Why it is handled differently
After about 12 weeks the pregnancy is larger and the risks of bleeding and complications are higher. For that reason, second-trimester termination is generally done where hospital-level support, blood access and monitoring are available, and sometimes with a short stay.
Legal conditions
Up to 20 weeks one registered medical practitioner's opinion is needed. From 20 to 24 weeks the Act limits termination to specified categories of women and requires two practitioners' opinions. Details are in the MTP summary and the MTP Act explained.
Methods
- Medicines: a sequence of mifepristone and repeated doses of misoprostol brings on labour-like contractions. This takes place under observation and can take many hours.
- Dilation and evacuation (D&E): a surgical procedure by a trained provider, with anaesthesia.
The right choice depends on gestation, previous surgeries such as caesarean sections, and the facility's capabilities. Ask the doctor to explain why one is recommended over the other.
What assessment includes
Expect a detailed history, an ultrasound to measure gestation and check the placenta, blood tests including blood group, and a discussion of consent and the legal category that applies. Do not wait for symptoms to settle before getting assessed. Each week can change the options.
Seek immediate care for heavy bleeding, severe pain, fever or fainting at any point before or after treatment.
How it is done after 12 weeks
Methods include medicine-induced termination, where contractions are brought on and the pregnancy is passed under observation, and dilatation and evacuation (D&E), a procedure done by a trained surgeon under anaesthesia. The choice depends on the weeks, your health and the facility. Both need a hospital with blood and emergency back-up.
Who qualifies from 20 to 24 weeks
The MTP Rules list the categories: survivors of sexual assault or incest, minors, women whose marital status changed during pregnancy, women with certain physical or mental disabilities, pregnancies with serious fetal abnormality, and women in humanitarian settings. Two registered doctors must agree. The doctor will explain whether your situation fits.
Why earlier is simpler
Risks rise as pregnancy advances, and the recovery is longer. If you are weighing options, an early assessment keeps more of them open. See options by week of pregnancy.
Common questions
Is a hospital stay required?
Often yes, for observation, especially with medicine-induced termination. Ask what your plan will involve.
Can I still choose to terminate at 20 weeks?
Between 20 and 24 weeks it is permitted only for specified categories and with two doctors' opinions. A consultation can clarify whether this applies to you.
General information. This page is educational and does not replace advice from a doctor who has examined you. Read our medical disclaimer.