Thursday night will perhaps be the longest ever for Nisha Sanghvi (name changed) and her husband. The couple are on tenterhooks as they await an approval from the Supreme Court (SC) to abort their first child during a hearing on Friday. Nisha, who is 21 weeks pregnant, had to make the heart-breaking decision after scans revealed her unborn child has fluid in the brain which is life threatening.
Indian laws do not permit abortions after 20 weeks of pregnancy. This has compelled many women like Nisha, whose unborn children are detected with abnormalities during scans, to knock the doors of the SC. While Nisha is awaits a nod, two others have approached the Apex Court with similar pleas. Another woman is also set to file a petition.
“Nisha was a regular with her antenatal check-ups at a municipal hospital in Mumbai. However, the deformity was picked up by the time she was beyond 20 weeks pregnant. While we filed her case, two more women who have crossed the 20-week deadline have decided to approach the SC,” said gynaecologist and activist Dr Nikhil Datar, medical director and gynaecologist at Cloud Nine hospital.
Dr Datar said most of these patients are from lower socio-economic background. “The second woman who has approached the SC too was visiting a municipal hospital in Mira-Bhayander. She came to know that her unborn child has serious a developmental defect called anencephaly – absence of brain. She was 18-19 weeks pregnant then,” he informed.
Since the hospital was not equipped to handle abortions, they asked her to go to another hospital. “By the time she approached another public hospital, she had crossed the 20-week deadline by two to three days,” Dr Datar added.
The third woman, a resident of Satara, is in her 24th week of pregnancy and her unborn child has a severe form of cardiac impairment called pulmonary atresia and the fourth woman, aged 25, is in the 21st week of pregnancy and her unborn child too has been detected with anencephaly.
In past one year, Dr Datar has helped nine women approach the SC. Seven of them were given permission for abortion by the court. “Seeing the sheer magnitude of the problem, it is high time that either the policy makers or the SC takes a call on the 20-week deadline to bring respite to such people. At present out of the four women, who has crossed the 20 week deadline and want abortion because their unborn child is having life-threatening defects, decides to approach SC with a plea for abortion. This means there is a high risk to the lives of both women and their babies,” he said.
Medical experts in India have been demanding that a few abnormalities should be included as a valid reason for MTP (Medical Termination of Pregnancy) after 20 weeks and empower women to make a decision on whether they choose to go ahead with the pregnancy or not.
Dr Rishma Dhillon Pai, president of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), the umbrella body of gynaecologists in India which has 34,000 members, said, “Every patient cannot approach the court of law to seek permission. Pregnancy is a very private matter. No one wants it to make it front pages of newspapers for this and her pregnancy to be discussed in the public domain. FOGSI has taken a stand that we need an extension of MTP to 24 weeks. The period between 20 to 22 weeks offers good opportunities to check for cardiac anomalies in foetuses through a sonography.”
Dr Dhillon Pai said outside metro cities women still do not register at hospitals for delivery till as late as seven months into their pregnancy. “The anomalies are picked up late in such cases and by the time they are referred to bigger institutions and second opinion is taken, it is almost always past the 20-week deadline,” she said. She also added that the act needs to be reviewed and strengthened since latest diagnostic and medical facilities are now available.
What the law says
In India, Section 3 of the Medical Termination of Pregnancy (MTP) Act, 1971, does not allow abortion after 20 weeks of pregnancy. The National Commission of Women (NCW) had recommended to the Union Health Ministry to allow abortions till 24 weeks of pregnancy. After which, in 2014, the Ministry of Health and Family Welfare proposed amendment to the present MTP Act.
The amendment, which will be called The Medical Termination of Pregnancy (Amendment) Bill, 2014, proposes to increase abortion limit from present 20 weeks to 24 weeks.
According to the draft law, for which the ministry had sought public comments in 2014, decision to allow abortion between 20 and 24 weeks can be taken “in good faith” by a healthcare provider if, among other conditions, pregnancy involves substantial risks to mother or child, or if it is “alleged by the pregnant woman to have been caused by rape”.
Dr Datar had moved the SC in 2008, seeking permission for his patient, Mumbai resident Nikita Mehta, to abort her unborn baby that had cardiac abnormalities after the 20-week limit. In July 2016, he helped a rape survivor file petition with the SC to abort her unborn child with same abnormalities in the 24th week of pregnancy.