Calcutta HC allows abortion at 34 weeks

KOLKATA: The Calcutta high court on Thursday allowed a 37-year-old woman to medically terminate her pregnancy at 34 weeks — making it the most delayed abortion in the country to receive legal sanction — on the grounds that the fetus had spina bifada, an incurable disorder.

The woman from north Kolkata had filed a petition last week saying that doctors at several private hospitals had ruled that the birth defect wouldn’t allow the baby’s spine and spinal cord to form properly. A baby born with this condition cannot move or perform normal bodily functions and could die within weeks.

The most delayed abortion in the country so far was at 33 weeks. It was sanctioned in August last year by the Bombay high court, which allowed a 20-year-old woman to medically terminate her pregnancy because her fetus suffered from Arnold Chiari malformation II — a group of brain malformations that lead to serious spinal disorders — and bilateral clubfoot.

In the case of the Kolkata woman, Justice Rajasekhar Mantha asked her whether she was ready to take the risk of such a late abortion and allowed it after she replied in the affirmative. The court, however, made her and her husband sign an undertaking in the form of an affidavit saying they wouldn’t hold anyone responsible if anything goes wrong during the procedure.

A medical board was formed at SSKM Hospital, which endorsed the termination appeal.
This is the third case of medical termination of pregnancy (MTP) in Kolkata, allowed by the court since 2017. In the last case, in 2019, a woman 24 weeks pregnant was allowed to undergo an abortion on the ground that the unborn child had an incurable cerebral disorder.

The Medical Termination of Pregnancy (MTP) Act, 1971 allows a woman to undergo abortion till 24 weeks of pregnancy, subject to the condition that the pregnancy, if allowed to continue, poses a threat to the mother’s life, or if the fetus has an incurable abnormality. Beyond 24 weeks, court approval is required.

Mumbai-based gynaecologist and medico-legal expert Nikhil Datar said there was no medical reason to disallow MTP since the risk involved is not higher than that of an induced delivery. “Procedurally, both are same. Only the intention of the procedures is the opposite of each other. While in inducing delivery, the purpose is to salvage and safeguard the baby, termination is done when it is futile to continue the pregnancy as no good outcome is expected,” said Datar.
The woman and her husband appealed for an MTP last week after reports confirmed the ailment of the fetus. “Three sonography tests were done, one at a government hospital and the others at two private hospitals, which confirmed spina bifida. She immediately sought the opinion of doctors at multiple private hospitals, and they endorsed the abortion. The reports were analysed by the medical board before it permitted the termination,” said Sutapa Sanyal, the woman’s lawyer.

Doctors say that abortion during the first trimester (within 12 weeks) is the best since it leads to few complications. “But some anomalies in the fetus can only be detected at a later stage of pregnancy. For example, some cardiac anomalies can be seen through foetal echocardiography at only around 22 weeks,” said a gynaecologist.

In this case, however, the fetal abnormality could have been detected around the 20th week, said Datar. “A baby suffering from spina bifida is likely to have an associated cerebral disorder which prevents normal development of the brain. They can’t move or perform normal bodily functions and could die within weeks,” said Datar.

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