Self-administration of MTP Pills and its Complications: An Observational Study

  • Anju Dogra SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India
  • Vinay Kumar SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India
Keywords: Medical termination of pregnancy pill, Over-the-counter, Self-medication, Unsafe abortion, Unwanted pregnancy Access this article online Month of Submission : 08-2019 Month of Peer Review : 09-2019 Month of Acceptance : 10-2019 Month of Publishing : 10-2019 Corresponding Author: Dr. Anju Dogra, House No. 124/4, Pomposh Colony, Janipur, Jammu, Jammu and Kashmir, India. Print ISSN: 2321-6379 Online ISSN: 2321-595X


Background: Medical termination of pregnancy (MTP) has been legalized in India since 1971. MTP pills are well effective in the early weeks of gestation and safe only when used under medical supervision.
Aims and Objectives: The aim of the study was to find out the clinical presentations and complications following self-administration of MTP pills.
Materials and Methods: This was a retrospective observational study conducted at SMGS Hospital, Government Medical College Jammu from July 2018 to June 2019. Hundred patients were included in the study. Following factors were studied such as chief complaints, complications, treatment given, and blood transfusion.
Results: Majority (57%) of patients were aged between 30 and 39 years. About 66% were gravid three or more. Only 28% had taken the pill within prescribed gestational age limit for MTP, i.e., <7 weeks. Mid-trimester pill intake was encountered in 14% patients. About 41% presented with incomplete abortion. Anemia was present in majority of patients and blood transfusion was done in 38% patients. About 24% patients presented with life-threatening shock. Sepsis was present in 5% patients. Emergency laparotomy was required in 4% cases. Hysterotomy was done in 2% cases. Continuation of pregnancy was noted in 6% patients. Unintended pregnancy and limiting family size were main reasons for abortion 62% and 32%, respectively.
Conclusions: Unauthorized over-the-counter availability despite legal ban and ignorance of women have led to increased number of unsafe abortions. Increasing awareness among women regarding complications of unsupervised pill intake and easily availability of safe contraceptive methods can help control this health hazard.

Author Biographies

Anju Dogra, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India

Senior Resident, Department of Obstetrics and Gynaecology, 

Vinay Kumar, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India

Lecturer, Department of Obstetrics and Gynaecology, 


1. Shivali B, Lajya G, Shivam B, Kaur B. Self administered medical abortion
pills: Evaluation of clinical outcome and complications among women
presenting with unsupervised pill intake. Int J Reprod Contracept Obstet
Gynecol 2018;7:1537-42.
2. Use of RU-486 with Misoprostol for early abortions in India. Guidelines for
Medical Officers, WHO-CCr in Human Reproduction. All India Institute of
Medical Sciences, Ministry of Health and Family Welfare, Government of
India Council of Medical Research; 2003.
3. World Health Organization. Safe Abortion: Technical and Policy Guidelines
for Health Systems. 2nd ed. Geneva: World Health Organization; 2012.
Available from:
unsafeabortion/9789241548434/en/-31k. [Last assesed on 2019 Apr 14].
4. Guidelines for Medical Abortion in India Material Circulated by CASSA
During the State Level Workshop on “Review of MTP Act 1971 in the
Context of Women’s Right to Safe Abortion and Halting Sex Selective
Abortion; 2007.
5. The Federation of Obstetrics and Gynaecological Societies of India.
Available from: w=article&id=97&Itemid=16. [Last assesed on 2019 Apr 14].
6. Government of India. The Medical Termination of Pregnancy Rules
(Amendment). 2003. Ministry of Health and Family Welfare. New Delhi:
Department of Family Welfare; 2003. Available from: http://www.mohfw. [Last accessed 2015 Jun 11].
7. Mishra N. Unprecedented use of medical abortion can be injurious to
health. JEMS 2013;2:856-9.
8. Giri A, Srivastav VR, Suwal A, Sharma B. A study of complications
following self administration with medical abortion pills. Nepal J Obstet
Gynaecol 2015;10:20-4.
9. Kumari R, Sharma A, Najam R, Singh S, Roy P. Mortality and morbidity
associated with illegal use of abortion pill: A prospective study in tertiary
care center. Int J Res Med Sci 2016;4:2598-602.
10. Agarwal M, Datta A. How safe are over the counter abortion pills-differences
between its intended and practical usage and its implications a study
conducted in a tertiary care centre in Shillong, Meghalaya, India. Int J
Reprod Contracept Obstet Gynecol 2016;5:3036-40.
11. Thaker RV, Deliwala KJ, Shah PT. Self medication of abortion pill:
Women’s health in Jeopardy. NHL J Med Sci 2014;3:20-4.
12. International Consensus Conference on Non-surgical (Medical) Abortion in
Early First Trimester on Issues Related to Regimens and Service Delivery:
Frequently Asked Clinical Questions about Medical Abortion. Bellagio:
WHO; 2006. Available from:
publications/medical_abortion/faq.pdf. [Last assesed on 2019 Apr 14].
13. Stillman M, Frost JJ, Singh S, Moore AM, Kalyanwala S. Abortion in
India: A Literature Review. New York: Guttmacher Institute; 2014. p. 12-4.