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/

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.

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/

Indian court allows 10-year-old rape victim to have an abortion


Girl had crossed 20-week legal limit after which terminations are usually only allowed if there is danger to life of mother or baby

A 10-year-old girl who was raped will be allowed to have an abortion even though she has crossed the 20-week limit for terminations in India, police in the country said on Wednesday.

The child has said she was repeatedly raped by her stepfather, who has since been arrested.

Her case only came to light last week, by which time she had crossed the 20-week legal limit after which terminations are only allowed where there is a danger to the life of the mother or the baby.

“The court had asked the medical board to take a call and doctors have decided to go ahead with the abortion,” Garima Devi, the police investigation officer assigned to the case, told AFP.

“The board has not said when they are planning it (abortion) but it will be any time soon.”

In recent months India’s top court has received a number of petitions from women – including rape survivors and trafficking victims – seeking abortions where pregnancies had gone beyond 20 weeks.

Activists say the restriction should be extended to 24 weeks as victims of rape are often late to report their pregnancies.

The Indian Express said the victim’s mother wanted the accused to be set free as he had apologised and that she had other children to take care of.

“The girl’s life is destroyed but what will happen to my other children? I need to think about their future too,” the daily quoted the mother as saying from a hospital in Rohtak, a district in northern Haryana state.

India has a gruesome record on rape, with the capital New Delhi alone registering 2,199 rape cases in 2015 – an average of six a day.

A UN Committee on the Rights of the Child in 2014 expressed alarm over the widespread sexual abuse of children and said one in three rape victims in India was a minor.

Abortion sans wife’s consent a grave crime; pre-arrest bail denied to man


Mumbai
Abortion without the wife’s consent is a heinous crime, the Bombay high court has held while refusing the pre-arrest bail to a Wadala resident. Irshad Haq faces charges of dowry harassment and conspiring with a doctor and a nurse to get his wife’s pregnancy medically terminated without her consent.“It is a heinous offence. The husband, doctor and nurse have connived to abort the foetus of the woman without her consent and by fabricating the records,“ said Justice Sadhana Jadhav. The court pointed out that Irshad himself had taken his wife to the hospital. “Taking into consideration the material collected in the course of the investigation and upon perusal of the record, this court is of the opinion that the applicant does not deserve to be enlarged on bail,“ added the judge.

Irshad has been charged for the offence of causing miscarriage without the woman’s consent under Section 313 of the Indian Penal Code. If convicted, the maximum punishment prescribed for the offence is life imprisonment. He has also been booked for offences of dowry harassment, assault, criminal breach of trust and intimidation.

Additional public prosecutor M G Patil informed the court that while a nurse has been held, another co-accused, Dr Gazi Rehman, is yet to be arrested. Irshad had married the victim in 2010. In her complaint, the wife said that he would regularly demand that she fetch money from her parents.In November 2016, she got pregnant and Irshad demanded that she drop the baby . On December 17, 2017, he allegedly kicked her, assaulted her with a belt and threatened her that if she did not go in for an abortion, he would divor ce her. He then took her to ti Clinic where she was gi Jyoti Clinic where she was gi ven a tablet by the nurse. When she suffered from excessive bleeding, she called her brother, who took her to Sion hospital.She then lodged an FIR against her husband at Wadala TT police station. Irshad claimed he was falsely implicated in the case and his wife had consented to the abortion. The judge perused the hospital papers and pointed out that his wife had consented to admitting herself to the hospital and not the abortion. In her statement, the nurse told the police that Dr Gazi had allegedly accepted Rs 14,000 for the abortion and asked her to throw the foetus in a canal.

“It is clear that it is not a consent for abortion. It is a consent for admission. The records have been fabricated to show that the patient was discharged against medical advice although she had undergone abortion in the said hospital in the intervening night,“ said the judge, while dismissing Irshard’s application.

SC allows Mumbai woman to abort 24-week foetus with no kidneys


According to PTI, the apex court relied on Mumbai’s KEM Hospital medical board report saying foetus suffers from disorders and continuation of pregnancy would endanger mother’s life.

kem hospital, supreme court order, sc abortion ruling, mumbai hospital, kem hospital abortion case, king edward memorial hospitalThe Supreme Court. (File Photo)The Supreme Court on Tuesday allowed a Mumbai woman to abort her 24-week-old foetus that had no kidneys and would most likely die after birth. According to PTI, the apex court relied on Mumbai’s KEM Hospital medical board report stating that the foetus suffered from disorders and continuation of pregnancy would endanger mother’s life. This is the second case this year in which the Supreme Court has intervened to allow an exception under the Medical Termination of Pregnancy (MTP) Act, 1971.

Earlier on Monday, KEM Hospital had submitted its report to the apex court regarding the woman’s case. The court had asked the hospital to give its opinion on the case after diagnosing the petitioner and her foetus.

According to the woman’s petition, she was in her 21st week of pregnancy when the foetal growth anomaly termed as bilateral renal agenesis was diagnosed.The condition means absence or failure of both kidneys in body. This also causes deficiency in amniotic fluid that can cause further malformations in a baby. According to doctors, a baby with this anomaly cannot survive for more than four hours after birth.

Earlier, a 22-year-old Thane woman was allowed to undergo abortion after the Supreme Court observed that the foetus suffered from anencephaly, a life threatening condition in which the skull is not fully developed.http://indianexpress.com/article/india/sc-allows-22-year-old-mumbai-woman-to-terminate-her-24-week-pregnancy-4511855/

India – Family Planning is Certainly Not ‘Women’s Business’


NEW DELHI: Talking about family planning has never been easy. Political parties have for too long shied away from the subject, not wanting to earn the ire of their vote banks. The hangover of the ‘nasbandi’ days continues with vasectomy being seen more as an ill than panacea. Myths and misconceptions thrive and the only way of keeping a check on the population has been by holding sterilisation camps for women and doling out condoms by way of contraceptive choices.

So when the Supreme Court recently gave a historic verdict to ensure sterilisation procedures are conducted in accordance with legal norms, medical procedures and provisions of the manuals, and that those suffering from failure or complications are adequately compensated, it finally stirred up a larger conversation on planning families and women’s reproductive rights.

As someone with decades of activism behind her, Poonam Muttreja, Executive Director, Population Foundation of India (PFI), which has been at the forefront of policy, advocacy, and research on population, believes that the landmark judgment has come at the right time and will be vital in paving the way for a more vigorous, inclusive discussion on advancing sexual and reproductive rights of women and men – with, of course, “the media as a powerful ally”. An interview.

Q: Why is the recent Supreme Court (SC) judgment significant and what does it mean for the family planning programme in India?

A: The judgment has taken the conversation on family planning and women’s rights forward, moving from the narrow prism of numbers to prioritise issues of women’s reproductive health and rights. The verdict underlines the importance of quality of care in provision of family planning services with special reference to sterilisation. It calls for stopping the practice of holding sterilisation camps within a period of three years. It has freed state governments from pushing family planning targets, putting a stop to forced/non-consensual sterilisations. The judgment also recommends improving implementation of family planning programmes by ensuring easy access to empanelled doctors, making information available in local languages and ensuring informed consent of patients.

Q: Why is there is a need to reposition family planning and how should this be done?

A: A major focus of the national programme so far has been on promoting family planning. This has to change, given that the largest group of young people in Indian history is currently in their reproductive years. Even countries like Indonesia, Sri Lanka, Bhutan and Nepal offer at least six contraceptive choices whereas in India we have only female sterlisation at 74.4 per cent followed by condoms at 11.4 per cent, the pill at 7.5 per cent and IUD (Intra Uterine Device) at 3.7 per cent. Not only must we provide more options to the youth but also put as much emphasis on repositioning family planning and maternal and child health policies and programmes within the women’s empowerment and human rights framework. From promoting ‘population control’ approaches as a solution to stabilise population, we must look at providing services.

Q: Deep rooted myths surround the issue of family planning, including the notion that certain religions want their women to be baby producing machines.

A: It is unfortunate that women’s bodies and their fertility become objects that fuel fires of communalisation. Improvement in fertility/decline in population is dependent on education, income and employment opportunities and not on religion. Declining trend in population growth is secular. The sex ratio among Muslims as per Census 2011 stands at 951 females for every 1000 men which is significantly better than 939 among Hindus. Further, it shows marked improvement from 936 in 2001 to 951 in 2011 among Muslims whereas for Hindus it shows marginal improvement from 931 in 2001 to 939 in 2011. It is a proven fact that female education, employment opportunities and access to bigger basket of contraceptive choices help women make the right choice. Contrary to popular belief, women, across the board, want a smaller family.


Q: In the context of family planning, what have been the biggest missed opportunities post-Independence?

A: Not addressing the unmet need and robbing millions of women the choices for contraception is a huge missed opportunity. This has forced young women to opt for abortions, many of them unsafe. In the absence of counselling and open discussion, they are using emergency contraceptive pills as a family planning method. According to national data, the unmet need for family planning is a staggering 32 million. More than six lakh abortions were recorded in 2013-14, majority of which resulted from lack of access to contraceptives. The focus clearly must be on creating awareness, making services available, expanding the basket of choices, ensuring quality of care and increasing family planning budgets.

Q: If awareness building is a key aspect, how do you think media can contribute to mobilising support and initiating sustained action to enhance reproductive and sexual rights of women?

A: Media is a vital ally and partner to all of us working to improve access to sexual and reproductive health rights for youth and adolescents. It plays a crucial role in bringing issues around family planning to the attention of policy-makers and influencers. However, so far, coverage around stories on family planning remains negligible. PFI recently conducted a media consultation in Delhi in an attempt to initiate a robust debate on family planning, women’s health and reproductive rights. We wish to see family planning become part of the mainstream media narrative. PFI has worked with media to generate evidence-based coverage on family planning and reproductive health. Our behaviour change communication initiative, Main Kuch Bhi Kar Sakti Hoon, addresses social determinants of health and has deep outreach and impact. Media can help in positioning family planning not as a women’s issue or men’s issue but as a people’s issue. Highlighting negative events through sensational headlines and photos that shock and awe are important but so is following up with those stories and tracking what happened to those featured in them. This would help put pressure on the government and related agencies to act and take responsibility. Media can also contribute greatly to the initiation of dialogue and debate around positive decisions that have the potential to impact demographic trends and quality of life. So far, there has, in fact, been a narrative to demonise family planning. It is time to create champions and join hands in ensuring women are educated, men and boys are part of the discussion and women’s sexual and reproductive rights are protected.


Q: Why is involving men so important in something traditionally viewed as “women’s business”?

A: Our experience has been that if you reach out to men, they will be responsive. They treat women’s reproductive health as a “woman’s issue” because that’s the belief that has been perpetuated widely. It is necessary to involve them in family planning. There should be an emphasis on changing mindsets and stereotypes so as to enable women to take decisions regarding their own health and increasing spousal communication. There remain myths and misconceptions around vasectomy, including baseless speculation on loss of virility. Men must be encouraged to accept vasectomy as a family planning method. At the same time, male engagement should not be confined to vasectomy alone but extend to their involvement in decisions related to the education of their daughters, choosing the best contraception available, spacing and age of pregnancy.

Q: What are the strategies for the future?

A: We need to be vigilant and monitor on-ground implementation of the SC directives. Having said that, we need to continue supporting the government and reviewing adherence to quality guidelines in implementing the injectable roll-out and generating evidence through research on contraceptive options of Progestin Only Pill and Centchroman. This will enhance the basket of contraceptive choices for women and young people.

(Women’s Feature Service)

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