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Society
Abortion
Dilemmas: Perfect Baby, Imperfect Society
by Geeta Seshu
 Stunned at
the intense publicity that surrounded her plea, filed in the Mumbai High
Court, to abort her 25-week-old fetus, Mumbai-based Nikita Mehta never
imagined the case would draw such a welter of responses from people from
all walks of life. The Mehtas had appealed to the court for allowing
abortion, despite the fact that they were four weeks into the
permissible 20-week deadline under the Medical Termination of Pregnancy
(MTP) Act, 1971. After this, the law only allows an abortion if the
mother's life is endangered by a continued pregnancy and if the fetus
would suffer a permanent disability.
Today, despite the rejection of her plea, the issue shows no signs of
abating. Doctors, women's rights activists, bloggers, television chat
shows and even local train commuters are debating the issue furiously.
There are a whole host of questions that the case throws up: Is
individual liberty more important than social responsibility? Would this
not mean a back-door acceptance for sex pre-selection and genetic
engineering? Would it not lead to a further devaluation of differently-abled
people in an uncaring society? Would it not lead to the weeding out of
potentially "abnormal" babies?
Public opinion has ranged from those in favor of abortion, irrespective
of the time factor, to those who completely reject the move. A middle
ground, favoring a relaxation of the rules in very exceptional cases,
has also been voiced, not specifically in the case of the Mehtas but
perhaps applicable in other, severe cases.
For several people, the issue hinged around the individual right of the
parents to determine the fate of the fetus. Bloggers, newspaper readers
and television viewers, who participated in SMS polls, were
overwhelmingly of the opinion that the right of parents to decide to
abort was an absolute. Medical health activist Dr Kamaxi Bhate wondered
how the courts could interfere in this matter. Echoing the empathy
expressed by many towards the plight of parents who take care of
disabled children, she says, "There is hardly any support system for
women to bring up 'normal' children, so what happens to people who have
children with congenital defects or disabilities?"
However, this line of thinking is disturbing for activists like
Chayanika Shah, who has been at the forefront of the movement against
sex determination tests. "I have very mixed feelings about this
controversy. I think we need to re-examine our stand on the entire
issue. We also need to look at issues raised by the disability rights
movement," she says.
In the mid-1980s, women's organizations in Mumbai had launched a
campaign against the misuse of sex determination tests, hitherto used to
detect certain gender-specific genetic abnormalities in the fetus, to
determine the sex of the fetus and then selectively abort female
fetuses. The campaign, spearheaded by the Forum Against Sex
Determination and Sex Preselection (FASDSP), led to the passage of the
Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse)
Act, in 1987 in Maharashtra, which was, subsequently, extended to the
entire country.
Despite the stringent provisions of the Act, it is clear that the
rampant abortion of female fetuses has continued, albeit underground.
The child sex ratio in India is an alarming 927 girls to 1,000 boys,
according to the 2001 Census. Correspondingly, there has also been a
veritable explosion in new reproductive technologies, with in-vitro
fertilizations - the test-tube babies, and surrogate motherhood becoming
commonplace and genetic engineering waiting in the wings.
But what does this have to do with the plight of the Mehtas? Ammu
Abraham of Women's Centre, a Mumbai-based shelter and counseling
organization, says that for several years the FOGSI (Federation of
Obstetric and Gynecological Societies of India) has been supportive of
public interest litigations and other efforts to test the limits of the
law governing abortions and has extend the powers of doctors within the
framework of reproductive and contraceptive rights. The present
controversy should also be seen in this light, she felt.
"When women's organizations and health activists debated the sex
determination tests, there were three strands of opinion - those that
took the stand of free choice to abort, irrespective of sex, genetic
abnormality or time; those that wanted a complete ban on all tests; and
those that sought a partial ban, saying that working women, who delayed
pregnancies, should get a fair chance to determine whether the, usually
single, child they wished to bear was free of abnormalities. Today,
unfortunately, gender itself is seen as a 'genetic abnormality' and the
cultural devaluation of the female foetus is rampant," she rued.
FOGSI head Dr Narendra Malhotra has gone on record to state that the
federation would discuss the issues raised by the Mehta's plea and seek
an amendment to the MTP Act. However, not all doctors are in favour of
this. Observes well-known gynecologist Dr Kiran Coelho, "I do feel sorry
for the couple. Certain kinds of cardiac malfunctions are made out
between the 20th-24th week and sometimes later, when it is too late for
an abortion. But after the 24th week, it is really dangerous for the
mother to undergo an abortion. And what of the ethical issues? Suppose
the fetus, which is viable outside the womb after the 20th week, is born
alive? What are doctors going to do with it?"
Besides, Coelho says, medical science has advanced greatly and fetal
therapy has helped doctors to intervene and save many a mother and
child. In a case she handled where the fetal heartbeat was irregular in
the 26th week, cardiac surgeon Dr Yash Lokhandwala successfully
administered fetal therapy to correct the malfunction. "The baby is now
nine months old. In several other instances, we detect abnormalities but
they correct themselves by the time the baby is born," she says,
expressing apprehensions that any amendment to the MTP Act to allow for
an extension in the time-limit for abortions would be liable to be
misused. "As it is, we are seeing a pathetic male-female ratio. The
warped mindset against the girl child has made selective abortions of
female fetuses rampant," she says.
But the jury is still out on the justification to abort because the
child may be born handicapped or with congenital abnormalities. "This is
a disturbing trend in today's society. While it is very hard for
individuals to bring up children who are handicapped, society cannot
shirk from its responsibility to take care of them," feels Shah.
Reproductive technologies, like pre-implantation genetic diagnosis, that
fiddle with genes to isolate and eliminate problem genes and selectively
encourage 'positive' genetic traits and features are a distinct
possibility in the near future. Abraham, who feels that the overriding
competition for excellence has now entered the pre-natal stage, is
apprehensive. "How far can one fiddle with the fetus. We are fooling
ourselves that only the medical profession is responsible for this. They
are only fulfilling a demand from the market. Ultimately, who defines
what is perfect?"
Lawyer and health rights activist, Kamayani Bali Mahabal, says,
antenatal screening has 'medicalised' pregnancy by raising the
expectation that medical expertise is capable of providing a baby free
from impairment or illness, and that it would be 'selfish' or even
'antisocial' for parents not to avail themselves of this service.
Mahabal, also the South Asia Advocacy Coordinator of Women's Health and
Rights Advocacy Partnership (WHRAP), adds that technology has had the
effect of encouraging a mother to distance herself from the child she
carries.
But no technology can really guarantee the 'perfect' healthy child, she
says, stating that non-coercive, unbiased reproductive counseling was
necessary to provide parents with the right perspective on possible
disabilities. Perhaps this will help parents understand the potential of
all human life, rather than its limits.
August 31,
2008
By arrangement with
WFS
Image under license with Gettyimages.com
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