Child denied abortion, mother asks: What does a 10-yr-old know


The girl, subjected to repeated rape, allegedly by her maternal uncle, is approximately 30 weeks pregnant, according to doctors at the Government Medical College and Hospital (GMCH), Chandigarh, who have examined the girl.

SHE loves to draw, and her favourite cartoon on television is Pokemon. Her elder sister says her favourite subject is English, though for many months now, she has not attended school. At their one-room home, the servant quarters of a government official’s residence in Chandigarh, the 10-year-old girl walks around for a few minutes in the lawn — “doctors have said she should remain active”, says the mother.

The girl, subjected to repeated rape, allegedly by her maternal uncle, is approximately 30 weeks pregnant, according to doctors at the Government Medical College and Hospital (GMCH), Chandigarh, who have examined the girl. On July 18, Chandigarh’s Additional District and Sessions Judge Poonam Joshi turned down permission for the medical termination of her pregnancy on the basis of a report by doctors at GMCH who said that if the girl went in for an abortion, there could be “high chances of physical trauma”, considering her age and her health – three years ago, the girl had undergone a surgery at PGIMER for a hole in her heart. A Delhi-based lawyer has now filed a Public Interest Litigation in the Supreme Court, seeking medical termination of her pregnancy. The case is coming up for hearing on Monday.

“What does she know, she is only 10 years old. She doesn’t understand all this, she has no idea about her pregnancy. Our plight has become public news… we didn’t want that. We just want her to be healthy and happy. We don’t need any help, we are okay alone. Her father doesn’t want us to talk or say anything about her. He is a broken man since we found out,” said the mother, her eyes brimming with tears.

The mother works as a domestic help at the government official’s residence. Her husband is a watchman in the UT administration, and is studying for an MBA degree through correspondence. The family is originally from Nepal and has been living in Chandigarh for several years.

Last week, it was a neighbour who first noticed the 10-year-old’s swollen stomach and brought it to the mother’s notice. “She is a bright girl, regular to school. She would come to me, for help with her English or maths, sometimes with her homework. She was always quick to respond and answer questions. I was the one who asked her mother why her stomach was swollen,” the neighbour said.

“I asked the girl if she was taking medicines for her heart, thinking the swelling could be a side effect of the medicines. She seemed to have put on weight, but the bulge looked like a pregnancy. When I asked her mother if the girl’s periods were regular, she said she hadn’t had them for some months. I asked her to immediately take the child to the doctor,” the woman said.

That same evening of July 13, the mother’s relatives bought home a pregnancy test kit, which confirmed their worst fears. That’s when the girl said her uncle had raped her “five or six times” and allegedly warned her not to talk about it to anyone.

On July 14, the mother lodged an FIR with the police, accusing her brother of rape. The mother told the police that her brother, a watchman in Chandigarh’s Sector 35 and a frequent visitor to their home, had stopped visiting them in March. Police have arrested the 40-year-old, who is now in judicial custody in Burail jail. His wife and three children are in Nepal.

On July 15, after the family approached the district court, the judge ordered the constitution of a medical board with experts from GMCH and asked them to submit a report on the feasibility of medical termination of pregnancy for the 10-year-old.

“We informed the district court that there are high chances of physical trauma. A psychiatrist who was on board concluded, after interacting with the victim, that she doesn’t understand that she is pregnant or the implications of being pregnant,” said a doctor from the Obstetrics & Gynecology department at GMCH who was a member of the medical board constituted by the court.

The Medical Termination of Pregnancy Act(MTP), 1971, does not permit termination of pregnancy after 20 weeks, but in some cases, courts have made exceptions, especially when continuation of the pregnancy poses a danger to the mother or the unborn child.

“‘We submitted our report to the district court after examining the patient and going through the available law and rules. Since the victim’s pregnancy is in an advanced stage, it is a matter of saving two lives. Let the Honorable Supreme Court take a call now on the matter,” said the doctor.

After an examination of the girl, doctors at GMCH found that at this stage, the baby has to be delivered prematurely. “The case can no longer be considered for abortion. It has to be considered as a premature delivery now,” said another doctor at GMCH who is familiar with the case. Doctors said that they cannot predict the outcome of the case or the baby’s chances of survival in case of a premature delivery. The girl’s health, especially her heart ailment, is also a worry, say doctors. “We don’t know what is going to happen in this particular case. The pelvic bones of the 10-year-old are not fully developed,” said the GMCH doctor.

Doctors at GMCH said they are also considering sending the girl to PGIMER. “This is a very unique case and we don’t really know what is going to happen… Infection and hemorrhage to the girl at the time of delivery could be some of them,” said a doctor from the department of Obstetrics and Gynecology at PGIMER.

Source:http://indianexpress.com/article/india/child-denied-abortion-mother-asks-what-does-a-10-yr-old-know-4763037/

Delhi Court Says Sex Determination Of Foetus Is Discriminatory To Women


The court made this observation while refusing to release an ultrasound machine, a computer and other medical equipment belonging to a doctor who was allegedly found indulging in sex determination of foetus

Delhi Court Says Sex Determination Of Foetus Is Discriminatory To Women

The court dismissed the revision petition of a doctor, who runs a clinic in Rajouri Garden.

NEW DELHI:  The practices of sex determination and gender selection of the foetus before conception are discriminatory and affect the dignity of women, a Delhi court has said. The court made this observation while refusing to release an ultrasound machine, a computer and other medical equipment belonging to a doctor who was allegedly found indulging in sex determination of foetus.

Additional Sessions Judge Smita Garg said in the cases where doctors indulged in sex determination and misused modern pre-natal diagnostics technology, the prevention of the crime is best achieved by sealing and seizing the machines so that repetition of such crime is curbed.

“It has been noticed that these techniques are being used on a large scale to detect the sex of the foetus and to terminate the pregnancy of the unborn child if found to be female. Nowadays, techniques are also being developed to select the sex of the child before conception.”

“These practices and techniques are clearly discriminatory to the female sex and affect the dignity and status of the women. With the object to regulate the use of such techniques for the dishonest and illegal purpose and to provide deterrent punishment to stop such inhuman acts, Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act was enacted,” the court said.

It said the object of the Act is to prohibit pre-natal diagnostic techniques for determination of sex of the foetus leading to female foeticide.

The court dismissed the revision petition of the doctor, who runs a clinic in Rajouri Garden in west Delhi, challenging a magisterial court’s order denying his plea to release his ultrasound machine on the ground that he might use it again for the same purpose.

Regarding the doctor’s apprehension that the machine would lose its worth if allowed to remain in the police custody, the court said the plea has already been taken care of by the magisterial court by directing senior police officials to keep it in safe to avoid any harm to it.

A raid was conducted at the doctor’s clinic on March 2 last year based on information that sex determination was being carried out there and the equipment were seized.

In Tamil Nadu, registration of pregnancies to become compulsory


Pushpa Narayan| TNN |

HIGHLIGHTS

  • Tamil Nadu is planning to make it mandatory for all pregnant women to register themselves with the health department
  • The registration will help the health department track the expectant mothers’ medical records
  • More than 60% of deliveries in Tamil Nadu happen in government hospitals

Representative imageRepresentative image

CHENNAI: If you are pregnant, you may soon have to break the news to the state government.

Tamil Nadu is planning to make it mandatory for all pregnant women to register themselves with the health department to ensure that the pregnancy and child birth happen safely. Those who don’t register pregnancy will not get to register the child birth, and hence not get a birth certificate for the child.

By July, when the scheme is launched, women will also be allowed to register by calling a dedicated non-emergency medical number, 102, or through any private hospital. “It’s an ambitious project that attempts to bring down maternal and infant mortality rates by keeping a tab on every pregnant woman in the state,” said health secretary J Radhakrishnan.

The registration will help the health department track the expectant mothers’ medical records, send reminders for doctor’s visits, and warn them about anaemia, diabetes and hypertension. For the past one year, a special platform called Pregnancy Infant Cohort Monitoring and Evaluations (PICME), is being tested in three districts of Tamil Nadu.

A pilot, this programme seeks to cover pregnant women from all socio-economic groups visiting private and public hospitals by registering themselves through health nurses or by logging on to the health department’s web page.

Although more than 60% of deliveries in Tamil Nadu happen in government hospitals, women delivering at private hospitals and homes remain out of the government’s information net. In rural areas women who have more than two children do not report on time to government hospitals because they are not eligible for welfare schemes like the Muthulakshmi Reddy scheme that draw them to government hospitals. “When women move places for delivery, we want to make sure health care providers at the new place have adequate information about the expectant mother. Information usually reaches district headquarters only when it audits maternal death. The new platform keeps everyone informed,” said a senior doctor working on the project. This has worked in Vepper (Perambalur), Shoolagiri (Krishnagiri) and Viralimalai (Pudukkotai) where the pilot programme is on.

This will also help the state get information on the number and reasons for termination of pregnancy and caesarian deliveries in private hospitals.

Maternal mortality ratio (the number of women in the 15-49 age group who die of pregnancy-related causes within 42 days of pregnancy termination per 100,000 live births) has been coming down across the country.

Kingpin of a racket involved in sex determination activities arrested


Syed Intishab Ali| TNN |

Representative image. Representative image.
JAIPUR: Ravi Singh, who has base in 15 districts and in neighbouring states including Uttar Pradesh, Madhya PradeshHaryana and Punjab arrested from Khetri of Jhunjhunu district on Monday on charge of having involvement in sex determination activities. Besides, a nurse from Hathras in Uttar Pradesh has also been arrested.

His modus operandi is quite unique. He has his agents who kept protecting him from the PCPNDT cell. The PCPNDT cell had tried to trap him in decoy operations at least six times but he escaped all the time. His gang had a portable sonography machine. PCPNDT cell officials said that he has gang members who have different works — one talks to the client, another brings the client to him. There are others who keep portable sonography machine and he himself remains vigilant and alert all the time. He never stays at a place for 10 minutes after conducting the sonography.

PCPNDT officials said that earlier also, he had been arrested twice but he continued conducting illegal sonography for sex determination of fetus. Officials said that he is 10th class fail but he knows how to conduct sonography. He had worked as a helper in a private hospital in Delhi and some other places where he learnt how to conduct sonography. But, whithin no time he has become kingpin of a gang involved in sex selection, the PCPNDT cell officials said.

State appropriate authority (PCPNDT) Navin Jain said, Ravi Singh is a resident of Singhana of Jhunjhunu district. He is active in 15 different districts and four neighbouring states — Uttar Pradesh, Madhya Pradesh, Punjab and Haryana.

The PCPNDT cell took help of Jhunjhunu district collector Dinesh Kumar and superintendent of police Manish Agarwal to nab him. He was arrested in a decoy operation conducted in Jhunjhunu district.

Besides, PCPNDT cell conducted a decoy operation in Hathras on Monday. They arrested a private hospital nurse who allegedly fooled her clients from Bharatpur, Dholpur and Alwar by saying that there is a female fetus in the womb of pregnant women. The PCPNDT officials said that she advises her clients to undergo feticide. But, in reality, she conducts general sonography and she herself does not know the sex of fetus. PCPNDT cell officials arrested owner of private hospital, who was absconding since August 2016 in Mathura. Officials said that in the hospital, a nurse was involved in sex determination activities.

KEM hospital panel that ruled out abortion of foetus with neurological problems did not have subject specialist


 Child born after Supreme Court turned down plea to abort pregnancy in critical condition at KEM hospital

Mumbai city news
(HT File)

Last Saturday, a 28-year-old woman gave birth to a boy with Arnold Chiari Syndrome Type-II — fluid accumulation in the brain and spinal deformities that leave him little chance of survival. She and her husband had moved the Supreme Court to be allowed to abort her pregnancy in the 27th week once they knew about the problems the foetus had, but the court had on March 27 turned down their plea based on the report of an expert team of doctors from Mumbai’s KEM hospital. The child is now in a critical condition at the KEM hospital where he was born. The law now prohibits abortion of foetus beyond 20th weeks, unless otherwise advised by a medical panel.

It now transpires that the expert panel did not have a neurologist on it though the foetus had a complex neurological condition. Chiari malformations cause structural defects in the cerebellum (part of the brain that regulates muscular activity) and children with Type-II re usually born with incomplete development of the spinal cord and its protective covering.

“There should be a neurologist on board while preparing reports on such cases because he will know the condition of the woman and foetus better. A neonatologist or general surgeon, based on hearsay evidence, cannot offer an accurate prognosis,” said a senior doctor from KEM Hospital who was involved in the case. The doctor spoke on condition of anonymity.

 

The KEM hospital dean, Dr Avinash Supe, said, “The law doesn’t permit us to advise the SC on whether the abortion should or shouldn’t be permitted. We can only analyse the medical condition of woman and foetus and offer a clinical suggestion on whether the child is ‘incompatible with life’.”

The committee had reported that if the mother was allowed to abort, the child might be born alive. “Complications could’ve been much worse then. Right now, they are at least clinically treatable,” Dr Supe added.

Dr Devi Shetty, founder and chairman of Narayana Health, who recently submitted a report based on which a woman from West Bengal was allowed to abort in the 27th week of pregnancy, told HT that an expert committee did not need doctors from specialities such as neurology or cardiology.

“If the foetus is diagnosed with any structural deformities, related to heart, brain or other vital organs which will limit its lifespan or the deformity itself is incurable, then the woman should be allowed to abort until week 26 or 27 of gestation. In today’s world, technology does the diagnosis and anyone with a post-graduate medical degree can be called upon as an expert by the courts,” said Dr Shetty.

 

The Mumbai woman underwent a scan at a civic-run maternity home in Borivli in the 15th week of her pregnancy, but the neurological malformation was not picked up then. The second scan was done in the 24th week, when doctors finally diagnosed the anomalies.The rate of survival is as weak as 1.2-2 per 1,000 births.

Solicitor General Ranjit Kumar had told the Supreme Court bench that as per the report of the medical board of KEM Hospital, the foetus has severe physical abnormalities but the doctors have advised against termination as the mother was in the 27th week of pregnancy.

Dr Nikhil Datar, gynaecologist and obstetrician who is a prime petitioner in the case before the Supreme Court seeking extension of the pregnancy termination limit to 24 weeks, blamed the civic-run clinic’s inability to detect the malformation in time for the couple’s present predicament.

Rajasthan- At 861 girls, sex ratio slides alarmingly


Image used for representation
JAIPUR: Despite several initiatives taken by the state government to increase the sex ratio, the number of girls born in the state against 1,000 boys has gone down to 861 during 2013-15 in the state. This was constant 893 from 2010-12 to 2012-14.

For the past few years, the sex ratio at birth was a constant 893. This has slipped to 861. Despite several initiatives taken by the state government to bring down the ratio at birth, it has fallen drastically between 2013 and 2015.

This is a fall by a whopping 32 points, as per the latest sample registration system (SRS) statistical report 2015 released by the Centre.

The three consecutive SRS statistical reports 2012, 2013 and 2014, had shown that the sex ratio was constant at 893, but the latest SRS 2015 report has shocked the state as it shows that it has slipped noticeably.

“The sex ratio at birth for the country for the period 2013-15 (3-year average) has been estimated as 900. At the national level, it is 903 in rural areas and 890 in urban areas. Among the bigger states/UTs, the sex ratio at birth varies from 967 in Kerala to 831 in Haryana. In rural areas, the highest and the lowest sex ratio at birth are in the states of Chhattisgarh (9870 and Haryana (836), respectively. The sex ratio in urban areas varies from 954 in Madhya Pradesh to 821 in Haryana,” the report says.

Health authorities claimed that the situation was much better in terms of sex ratio at birth now. “At present, the sex ratio at birth is above 940 girls per 1,000 boys born in the state. We collect figures of births from across the state through our online pregnancy and child tracking system (PCTS). We register each and every birth (100% births) on PCTS,” Navin Jain, state head (mission director), National Health Mission (NHM), said.

He said that according to registries in PCTS, the sex ratio at birth in the state was 939 in 2016.

Over the past few years, health authorities have stepped up efforts to curb female foeticide in the state. There are 2,760 sonography centers in the state. Officials said that they have conducted more than 11,000 inspections at sonography centres till date. In 2014, they have conducted 837 inspections. In 2015, this increased to 1,430 and, in 2016, the officials conducted 2,468 inspections. This year, till May, they have conducted 473 inspections. During inspections, they suspended registrations of 196 centres for flouting provisions of the PCPNDT Act. They also cancelled 472 registrations of sonography centres.

Officials said that 652 cases were undergoing trail in different courts in the state for flouting the PCPNDT Act.

Doctor to lose license if C-Section rate exceeds 25 percent: MP State Woman Commission


abortionLAWS

 

 

Madhya Pradesh: If in a private or a government hospital, any doctor is found performing more than 25% of all deliveries by Caeserean Section in a period of 5 years, his/her license should be cancelled- Such is the recommendation made by the  MP State Woman Commission to the state government, recently. The commission was seen responding to the rising rates of  deliveries through Caeserean Section in the state and also rising complaints that gynecologists are indulging in the practice of unnecessary C-sections …

State commission, after going through figures of normal and Caesarean deliveries in MP, made certain recommendations including initiating action against doctors that indulge in this practice. The major recommendation stated that All the hospitals shall have to display figures of Caesarean deliveries of the hospital so that a pregnant woman could decide about the treating doctor.

For the Purpose of Action in case of violations, the Committee suggested a analysis of deliveries done during a 5 – year period, and  actions would be according to the following

Sno % of Delivery Done by C-Section in a 5 year period        Recommended Action

1  Upto 15% This is acceptable.                                              No Action will be initiated

2 More than 15%, but less than 20%                                       Warning shall be issued

3 More than 20% but less than 25%                                        Fine upto Rs 5 lakhs

4 More than 25%                                      Cancellation of Licence and Blacklisting of Doctor

Speaking to Medical Dialogues Team, Mr.Pramod Dube, chief advisor to the committee that brought about the recommendations said, ” These has been a sharp rise in deliveries through C-section in the past recent past. With this, even the thinking pattern of the public has changed. In earlier days people used to congratulate on Birth of baby .Now people hesitantly are seen asking whether delivery is Caesarean or normal.” “These are our recommendations to the state.

The government may act as it deems it deemed fit. The complaints are rising by the day and our insistence is that, this issue of unwanted c-section be addressed by the government. ” he added.

Private hospitals perform more than thrice the number of c-section deliveries as compared to government hospitals, showed the data from National Family Health Survey-4 (2015-16), released by the Union health ministry in the month of March 2017

 

The data showed that Private hospitals carried out 40.9% caesarean sections (C-sections) as compared to 11.9% performed in government hospitals. The figures were a sharp rise from the previous survey figures which were 27.7% and 15.2% respectively. World Health Organisation recommends the “ideal rate” for caesarean sections to be between 10% and 15%

Read more at Medical Dialogues: Doctor to lose license if C-Section rate exceeds 25 percent: MP State Woman Commission http://medicaldialogues.in/doctor-to-lose-license-if-c-section-rate-exceeds-25-percent-mp-state-woman-commission/

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