Last month, a 43-year-old woman dressed in a sari from Wagholi, Pune, stood in a local medical shop waiting for the queue to thin out. When it did, she asked a store clerk for an abortion pill, adding that she needed it urgently. At first, the employee refused his request, but on his insistence, he asked him to wait since he had to get supplies from his friend.
“He said he was not a supplier. He however considered my request and asked me to come after half an hour,” the woman said.
After waiting nearly two hours, the clerk took her to a secluded alley near the store and handed her the abortion pill kit for ₹3,000 as opposed to the actual cost of ₹430. Reason: She didn’t have a doctor’s prescription.
What this man didn’t know was that the woman posing as pregnant was an undercover drug inspector for the Food and Drug Administration (FDA) – the top regulatory body – who was part of an investigation. of a month between July and August on the retail trade. and the illegal online sale of abortion pills without a doctor’s prescription. He was arrested by FDA agents and a first information report (FIR) was filed.
This is not an isolated case. Across the state, several pharmacies sell abortion pills, also known as medical termination of pregnancy (MTP) kits. Selling abortion pills without a prescription or proof of age is illegal and a punishable offense under the Medical Termination of Pregnancy Act (MTPA). The sale of MTP kits without a prescription is prohibited in India under the Medicines and Cosmetics Act 1940 and Rules 1945.
Acting on whistleblowers, the FDA inspected 384 medical stores through the first week of August. Several decoy clients were sent to buy abortion pills without the required documents and a total of 14 cases were registered in Mumbai, Thane, Pune, Nagpur, Aurangabad, Nashik and Amravati. Eleven defendants have been arrested and drugs are worth ₹47,378 were seized.
MTP Kit is a Schedule H drug under the Medicines and Cosmetics Act 1940. It contains a combination of mifepristone and misoprostol tablets which help to perform medical termination of pregnancy (non-surgical removal of the embryo from the uterus). Currently, abortion requires the advice of a doctor if it is performed within 12 weeks of conception and of two doctors if it is performed between 12 and 20 weeks.
FDA officials focused on districts with an skewed sex ratio. “This type of illegal activity is more common in areas where there is a huge sex ratio gap. So first we identified these districts, which were mostly from the western part of the state, and have started sending our agents as clients,” said DR Gahane, Joint Commissioner, FDA Maharashtra. FDA agents said the investigation will also continue in other districts.
During the investigation, they discovered that most of the kits are sold at exorbitant prices, taking advantage of helpless women. “Many times young women in need fall prey to these providers who exploit them by overcharging,” he said.
Many medical stores and hospitals have also been found guilty of not keeping MTP records. In fact, an FIR was registered against a physician in the Western Region who refused to provide information on the use of MTP kits.
Doctors have warned that consuming abortion pills without a doctor’s supervision can even lead to death due to health complications. Every month, large, citizen-run hospitals treat young women who complain of excessive bleeding after consuming the pills without a doctor’s supervision.
“A gynecologist first performs an ultrasound to confirm that there is a pregnancy and to decide for how many weeks. If the woman then wants to terminate the pregnancy within the legal period, she is given the prescription. Sometimes she can 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.
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In June, the FDA office in Pune received a complaint from the Pune Chemist Association that major online shopping portals were illegally selling abortion pills. The FDA began its investigation by reviewing 34 online sites.
“During our investigation, we found many portals selling MTP kits in violation of the law. We ordered the kits on the portals as customers to generate invoices for our proofs. The first order came from a pharmacy in Ahmedabad against which we filed an FIR,” said Suresh Patil, Co-Commissioner, Medicines Division, FDA Pune.
All the kits purchased by the drug inspectors came from states such as Gujarat, Uttar Pradesh and Orissa. “In one case, the portal registered the order and took the money but did not deliver the kit,” he said.
The FDA then sent notices to the portals asking for an explanation. “These portals responded by saying that they only provide a platform to sell anything but have no role in procurement. We advised them to include an option to download prescriptions on the website,” said Dr Gahane, Co-Commissioner, FDA Maharashtra.