Abortion – No myth, a reality

                              Confused 🤔 

                                                                                                                                       

Abortion services is viewed as a myth rather than a reality. The usual scenario is, when the lady is pregnant and become aware of it, continuing the pregnancy is the only option in her mind. The autonomy of her body gets jeopardized when family and society indulges. She is confused, tired and faces difficulty in taking decisions.

This general norm was broken completely for a lady whose story goes about as below since she decided to abort her two-months pregnancy. This incident took place ten years back. 

She approached the health provider initially. She referred her to the doctor for counselling and advice. After a detailed analysis of her history, it was understood that she was forced for a relationship within the institution of marriage. The doctor explained the situation to the lady and referred her to a gynecologist, as it was not under the capacity of the doctor to give abortion services in that situation.

Later, she was followed and understood that she was denied abortion service in the referred place. She remembered the advice of the doctor and explanation as to why she is a candidate who can avail abortion service. The incident took place before the revision of the Medical Termination of pregnancy Act.

The first denial to abortion did not stop her and she approached another doctor. She explained her scenario adding the reasons why she can avail the service. The doctor gave her the necessary medication for the first trimester pregnancy and she could abort the pregnancy. The doctor who bravely took this decision should be applauded for the courageous act of the time period when, abortion was a myth, stigma and next to impossible.

The situation seems very simple when jotted down. But the emotional trauma undergone by both the doctor and the lady is immense. The doctor may be penalized if the reason for abortion is not booked appropriately. The lady may have to undergo the strain of pregnancy, stigma and isolation. In spite of this, questioning of the lady, validation of the doctor, assessment of the doctor for the discretionary choice he or she made were the hurdles crossed for a simple decision of the lady to abort a pregnancy which she did not want to continue. The reason for abortion was also, protocol- wise difficult to decide and process, due to the constraints in the system.

This conveys the message that being true to policies in place and at the same time, providing services boldly respecting the lady’s autonomy, right decision at the right time, is the best way to balance between accusations at work and commitment to the work. This is the healthcare provider perspective. Whereas, in the service seekers’ perspective, taking informed decisions and standing up for the right decision is the best way to balance between denials, stigma and satisfaction to have their rights accepted. 

In India, Medical Termination of Pregnancy Act (MTP Act) of 1971 which allows abortion for contraceptive failure, survivors of pregnancy due to rape, minors and any condition which harms the health of the mother and child. This Act is vague in itself, can have interpretations in various dimensions and confuses the decision maker as well as service seeker. 

There were revisions in 2017, 2021 and amendment in 2024 with extended clauses as opinion of single registered practitioner upto 20 weeks, no need for medical board opinion upto 24 weeks, unmarried women can avail the service, ‘mental retardation’ changed to Intellectual disability and also stringency to provide confidentiality and privacy.

(Dr. Athira Krishnan S)

Abortion services should be available like any other services in order to reduce unsafe abortions in place of denied safe abortion service. The ability of the lady to have autonomy over her body, to know herself, to explore herself and correct herself lies with her. Adolescent education and services, contraceptive awareness and services and safe abortion education and services are the need of the hour for the budding generation to take informed decisions which pave safer life paths.