Rampant illegal sale of abortion pills across Maharashtra
Last month, a sari-clad 43-year-old woman from Wagholi, Pune, stood at a local smedical store waiting for the queue to thin out. When it did, she asked an employee of the store for an abortion pill adding that she needed it urgently. At first, the employee refused her request, but on her insistence, he asked her to wait since he had to source it from his friend.
“He said he was not a supplier. He, however, considered my request and asked me to come after half an hour,” said the woman.
After waiting for nearly two hours, the employee took her to an isolated alley near the store and handed over the abortion pill kit for ₹3,000 as opposed to the actual cost of ₹430. Reason: She didn’t have a prescription from a doctor.
What this man didn’t know is that the woman posing as being pregnant was an undercover drug inspector with the Food and Drug Administration (FDA) — the apex regulating body — who was part of a month-long investigation between July and August on retail and online illegal sale of abortion pills without doctor’s prescription. He was caught by FDA officers and a first information report (FIR) was registered.
This is not an isolated case. Across the state, several chemist shops sell abortion pills, also known as medical termination of pregnancy (MTP) kits. Selling abortion pills without prescription and proof of age is illegal and a punishable offence under the Medical Termination of Pregnancy Act (MTPA). Selling MTP kits without prescription is banned in India as per the Drug and Cosmetics Act, 1940 and Rules of 1945.
Acting on tip-offs, FDA inspected 384 medical stores till August first week. Several decoy customers were sent to purchase abortion pills without requisite documents and a total 14 cases have been registered in Mumbai, Thane, Pune, Nagpur, Aurangabad, Nashik and Amravati. Eleven accused have been arrested and drugs worth ₹47,378 have been seized.
MTP kit is a schedule-H drug as per the Drugs and Cosmetics Act, 1940. It has a combination of mifepristone and misoprostol tablets which help in performing medical pregnancy termination (non-surgically expelling the embryo from the womb). Currently, abortion requires the opinion of one doctor if it is done within 12 weeks of conception and two doctors if it is done between 12 and 20 weeks.
FDA officers focused on districts with skewed sex ratio. “These kind of illegal activities are most common in areas where there is a huge gap in sex ratio. So, first, we identified those districts, which were mostly from the western part of the state, and started sending our officers as customers,” said DR Gahane, joint commissioner, FDA Maharashtra. FDA officers said the investigation will also continue in other districts.
During the investigation, they found out that most kits are being sold at exorbitant prices, taking advantage of helpless women. “Many a times, young needy women fall prey to these suppliers who exploit them by overcharging,” he said.
Many medical stores and hospitals were also found in violation of not maintaining MTP records. In fact, an FIR has been registered against a doctor from the western region who refused to submit information about the usage of MTP kits.
Doctors have warned that consumption of abortion pills without doctor’s supervision can even lead to the death due to health complications. Every month, major civic-run hospitals treat young women who complain of excessive bleeding after consuming the pills without doctor’s supervision.
“A gynaecologist first conducts a sonography to confirm there is a pregnancy and to decide by how many weeks. If the woman then wants to terminate the pregnancy within the legal time period, she is given the prescription. It can sometimes lead to incomplete abortion causing heavy bleeding. This can prove fatal for the woman, especially if she is a minor,” said Dr Ramesh Bharmal, dean of BYL Nair Hospital.
In June, FDA office in Pune received a complaint from Pune Chemist Association that major online shopping portals are illegally selling abortion pills. FDA began their investigation where they scrutinised 34 online sites.
“During our investigation, we found many portals selling MTP kits in violation of the law. We ordered the kits from the portals as customers to generate bills for our evidence. The first order came from a chemist shop in Ahmedabad against whom we have filed an FIR,” said Suresh Patil, joint commissioner, drug division, FDA Pune.
All kits that were procured by drug inspectors were supplied from states such as Gujarat, Uttar Pradesh and Orissa. “In one case, the portal registered the order and took the money but didn’t supply the kit,” he said.
FDA then sent notices to the portals seeking explanation. “These portals have replied saying they only provide a platform to sell anything, but have no role in the supply. We have advised them to include an option of uploading prescriptions on the website,” said DR Gahane, joint commissioner, FDA Maharashtra.