and paracetamol and an anti-inflammatory handle most of it. Most women feel physically able to return to ordinary activity the next day, though taking a day or two off is entirely reasonable and worth arranging in advance.

Use pads instead of tampons and avoid sex, swimming and tub baths until the bleeding has stopped, in order to reduce the chance of infection. Your next period should arrive in four to six weeks.

Fertility returns immediately, and ovulation can happen within two weeks, well before that first period. So contraception is discussed at the same visit and can be started straight away; if you want a long-acting method, ask about it at the follow-up, when it can usually be arranged. How you feel about all of this varies enormously and there is no correct version. Relief, sadness, or both at once are all common, and if low mood persists beyond a few weeks it is worth going back and saying so.