Recently, a sensitive case had come up for hearing in the Mumbai High court. A middle aged woman, who was in her 26th week of gestation, had moved the high court for Termination of the pregnancy, as the foetus was detected to have a complete congenital heart block along with complete transposition of great arteries. She had moved the court, as legally, Medical Termination of Pregnancy (MTP) can be carried out only upto 20 weeks of gestation….
Now lets look at the salient features of this act… (MTP act, 1971)
MTP can be carried out when
• The continuation of pregnancy would involve serious risk of life or grave injury to the physical and mental health of the pregnant woman.
• There is a substantial risk of the child being born with serious physical and mental abnormalities so as to be handicapped in life.
• When the pregnancy is caused by rape, both in cases of major and minor girl and in mentally imbalanced women.
• Pregnancy caused as a result of failure of a contraceptive.
When termination has to be done upto 12 weeks, one qualified medical practitioner can do it, whereas if it is between 12-20 weeks, opinion of 2 practitioners is required
For the entire act, you can refer to : http://mohfw.nic.in/MTP%20Act%201971.htm
Fair enough… here the main concern was that there was a substantial risk of the child being born with serious physical and mental abnormalities so as to be handicapped in life… and so the judgment basically depended on the JJ Hospital committee’s report. And here, the government employees did a major goof up of typing “… there is a very LEAST chance of….” Instead of the earlier report which said “… there is a very FAIR chance of….”
That one word just turned up the case upside down…. And the court turned down the appeal stating that there was nothing to suggest that it was an extraordinary case that they would be allowed to go against the law for just this time…
Personally, I feel this is an extremely sensitive issue, just like euthanasia, which is deemed illegal in India. What has got this issue into the limelight is that the couple approached the high court, as I believe, hundreds of such and similar other cases are tackled illegally all over the nation. The mother could have paid up the doc below the table and had got it aborted and no one would have got a hint of it, unless of course if the mother had developed any complications during the process, which is the main reason why the doctors would had been shying away from it…
A complete congenital heart block is a serious disorder. As everyone must have read in the newspapers, it MAY require a pacemaker insertion immediately after birth… Even if the prognosis is good, usually they may require it after about 7-9 years of age. Transposition of great arteries is a condition in which there is shunting of blood, in which impure deoxygenated blood gets circulated in the body, as the aorta here arises from the right ventricle instead of the left. This may get nullified by a ventricular septal defect, but still, such defect requires surgery, and they do cause a lot of financial strain. The life of the child before and after the surgery is also not too good. A simply crying spell can be the cause of their death. The child also has to live a compromised life later on…
Still, I cannot comment on how GRAVE the physical deformity would had been…
Some NGOs came forward and asked the couple to give the child to them so that they would take care of the child, but is this done??
Would the parental instincts let them simply give away the baby to an NGO cause he suffers from a cardiac deformity?
Aborting a fetus [note: I am calling it a Fetus and not a baby or a child] when detected is what I feel, is the best way to go. The MTP act was made in 1971, when facilities like amniocentesis, chorion villi sampling etc where very rudimentary. A lot has changed in these 37 years in the medical arena, and detection and management techniques of such cases have also improved manifold.
But also, the drawback of this case was that, if the woman had been allowed to undergo abortion, it would have opened a whole new pandora’s box….
More and more women would had come forward citing similar reasons for abortion after the 20th week…
Human rights activists are also up in arms against it, as they say that the unborn child also has the equal right to live… but, when asked to the child who suffers from such a severe disorder, I strongly feel that the child would had preferred to not have born in the first place…
This case has everything – medical, legal, social, ethical, emotional issues bound into one… I feel that the limit of 20 weeks should be increased to 24 weeks as the mother also has the right to decide if she wants to keep that child. This provision should clearly provide and specify which cases are included in the 20-24 week period that can be allowed to be aborted, as for every law there are people who misuse them.
Right now, the woman has got no option but to carry on with her pregnancy as it has already crossed 26th week , and by the time a supreme court appeal comes to hearing, she would have already delivered!! I pray that the child is not treated like an unwanted child like the mother, as that would be a serious injustice to the child.
All in all, it’s a LOSE-LOSE situation for the child, whether born, or unborn… His/Her fate now lies in the hands of medical professionals and her parents….