How a mother fought to end her 29-wk pregnancy

She moved HC after congenital heart abnormality was detected in the foetus

MUMBAI: Manisha, 37, a Mira Road resident, is recuperating after undergoing a medical termination of pregnancy (MTP) at 29 weeks. While the loss of her much-awaited second child was traumatic, she finds solace in her decision that spared her baby from suffering. Doctors had detected a serious congenital heart abnormality – if the pregnancy were brought to term, the infant would have required many surgeries, the success rates of which are low.

Last month, the mother to a four-year-old daughter, had approached the Bombay high court (HC) to medically terminate her pregnancy at a private hospital under Dr Nikhil Datar’s care, the gynaecologist known for judicial activism and helping women navigate the complexities of the Medical Termination of Pregnancy (MTP) Act, 2021. While HC allowed her to undergo the procedure at a private hospital in the western suburbs under her chosen doctor’s care on April 25, her petition highlighted the shortcomings in the MTP Act, and the need to make it women-friendly.

But it was not easy, as she went through much emotional upheaval to achieve her goal.

When she was told about the seriousness of the anomaly of her unborn child, she knew she was racing against time to turn things around.

She visited Dr Datar for the first time on April 8, and on his advice, went to JJ Hospital and met the permanent medical board (ordained by the MTP Act) to terminate the pregnancy which was already at an advanced stage.

“My trips to JJ Hospital were the toughest, as I underwent several procedures and medical examinations. My husband and I used to leave Mira Road by 8am and return by 7-8 pm,” she recalled. Once the board allowed the MTP, another hurdle awaited – the existing law mandates terminations beyond 24 weeks must be carried out only at government-approved institutions. Manisha and her husband preferred a private hospital.

“The law does not allow private hospitals to seek approval to perform the procedure, forcing women like me to undergo the procedure in a government facility. This was my first experience in a public hospital, and I was not keen to undergo surgery there. I wanted a private hospital and the trusted Dr Datar,” said Manisha.

The two then filed a petition in HC on April 22, seeking permission to terminate the foetus in a private hospital. Apart from this, Manisha and Dr Datar also highlighted the concern on JJ Hospital’s medical board’s report which stated that Manisha’s pregnancy can be terminated, but if the child were born it should be kept in NICU.

“After bearing the baby for 27 weeks, I took the painful decision to end my pregnancy because I did not want the child to suffer. So it didn’t make sense that the medical board’s report said if born alive, s/he will be kept in NICU,” said Manisha.

Her co-petitioner, Dr Datar, said when Manisha first approached JJ, he had sent a note with her for the medical board stating that the MTP in her case needs to be done to stop the foetal birth. When the suggestion was declined, they were compelled to move court.

“One is seeking to terminate the pregnancy as the foetus is abnormal. Simultaneously, you are resuscitating the child so that s/he stays alive. Why are we then going ahead with MTP? You need to first stop the foetal heart sound and then terminate the pregnancy based on central government’s guidelines,” argued Dr Datar. He submitted crucial suggestions in his affidavit to HC, aimed at improving the implementation of the Act.

The patient-doctor duo said they experienced confusion regarding rights as they fought their case in court.

“A mother has an unquestionable right over the foetus. Most doctors also don’t understand the difference between the words ‘child’ and ‘foetus’. A foetus doesn’t have independent rights -- ethically, legally or morally. Till there is no live birth, no rights are accrued to the foetus. Only after the infant is born alive, separate rights of survival accrue to the child,” said Dr Datar, who has helped more than 324 women with over 20 weeks of pregnancy with court approvals.

“It is not logical that after 24 weeks, terminating a pregnancy is suddenly is termed unethical,” he said. Today, Manisha “hopes my case sets a precedent and no other woman suffers what I went through”.