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Abortion Hurts Women

Abortion Hurts Women

by Monika Rahar

Introduction

“Abortion is the dread secret of our society. It has been relegated for so long to the darkest corners of fear and mythology that an unwritten compact virtually requires that it remains untouched and undiscussed."  Lader[1]

In a world in which; (i) 7 billion people live, (ii) tremendous diversity in societies, economy, political structure, ethnic composition exists, (iii) passive obedience is revered more than intellectual revolution, (iv) culture or extremist or rudiment ideologies dominate, (v) ‘ego’ of a tiny ‘self- proclaimed protector’ takes toll on lives of millions of innocents, ‘enjoyment of the right of life and liberty’ is a rare found luxury and ‘justice is an elite concept.[2]

21st century is a century of transition; the more science is getting involved in everyday life of an individual the more it is ending up confronting the social and moral narratives controlling individual choices. Law and society are the two sides of the same coin. Demand or to say need of the later necessitates formulation of the former and implementation of the former defines or decides the nature of the later. A change in one is resonated by a corresponding change in the other. India is one of the nations which have taken a progressive stand by Legalizing abortion by passing the Medical Termination of Pregnancy Act, 1971 (the MTP Act). This act recognized the right of a woman to undergo abortion if her case falls under any of the categories specified u/s 3 of this act.

This article will address the issue of ‘abortion’ and will look into its meaning, legality, types in medical sciences, the processes employed to procure it and physical and mental implications.  More importantly, it will address the question as to what extent the conservative forces can go in imposing ‘morality’ on changing society.

Meaning Of Abortion In Medical and Legal Sciences

The word ‘abortion’ is derived from the Latin root word ‘aboriri’ meaning ‘miscarry.’[3] Although it is a medical phenomenon yet it has social, moral and religious notions and implication attached to it. Thus, the meaning attributed to it in medical sciences differs from that in legal sciences. Abortion, in terms of legal science implies expulsion (either illegally or forcibly) of the product of conception from the womb of a pregnant woman irrespective of her consent and the period of gestation.[4] While in terms of medical sciences it means to terminate pregnancy before the fetus is developed enough to lead extra- uterine life (that is before the birth naturally takes place). Generally, the time period is (i) prior to 20 week of gestation or (ii) when the embryo is not less than 5oo gm in weight or (iii) when the length of the embryo from the head to rump is 18 cm.[5]

How about a reality check?[6]

The reality of abortion is (i) every 8 minutes a woman (in a developing country) dies as a result of an unsafe abortion, (ii) every year, world over, 42 million women choose termination of unintended pregnancy half of which (20 million) are ‘unsafe,’ (iii) it cause death of some 68,000 women annually (iv) it constitutes to 13% of maternal mortality, (v) both unsafe and safe abortions leave lifelong physiological and psychological impacts on the woman undergoing it. Studies have shown a directly proportionate relationship between ‘unsafe abortions’ and ‘repressive abortion laws.’

  Techniques Of Abortions[7]

Abortions can be carried out by employing various techniques which can be classified into two categories namely; surgical and chemical. The techniques employed differ according to the stages of pregnancy and can be classified into three categories namely; (i) early stage, (ii) first- trimester; and (iii) second and third trimester.

(i)             Early Stage

In the early stage of pregnancy, abortion is procured by administering drugs. One such drug is the ‘morning- after pill.’ It is a contraceptive pill which needs to be taken within 72 hours of the intercourse. It delays the process of ovulation and prevents the fertilized egg from sticking to the lining of the womb. This is followed by administration of another drug which causes contractions and bleeding leading to abortion.

(ii)           First Trimester

Suction Aspiration or Vacuum Curettage- A suction tube with sharp cutting edge is used to dismember the developing fetus’ body, detach the placenta from the uterus wall and suck the left overs in a collection tube.  Dilation and Curettage- A ‘loop shaped steel knife’ is inserted in the cervix, the fetus’ body is cut into pieces and the placenta wall (the cord which connects the fetus’ body from that of the mother’s uterus wall and provides nourishment to the baby) is torn off causing severe blood loss and risks of infection. RU- 486- This is a French Abortion pill which uses to two synthetic hormones called mifepristone and misoprostol. On being taken by the expecting mother, this pill brings a halt to the action of progesterone which in turn leads to no-supply of nutrients to the baby through the placenta and hence the fetus dies of starvation. This step is followed by a dose of misoprostol which secures contraction in the uterus leading to expulsion of the fetus out of the mother’s body. The last step is to ascertain whether the fetus is aborted or a surgical operation is needed in case it is not. Methotrexate- This technique is similar to that of RU- 486 except for the fact that it is not a pill but is injected into the body.

(iii)         The Second and Third Trimester

Insertion of Drugs into Amniocentesis fluid - Amniocentesis is a yellow fluid which contains important nutrients needed for development of the fetus and also important cells of the embryo. This fluid is contained in amniotic sac (a transparent pair of membranes) which acts as a shock absorbent. A sample of this fluid can find out the stage of development of the fetus, its sex and status of its medical condition. Drugs like hyper tonic saline, urea, salt poisoning, and prostaglandins are injected in this fluid to cause death of the fetus. Thereafter forceps (a smooth metallic apparatus) is inserted in the cervix to cut the fetus’s dead body.

Partial- Birth Abortions- This method is performed between twenty to thirty two weeks of gestation. Taking the help of ultra- sound, the abortionists look into the uterus. After getting hold of the head, a scissors is jammed in the fetus’s skull; the wound is widened and eventually to the baby’s brain is sucked out. The death body is thus removed from the cervix.    

 

Abortion And Its Bitter Sweet Relationship With Law

 

International Response

Right to life and personal liberty is the heart and soul of the wider field of law called the ‘human rights.’ Reproductive rights were not explicitly enumerated but were provided protection under the umbrella of the ‘right to life and liberty’ until the coming into existence of various international and legal instruments (regardless of their justiciability) like the Proclamation of Tehran (1968), Cairo Program of Action (1994), Beijing Platform (1995), Yogyakarta Principles (2006), Article 12 of European Convention on the Protection of Human Rights and Fundamental Freedoms, African Commission on Human and Peoples’ Rights and Inter-American Commission.

Abortion Laws in India

The law governing abortion or to say medical termination of pregnancy can be divided into two phases; (i) Phase 1- Criminalization of Abortion under IPC; and (ii) Phase 2- De-criminalization Medical Termination of Pregnancy Act, 197.

(i)             IPC and Abortion[8]

Section 312 to 316 of the IPC makes it a punishable offence to procure a miscarriage whether done voluntarily or forcibly. The offences surrounding ‘miscarriage’ fall under the category of ‘Offences against the body.’

Section 312 penalizes miscarriage ‘voluntarily’ caused either by (i) a woman herself or (ii) some other person with her ‘consent.’ This section provides for two types of punishments differing in quantum of sentences offered, depending on whether or not the fetus so aborted was ‘quick with child’ meaning thereby; whether the child was aborted at very early stage or at a later stage after it started moving in the womb of the mother. Miscarriage caused without the consent of the woman undergoing it is penalized under section 313 IPC.  

Also, the code makes death of a woman caused while intending to cause miscarriage of such woman with a child, a punishable offence, regardless of whether the offender had the knowledge of the death becoming a probable occurrence during the course of carrying out such abortion. As per section 314 IPC, causing death of a child before or after birth by any act of the offender is an offence punishable with 10-year imprisonment. Also, the death of an unborn child amounts to ‘culpable homicide’ punishable with maximum ten years of punishment and fine. 

(ii)           Medical Termination of Pregnancy Bill, 1969[9]

In 1964, Shanti Lal Shah Committee, formed by the Central Family Planning recommended liberalization of laws related to abortion in India. This recommendation turned into the Medical Termination of Pregnancy Act, 1971 (MTP Act). This is a small yet significant piece of legislation which runs into ‘eight sections.’

A registered medical practitioner and any other person who procures termination of pregnancy are protected from being charged under the above mentioned sections of IPC by virtue of section 3 (1) and section 5 of the MTP Act, provided such termination satisfies the grounds listed under section 3 (2). This section empowers ‘registered medical practitioners’ to procure an abortion which they are of an opinion that (i) continuation of the pregnancy would endanger the life of the pregnant women or cause grave injury (including both physical and mental injury), (ii) the child so born would be severely handicapped owing to some mental or physical abnormalities. The explanation one and two attached to Section 3 (2) also enumerates, pregnancy caused as a result of ‘rape’ and ‘failure of contraceptive’ as grounds for valid abortion. The consent of; (i) the pregnant woman who is a major; (ii) guardian of a pregnant woman who is a minor or a lunatic, is necessitated in this act. However, if a minor girl or a lunatic (who is capable of knowing the nature of her act) do not consent to such termination, the guardian’s consent does not hold ground. 

The act also mandates taking consultation with; (i) one registered medical practitioners in case the period of gestation is up to 12 weeks; and (ii) two medical practitioners when the period exceed 12 week but is less than 20 weeks. However, this mandate can be broken when an emergency to save the life of the mother is to be addressed and the decision is taken in ‘good faith.’ 

The remaining sections empower the government to make such rules that are necessary to implement this act. The Medical Termination of Pregnancy Rules 2003 lays down rules which are to be followed by the abortionist and the other stakeholders while carrying on an abortion.

(iii) Role of the Judiciary[10]

While dealing with the issue of abortion, the judiciary is often confronted with the question of ‘when life begins.’  While deciding the constitutional validity of the MTP Act, the Apex Court consciously avoided this question and offered no answer to it. In fact, answer to this question is still aviating answer from the judiciary and the legislature around the world.  There are two groups called the ‘pro- life’ (life beings the moment the egg fertilizes) and ‘pro- choice’ (the embryo has no life and the parents have full right to decide what to do with such embryo).

Another question that is creating legal chaos is ‘should the time period of 20 weeks be extended to 24 weeks.’[11] The Indian Judiciary has taken different stands time and again. There have been some cases where the Apex Court permitted rape victim survivor to abort her child after 26 weeks of pregnancy while there are some verdicts given by the High Court of Andhra Pradesh and Bombay which did not permit minor rape survivors to abort their children after the ceiling time period of 20 weeks.

      Abortion Hurts Women

The medical techniques or methods employed in performing abortion have already been mentioned in this article. A thorough perusal of the same is enough to decide whether it hurts or not. Abortion comes with its own set of difficulties both physical and mental. It is sought only in limited circumstances of unwanted pregnancy where a woman conceives as a result of rape, or due to failure of contraceptives or where giving birth to a child can prove fatal to the mother in terms of her mental or physical injury or the child to be born is suffering from severe mental and physical handicap.

Hence, the occurrence of such type of pregnancy is stressful and so is its termination. Studies have shown those women who were seen more comfortable in reaching to the decision to abort her child are seen to have more stress than those who reached to this decision more reluctantly and went through emotional break-down. The concept of ‘guilt’ plays an important role here.

Medical research has proven the existence of an emotional state called the ‘Post Abortion Syndrome.’ This syndrome can change the life of a woman all together and she can turn into drug and alcohol addict and can have problems with their sexual, maternity and biological health. The effects can last for years to recover emotionally and the future pregnancy of such woman is also affected adversely. In case of chemical abortion the women sometimes end up seeing the child in her womb cut down into several pieces.[12] Abortion leads to various health risks including high chances of breast cancer. 

     Conclusion- Who are we To Decide What Is Moral and Amoral!

As a race, human beings are ‘driven by greed and controlled by emotions.’ History bears testimony my statement. The Social Contract Theory proposed by the various jurist states that the state came into existence owing to different reasons to serve common interest and because of a common cause and that is greed to survive, to seek pleasure of authority and sustain their rights to life and liberty.

I am surprised by the importance we give to views expressed by philosophers, jurists, political thinkers, sociologists, legislatures, diplomats, judges. A word penned down by a fellow human in form of a piece of legislation is enough to bind hands of another who tries to saves lives of millions of those who are victims of archaic notions initiated by another fellow way back and carried forward by another being for years without paying head to the need for change.

The Hindu ancient scriptures propagated unequivocally of the notion to have a son in order to attain ‘salvation’ and in Muslim religion females are offered blessing to give birth to sons. I fail to understand how some practice started centuries ego coupled with added notions of hell or heaven, fear, presence of supernatural powers and gaining their favour or inviting rage, can act like a blind fold for generations to come.

It is high time we address ‘socially uncomfortable and morally challenging issues with a rational mind.


[1] Abortion Laws, WORLD HEALTH ORGANIZATION, 1971 https://apps.who.int/iris/bitstream/handle/10665/41924/a53898_eng.pdf?sequence=1

 

[3] Oxford English Dictionary

[4]Abortion, SHODHGANGA (Accessed on January 29, 2019) http://shodhganga.inflibnet.ac.in/bitstream/10603/92687/9/09_chapter%205.pdf

[5] Supra note, at 112.

[6] Medical management of abortion, WHO, (2018) ISBN 978-92-4-155040-6, https://apps.who.int/iris/bitstream/handle/10665/278968/9789241550406-eng.pdf?ua=1

[7] Abortion from Medical Perspective, SHODHGANGA, (Accessed on January 30, 2019) http://shodhganga.inflibnet.ac.in/bitstream/10603/172165/7/07_chapter%202.pdf

[8] The Indian Penal Code, 1860, No. 45, Act of Parliament 1860

[9] The Medical Termination of Pregnancy Act, 1971, No. 34, Act of Parliament 1971

[10] Reproductive Freedom Including Right To Abortion Vis- a- Vis Right of The Unborn To Live, SHODHGANGA (Accessed on January 29, 2019) http://shodhganga.inflibnet.ac.in/bitstream/10603/172165/7/07_chapter%202.pdf

[11] Shaumya Rai and Shajid Shiekh, India's Abortion Laws Need to Change and in the Pro-Choice Direction, THE WIRE (May 11, 2017) https://thewire.in/gender/abortion-pregnancy-law-india,

 

[12] Supra note 8, at 24

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