A Chandigarh court’s refusal to allow a 10-year-old rape victim to abort her 26- week-fetus has left the medical community divided.
The case itself is a disturbing one – a 10-year-old was sexually abused by her maternal uncle over a period of seven months and was impregnated. No one in the family suspected anything and the pregnancy went undetected for 26 weeks.
The Indian Medical Termination of Pregnancy Act 1971 allows for termination by registered practitioners only up to 20 weeks and under very specific guidelines.
The Issue of Survival
Most gynaecologists say they’ve rarely come across a case of someone this young getting pregnant.
But the fact that she is 26 weeks along makes the case more complicated and there are no easy answers.
“It’s complicated because she herself is a child. At 10 her own organs and body are not fully developed. She is physically at risk of carrying the baby to term.,” said Dr Chadha who works with Apollo Hospitals.
But at 26 weeks, I feel abortion is also not possible. At this stage we consider the fetus a baby who can survive outside the womb. She’ll need specialised care and monitoring. If there is any risk, do a preterm delivery at 31 -32 weeks. As a doctor you have to weigh the risks and protect the rights of both the girl and the unborn baby.Dr Geeta Chadha, Gynaecologist, Apollo Hospital
Carrying a child to term for a grown woman itself is risky – in India nearly 45,000 mothers die due to causes related to childbirth every year, according to a 2015 World Bank report.
For a young girl, the risks are exponentially higher.
Very young pregnancies have a high risk of eclampsia, infection, preterm birth and intrauterine growth restriction.
Dr Suneeta Mittal, a senior gynaecologist from Fortis Hospital in Delhi supports the court’s decision. But she also points out that a baby born to a very young child will face health issues.
At this stage the girl’s own body needs nutrition and the fetus will also demand nutrition. Chances of the baby being stunted and under nourished are high.Dr Suneeta Mittal, Gynaecologist, Fortis Memorial Research Institute
Psychological Impact
It’s a complex medical case, where both choices seem dangerous – but the mental and emotional trauma for the 10 year old, first of the the abuse itself and then of being pregnant is torture in itself, some experts believe.
Doctor Puneet Bedi, a senior gynaecologist, strongly feels that the physiological risks to the young girl and the psychological impact far outweighs the risk of abortion.
An abortion needs to be done immediately. Yes, there are risks and abortion at this stage is tough, but for the girl who is still developing, the scars will be many... The only way to deliver if she manages to carry the baby to term is caesarean. That brings a whole host of risk factors.
A psychologist with Fortis, Dr Mimansa Singh feels that the child should be given counselling to deal with this trauma.
It’s the feeling of complete helplessness for the child. First of being abused by an uncle and then facing the trauma of going through the pregnancy when she possibly doesn’t even know what it is. She will need not just medical monitoring, but also psychological counseling.Dr Mimansa Singh, Psychologist, Fortis Healthcare
While we debate the complications of the case, physical, ethical and psychological, for the young girl, it’s a long road to recovery.
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