Abortion – a Mother’s Choice and Right

The issue of abortion has never been simple; always as much a question of morals and ethics as it is a question of health; always as much a question of life and death, as it is a question of choice. And the answers to the questions it raises are never easy to answer- not for doctors, not for social activists, not for politicians, not for families and definitely not for mothers. Abortion, which can broadly be defined as the spontaneous or induced termination of pregnancy, before the foetus reaches a stage of viability[i], will always find as many ‘pro-life’ adversaries as it will find ‘pro-choice’ advocates.

Even in a country like India, where pro-choice, owing to our large population and the large number of mouths to feed at our many homes, could mean a pro-life decision for the already born and surviving members of the country, where around 6.7 million abortions take place every year, a Niketa Mehta, asking for a late term abortion not yet sanctioned by our outmoded Medical Termination of Pregnancy Act creates front-page headlines. India divides as if it were the parting Red sea or maybe in our own cultural context, the Yamuna[ii]; and emotions are in a spate. There are those who will side with the mother, supporting her right to decide whether her child- diagnosed with a congenital heart block with a variable prognosis, which could clearly be defined only after the birth of the child itself- should be born. Then, there are others who will severely criticise her decision as selfish and non-maternal.

Because, even with our sky-rocketing abortion rates which show the number of people who do not want to feed another mouth, abortion can never be trivial. We are not talking politics, stock markets or entertainment. We are talking life – as plainly as we can. We are talking about the right of a child to live as opposed to the choice of the mother not to have the child. Therein comes the eternal question that baffles scholars of theology, stumps politicians, challenges doctors and confuses people: what is more important – a mother’s choice or the child’s right? Call it history, biology, physiology, mythology, legend, the plain wiles of a patriarchal definition of a mother or whatever you will, but can a mother ever go against her maternal instinct and decide not to have a child?

I will not claim to have the answer. I am not a mother. But, after having interned in the family planning section of the government general hospital at Chennai, and after having worked with mothers who have made such decisions for some very good reasons, which under my oath I cannot disclose without prior permission, I know that a woman will and she can. In 1971, the Government of India also thought so.

Women’s rights activists have always looked upon the MTP act[iii] passed by the Indira Gandhi government as a means to empower the Indian woman, helping her play an important role in controlling and planning her family. The act legalised abortion and allowed her to be the sole deciding factor, once the doctor had deemed it necessary or permissible, as long as she was over 18 years of age, and not suffering from mental challenges, in which case a guardian would be required to give the written consent in her stead.

In a country like ours, where only about 1 in 100 people recognise contraception as a means to family planning, where men still refuse to use condoms, in spite of the widespread campaigns promoting the same to decrease conception rates as well as the spread of sexually transmitted disease, where men defer sterilisation for the fear of losing their potency, where women are subject to domestic violence and complaints against the same are considered taboo, where sexual assault on a woman is a cross hers alone to bear, where illiteracy still stands in the way of sexuality education, the rights to abortion is a powerful tool in a woman’s hand.

But accessibility alone decides if it also a functional one.

According to a recent brilliantly written piece in The new Indian Express, a tribal population in the Naickeneri Hill in the Vellore district, where premarital sex is allowed in order to please the men, a girl has an average of at least two abortions in her life time. The local PHC[iv] is not equipped to conduct abortions and paying a private doctor to get the same is not an option. What do such women do? In this case, the local ‘medicine-woman’, with no knowledge of medicine solves their problems.

Thirty years after the legalisation of abortion, these unqualified abortionists survive aplenty all over India. Where PHCs fail to provide the promised medical care, people opt to see these ‘local doctors’. A large number of the clients are unmarried and widowed women, carrying a love-child that they now regard a shame, since the man is not ready to share the responsibility of parenthood.

Employing dangerous procedures, like the use of local irritants, powerful drugs that cause uterine contraction and violent local procedures, like the abortion stick (a stick dipped in the abortifacient drug popular in the area) and sometimes even the point of an umbrella, these men and more often women, cause more maternal mortality than the danger of continuing the pregnancy itself.  Clients of these charlatans suffer from early complications ranging from sepsis to shock, to sudden death and late complications that could include infertility.

In India thanks to illegal abortions, the maternal mortality rate is as high as 7.8 per 1000 random abortion; a figure that is very high for a country that has rapidly advanced in the medical field since independence. Education alone can be saviour in such cases. It is as necessary to create awareness about the complications of illegal abortion as it is to equip the PHCs with better facilities, to help a woman avail her right to abort an unwanted pregnancy.

The question still remains unanswered– is a woman- a mother- right in wanting to abort her child?

In our patriarchal society, where a woman as an economical dependant is forced to subject herself to her sexual partner’s demands, the right to terminate the pregnancy is a boon to her; especially since in many large and overburdened families, one more pregnancy could be life-threatening for the mother in question and one more child could be an unaffordable addition to the family. However, the evidently strong control that men have on women’s lives and their decisions, sex-selective abortion  and the general prevalence of illiteracy necessitates better counselling for the woman before she decides to opt for abortion, to make sure that she is not forced into such measures by her family and that she has a judicious reason behind her choice.

But essentially abortion does talk about the destruction of one life to sustain others. The large abortion rates tell us about the general lack of awareness about contraception, as well the irresponsible sexual behaviour in our country. In the long run, sexuality education aimed at both men and women, the wide spread use and availability of contraception, support to single mothers, laws to improve antenatal, postnatal and neonatal medical care and perhaps a less judgemental society would help mothers opt to give birth to children rather than abort them. But until then, let us hope that women will continue to benefit from this choice they are allowed to make.

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[i] Under normal circumstances, the foetus can exist as an independent entity, outside the body of the mother from the 28^th week of gestation. When expert peri-natal and intensive neonatal care can be given to the preterm infant, a child can survive even when delivered after the 20^th week of gestation.

 

[ii] By popular mythology the Yamuna parted and gave way, when on the birth of Lord Krishna his father needed to carry the baby to safety to a village across the flooded river.

 

[iii] Medical Termination of Pregnancy Act, 1971. Under this act, pregnancy can be terminated in or before the 20th week of gestation, when continuation of pregnancy could endanger the life of the mother, when there is the risk of the child being born with serious mental or physical abnormality, when pregnancy is caused as a result of sexual violence, when pregnancy results from the failure of contraception, when social and economic environment can harm the mother’s health or is not conducive to the birth of a healthy child. This law also defines who can perform such procedures, how they can be licensed to do so and where they can be conducted.

 

[iv] Primary Health Centre

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