FOGSI Policy Statement - Sex Determination - December 1986

• Resolved that the FOGSI ia quite against performing the Chorion Biopsy on the basis of Sex Determination and further FOGSI strongly disapproves selected MTP for unwanted sex of existing pregnancy
• However FOGSI feels that his method is good if done purely to diagnosis genetic disorders in the embryo

FOGSI Policy Statement - Medical Methods of Abortion - April 2003

• FOGSI recognises the universal evidence on the effectiveness and safety of mifepristone - misoprostol  for inducing Medical Termination of Pregnancy up to 49 days as approved for use by the Drug Controller of India.
• It needs to be stressed that under the existing laws they can only be administered by Gynecologists and Registered Medical Practitioners recognized for performing MTPs by the MTP Act of 1971.
• FOGSI recommends close monitoring of distribution and mode of use of these drugs and the medical profession and the medical profession and the pharmaceutical industry exercise due diligence in their promotion and use.
• It is also vital that consumers be educated regarding this recently introduced method its advantages, drawbacks, risks and limitations

FOGSI Policy Statement - Injectable Contraception - September 2003

• FOGSI confirms the WHO Guidelines and believes that injectable hormonal contraceptives are a safe, effective and  convenient form of contraception particularly for lactating and estrogen sensitive women.
• Extensive trials have proven that the method is reversible with additional health benefits.
• Proper counseling regarding menstrual irregularity will improve the compliance.
• FOGSI advises its members to use injectable hormonal contraceptives within the WHO Guidelines.

FOGSI Policy Statement - Population Stabilization - September 2003

• Meeting the unmet needs in contraception will play a vital role in population stabilization.
• It is our endeavor to promote all birth spacing methods such as barrier contraceptives, intrauterine devices and hormonal contraceptives without compromising the importance of permanent methods like tubal ligation and vasectomy.
• It is our commitment to disseminate awareness of and incorporate recent developments such as newer oral contraceptives and emergency contraception as also to dispel myths and faulty beliefs related to contraception.
• We support the individual’s right to make reproductive choices and decision without coercion and recognize the need to enhance responsible male participation.
• We believe this is the need of the hour.

FOGSI Policy Statement - Emergency Contraception - September 2003

• It is acknowledged that the widespread availability of emergency contraception can reduce considerably the incidence of unwanted pregnancy with a consequent reduction in unsafe abortions, maternal morbidity and mortality.
• Government of India and FOGSI believe that emergency contraception deserves to be a part of reproductive health care services to avoid unplanned pregnancy and associated health benefits. Proper counseling regarding menstrual irregularity will improve the compliance.
• FOGSI advises its members to use injectable hormonal contraceptives within the WHP Guidelines.

FOGSI Policy Statement - Low Dose Hormonal Oral Contraceptive Pills January 2004

• FOGSI confirms WHO Guidelines and believes that low dose hormonal contraceptive pills are safe, effective and convenient form of contraception to meet the unmet needs of contraception and thereby reduce the maternal morbidity and mortality due to unwanted pregnancies.
• Extensive trials have proven that the method is reversible with additional health benefits.
• FOGSI advises its members to use the newer low dose hormonal contraceptive pills 

FOGSI Policy Statement - Off Label Use of Drugs - January 2004

• FOGSI recognises the universal practice of the off – label use of a drug or treatment, where the clinical indication for using it is different from that which it was formally approved for.
• It is recommended that such off – label use should be supported by evidence based experience reported in medical literature.
• It must however be stressed that off – label use should be undertaken after informing the patient regarding the advantages, disadvantages and risks of such use.

FOGSI Policy Statement - Expanding Provider Base for Safe Abortion Services September 2008

• Our country despite having one of the most liberal laws on abortion still bears a disproportionate brunt of unsafe abortion.
• It is even more tragic when one considers the technology to provide safe abortions is safe, effective, easy to use and freely available in our country.
• The primary reason for it is the limited number of trained healthcare providers authorized to offer safe abortion care services to women as and when needed. This means that women who need safe abortion services are unable to access it.
• FOGSI has over the has over the years established itself as an institution towards improving the overall health of women and address their unmet needs.
• Hence FOGSI should recommend strategies in order to strengthen the role of non allopathic physicians and qualified non physicians in Comprehensive Abortion Care

FOGSI Policy Statement - Neonatal Resuscitation – May 2010

• Neonatal resuscitation at the time of birth is important and vital for the long term well being of the neonate.
• FOGSI appreciates the need that the members be well equipped with the knowledge of neonatal resuscitation and update themselves regularly in this regard.
• FOGSI endorses the need that the delivery facility be adequately equipped with neonatal resuscitation facilities.
• FOGSI approves of the Golden First Minute Project (GFMP)(which highlights that neonatal resuscitation provides maximum benefit when implemented in the first minute of birth and consists of simple neonatal resuscitation steps).
• FOGSI encourages its members to display the GFMP flow chart in the delivery room.

FOGSI Policy Statement -  Surrogacy – May 2010

• FOGSI believes, surrogacy is needed by many issueless couples and should be legalized in India.
• There should be a legal contract between the surrogate and the commissioning couple keeping in mind the various issues arising out of such a deal and keeping in mind the interest of all concerned with the rights of the surrogate, rights of the commissioning couple and rights of the child to be of prime consideration.
• The age of the commissioning couple should not be more than 55yrs, whereas the surrogate should not be more than 35 years. The surrogate can be a relative or a person known or unknown to the commissioning couple.
• In case of NRIs and foreign couples, commissioning couple should get a certificate from their country on the citizenship rights of the baby born out of such arrangement and a local guardian should be appointed legally to ensure that  the surrogate is taken care of during pregnancy and delivery. Role of the local guardian should be defined in case of any mishap during pregnancy or delivery and thereafter.
• There should be clear guidelines in the contract about addressing issues such as the situation of the child if one of the commissioning couple dies custody of the child if the couple is divorced, care and responsibility of complications of pregnancy in the surrogate and if the surrogate dies in child birth the provision of adequate compensation and to whom.
• FOGSI recommends that the surrogate should be insured wherever feasible.
• Similar sex couples should be allowed to have a baby through a surrogate, using donor egg or sperm, provided all the issues cropping up from such arrangements are discussed and a legal contract charted including the rights of the child in case of divorce or death of a partner.
• The surrogate should have no right to the child as such and must relinquish the baby to the commissioning parents.
• That all legal issues be handled by a special court with members from judiciary, FOGSI and society.

FOGSI Policy Statement -  Long Acting Injectable Progestogens – May 2010

• FOGSI recognizes the scientific evidence supporting the use of long acting injectable progestogens as a safe, effective, reversible, long acting method of contraception.
• Long acting injectable progestogens as a contraceptive method have been used since over two decades and are available worldwide in more than a 100 countries.
• The advantages of long acting injectable progestogens are that they are a highly effective, safe, long acting and easy to administer and use method of contraception, a feasible option when estrogen-containing contraceptives are not favored or medically contraindicated and with no adverse effects on lactation.
• For women they provide autonomy and choice with privacy about their use easily maintained and as a reversible method which can be discontinued without having to seek provider assistance.
• Concerns regarding menstrual disturbance and osteoporosis can be addressed by counseling while those involving risk of malignancy have no proven scientific basis.
• FOGSI believes that long acting injectable progestogens are an important component of the contraceptive choices which should be available to the women of our country through both the private and the public sector.   

FOGSI Policy Statement - Female Condom – May 2010

• FOGSI acknowledges the female condom as an effective form of barrier contraception, offering women choice, autonomy and control as well as the prevention of STIs.
• FOGSI appreciates that it has been shown to be effective in prevention of pregnancy and is accepted by users but has yet to achieve its full potential in national programs because of a relatively high cost.
• FOGSI appreciates that it is an important complementary technology that must be given a more prominent place in reproductive health programs with a potential to save the lives of millions of women and men.
• FOGSI believes that if high utilization rates of this new device can be achieved, it will make a substantial contribution in preventing of unwanted pregnancies and STIs, including HIV.  

 FOGSI Policy Statement - Contraceptive Implants – May 2010

• FOGSI endorses contraceptive implants as an efficient, reliable, long term method of contraception.
• It is an alternative for women who prefer not to think about birth control every day, week or month and has effectiveness independent of user behavior.
• As these are sub dermal implants, the training of the provider is very essential and the technique of insertion, although simple, needs to be learnt by providers before they attempt first insertion.
• The training also enables the provider to counsel women on the benefits and side effects associated with implant use, to select appropriate users and the correct time of insertion.
• FOGSI believes that implants are a promising, effective method of contraception and that should be available as an option for contraception.

FOGSI Policy Statement -  Non Scalpel Vasectomy – May 2010

• FOGSI believes there is an immediate need to promote male contraceptive methods which are languishing in India.
• Non Scalpel Vasectomy (NSV) is perceived by FOGSI as an effective method of permanent contraception for men.
• It should be offered as an alternative method when counseling for permanent sterilization
• FOGSI acknowledges the fact that this method is safe, minimally invasive and effective.

FOGSI Policy Statement -  Vaccination – May 2010

• FOGSI believes that girls and women of all ages be offered vaccination to protect them from various infections.
• It is now possible to avoid majority of infectious diseases by vaccination.
• This vaccination is to be offered based on the FOGSI guidelines.

FOGSI Policy Statement - Surgeons doing Hysterectomy and Caesarean Section – May 2010

• Hysterectomy is a surgery where in uterus is removed for different indications for the health of women.
• Women need to be counseled about pros and cons related to removal of uterus and ovaries, pelvic floor defects and different routes of removal of uterus (abdominal, vaginal and laparoscopic) before deciding the removal of uterus in reference with anticipated menopausal symptoms and signs.
• Hysterectomy demands a sound knowledge about the science related to the removal of uterus and, ovaries and pelvic floor defect identification and correction both before removal of uterus and as also its effects after repair is performed.
• This can be offered best by gynecologists and the surgeons can be called in the event of involvement of other organs and to assist in difficult situations to help.
• In case of a cesarean section the surgeons can perform these procedures as life saving measures in the absence of a gynecologist.
• Surgeon cannot give justice to understand the science of removal of uterus since removal of uterus is not just a surgical skill and training for the same is primarily imparted to gynecologists.

FOGSI Policy Statement - Gender Violence – May 2010

• FOGSI acknowledges the existence of gender violence in the community and abhors these injustices meted out to women.
• Every FOGSIAN is sensitive to this and other issues relating to domestic violence and is on guard regarding the same being encountered in his or her day to day clinical practice.
• The gynecologist will identify, assess, counsel and address such an issue.
• FOGSI opposes any kind of media display be it through movies, TV programmes, news papers, magazines or websites which is gender based and trivializes women.
• FOGSI offers to join hands with stakeholders to offer technical assistance and guidance to establish Adolescent Friendly clinics and centres.
• FOGSI appreciates the importance of empowering the adolescent population with the knowledge of life style skills which include sexuality, contraception, STDs, gender violence and general health care measures.

 FOGSI Policy Statement - Late Abortions – May 2010

• FOGSI recognizes the right of a woman to terminate the pregnancy beyond 20 weeks when there is a substantial risk that if child were born, it would suffer from such physical or mental abnormalities to be seriously handicapped.
• These terminations should be done for specific medical reasons.
• The FOGSI takes into account the current position of law and strongly recommends necessary amendment to the law.

FOGSI Policy Statement - Prevention Of  Vertical Transmission – September 2010

• To ensure 100% antenatal voluntary counseling and screening for HIV/AIDs.
• To ensure 100% coverage of pregnant women with “FOGSI guidelines for screening and prevention of vertical transmission” (prevention PMTCT strategy ) by FOGSI members.
• To reduce vertical transmission of HIV to less than 1-2% (this is at par with HIV transmission rate in any developed country).
• To increase the awareness and sensitivity about PMTCT amongst general population.
• To ensure post-exposure prophylaxis services to all FOGSI members through adoption of “safe work practice guidelines” and through “FOGSI pep help line”. This will remove the dread amongst obstetricians about HIV.

Uploaded in January 2011