On Friday, the Supreme Court refused to allow an abortion for a pregnant 10-year old girl who was raped allegedly by her uncle. The Chandigarh resident’s plea for abortion was turned down last week by the district court. News reports also suggest that she had an anomaly in her heart and had to be operated for it three years ago.
The doctors’ panel at Postgraduate Institute of Medical Education and Research, Chandigarh who examined the girl said that a medical termination was not safe either for the girl or the foetus, NDTV reported.
The girl is reportedly 32 weeks pregnant now. From the medical point of view there is no basis to say that her pregnancy is going to get safer as it progresses. In fact, it is only going to get more dangerous. The child is only 10 years old with a complication of heart disease and it is not safe for her to carry a full size foetus and deliver it. While a girl can get pregnant as soon as she starts menstruating, her pelvic bones are not fully developed till several years later and therefore carrying a pregnancy and delivering it can result in several complications for her.
The fact that the doctors said that they were considering two lives – that of the pregnant girl and that of the foetus – is unacceptable. This articulation of “the health of the foetus” in this scenario is worrying, since it is juxtaposed against the health of the girl who is carrying the pregnancy, herself a young child in this case. It is indeed cruel to force the girl to bring the foetus to maturity as she alone will bear the physical and mental trauma of pregnancy and childbirth.
This child is also a survivor of sexual violence. A psychiatric evaluation of the girl suggested that she is unaware of her pregnancy. It is also medically necessary for her to heal from the sexual violence and forcing her to continue the pregnancy that is an outcome of rape will impede her healing and obtaining any closure.
The Medical Termination of Pregnancy Act allows for abortion outside of the criteria laid down by the Act. Section 5 of the Act says that the restriction of 20 weeks of pregnancy does not apply if two registered doctors form an opinion in good faith that the termination of such a pregnancy is necessary to save the life of the pregnant woman. This section should have been invoked.
Even so, the Medical Termination of Pregnancy Act is restrictive and there is a lot of evidence to show that abortion may be safely allowed up to much later in the pregnancy, at least up to 24 weeks.
In 2014, the Ministry of Health and Family Welfare prepared a draft amendment to the law, which provided for abortion at up to 24 weeks. This amendment does not seem to be making progress.
A news report on the order said that the Supreme Court asked the Solicitor General Ranjit Kumar to consider its suggestion to set up a permanent medical court in every state to take a prompt decision on prospects of early abortion. While this is a welcome decision, we have to place it in the larger context of access to abortion. The state level board does not guarantee access to abortion. A woman dies because of unsafe abortion every two hours in this country. By restricting access to safe abortion, we are pushing them towards unsafe abortion.
Health system barriers
Most states do not provide access to abortion in institutions of primary health care. Abortion services are only provided at district hospitals or at medical colleges within the public sector. Women are then pushed to seek abortion in the private sector, which is expensive and exploitative. There is evidence to show that the more desperate the woman is, the higher the price of abortion services. High prices then force her to go to unqualified providers performing abortions.
We know that women who delay decisions to get abortions are women in very difficult circumstances. They might be single women, women who have become pregnant outside of marriage, victims of sexual violence, or with no wherewithal to access safe abortion services.
Instead of violating women’s right to make choices about their bodies, the state would do better to provide better and safer medical services.
The writer is a gynaecologist with the Rural Women’s Social Education Centre in Kanchipuram district, Tamil Nadu, and the chairperson of CommonHealth, a national level coalition for maternal and neonatal health and safe abortion.