August 25th, 2017
A baby boy, who was born with a severe neurological disorder at KEM Hospital on July 4, passed away 15 days ago, according to a doctor who had evaluated his 28-year-old mother her pregnancy, according to a report by Hindustan Times.
The mother had moved the Supreme Court in March after the foetus was diagnosed with Arnold Chiari Syndrome Type 2, a neurological disorder where fluid accumulates in the brain and spinal cord. The doctors had said, in such a critical medical condition, chances of survival were extremely slim.
When the mother approached the Supreme Court with her plea for adoption at 27 weeks, she was denied the permission. In India, abortion is only legal up to 20 weeks under the Medical Termination of Pregnancy Act. The bench, however, had rejected her plea saying the baby could be “born alive” during the abortion.
The rate of survival in this case is as weak as 1.2-2 per 1,000 births. On March 27, her plea was rejected by the apex court based on medical reports by a team of experts from KEM Hospital. The expert panel did not have a neurologist on it though the foetus had a complex neurological condition, said a report by Hindustan Times. In such cases of malfunctions, structural defects in the cerebellum occur and children with Type 2 are usually born with incomplete development of the spinal cord and its protective covering.
According to the gynaecologist Dr Nikhil Datar, who helped the woman to file the petition, the woman had undergone an ultrasound test on the 15th week of her pregnancy where abnormalcy of the foetus wasn’t detected. It was in the 24th week when she came to know about abnormalcy of the foetus. The child was born on July 4 and was put in the neonatal ward’s intensive care unit. The woman and her husband had initially hinted that they had wanted to abandon the child, but later took him home after being counselled by the police officials and doctors.
The Medical Termination of Pregnancy (Amendment Bill)
The long-awaited MTP (Amendment Bill) that proposes to extend the legal limit for termination of pregnancy from the present 20 weeks to 24 weeks is pending for more than 2 years. An amendment to the Medical Termination of Pregnancy Act was introduced in the parliament in 2006. It recommended extending the period for termination of pregnancies from 20 weeks to 24 weeks.
In half a dozen separate cases the apex court had granted termination in advanced pregnancy where the mother’s life was in danger. In February, a 22-year old woman was allowed abortion as her 23-week-old foetus lacked kidneys, besides having multiple anomalies. Another woman from Mumbai was granted permission in January this year to abort her 24-week-old foetus as it was malformed and also posed a risk to her life. In a landmark victory for Indian women, the SC had also granted termination of a 24-week-old foetus of a rape survivor in July last year as it suffered from brain abnormalities.
However, in this particular case, when the Maharashtra woman’s lawyer pleaded with the bench of justices S A Bobde and L N Rao for a special consideration on humanitarian grounds, the judges said, “It is sad that the child may suffer from physical and mental challenges and it’s unfortunate for the mother but we can’t allow an abortion. We have a life in our hands and we are also tied down by a law”.
There is already a PIL in the SC seeking to extend the legal limit of abortion from 24 weeks to 28 weeks
A Public Interest Litigation (PIL) was filed by a victim of the existing law and doctor Nikhil Datar who had challenged the 1971 act, terming it “irrational, outdated, unconstitutional and a violation of women’s rights to equality, health, and life”. The PIL is backed by The National Commission for Women, the Federation of Obstetricians and Gynaecologists of India (FOGSI), the international community, and several other women’s rights groups citing the Act’s provisions that violate a woman’s right to physical integrity.
Abnormalities in a foetus are detected after the woman loses on the MTP cut-off line as pregnant women undergo tests in the 18th week and the results are generated in three weeks.
The WHO estimated that out of the 26 million births that occur in India every year, approximately 2-3 per cent foetuses (5-6 lakh) have a severe congenital or chromosomal abnormality. To protect the mental or physical health of a pregnant woman, most nations including the US, UK, China which have legalised abortion, allow termination after 20 weeks in case of severe foetal abnormalities.
The Logical Indian take
The Supreme Court previously dismissed the plea of a 10-year-old rape survivor seeking to abort her 32-week-old (8+ months) foetus, basing its decision on doctors’ assessment that the termination would neither be safe for the child nor the foetus. The petition to allow the girl medical termination of her pregnancy was filed by a Supreme Court lawyer after she was denied permission by the district court in Chandigarh. The apex court had asked doctors at Chandigarh’s PGI to examine the girl and conclude if an abortion was safe. It later ordered that proper medical care is provided to the child.
When she had first filed for abortion, she was in her 26th week of pregnancy. However, as the Indian law does not permit medical termination after 20 weeks, she was denied abortion by the Chandigarh district court. Doctors had earlier opined that at such a tender age, the child’s bones are not strong enough to bear a full-term pregnancy.
There are many countries that allow medical termination of pregnancy beyond 20 weeks. The United Kingdom allows abortions till 24 weeks and, if there is a risk to life of the woman and a substantial risk of the foetus being born handicapped, the law does permits abortion any time. In China, abortions can take place until 28 weeks.
The Medical Termination of Pregnancy Act is a 46-year-old law that needs to amended with changing times. Extending the legal limit for abortion would give women more control over their bodies. The amendment would come handy not only for women bearing fetuses with abnormalities but also for rape survivors who may not wish to bear the child. The Indian Supreme Court needs to recognise the shortcoming of the present MTP Act and effectively overhaul the law.
The Logical Indian community opines that abortions post-20 weeks for such exceptional cases are a necessity.