Doctors consider it unlikely they will ever see a case like hers again. Anju Kushwaha, 26, is sure she is never returning to them. The woman who carried and lost 10 foetuses — the maximum borne by a woman in India — is spent, in money, energy and hope. Working in the kitchen of her small house in village Ranehi in Madhya Pradesh’s Satna district, two months after she miscarried the 10 foetuses, she says solemnly that they had expected to at least make some of that money back under a government scheme to promote institutionalised delivery.
“People think we got lakhs of rupees, but we got only Rs 1,400. We thought it would be 10 times that amount because 10 foetuses were aborted,” says her husband Santosh, 30, who sells vegetables to support the family’s meagre income from agriculture.
Anju, a Class V dropout, and Santosh got married in 2002, when she was 14. As she couldn’t conceive over the years, relatives, neighbours and friends advised her to visit quacks or try home-made remedies as “cure”.
A ‘Dina baba’ in Nagod told the family that Anju would conceive if they moved from their home in the middle of the village to a house near the small agricultural plot they owned at the farthest end of Ranehi. So they did.
Less than a year ago, the couple began visiting doctors in Kothi, Satna and Jabalpur for infertility treatment, spending, they say, thousands of rupees. In September, she visited the clinic of ‘fertility expert’ Dr Mahendra Singh in Satna, 30 km away. She had heard about him from a neighbour, who had conceived with his help.
Dr Singh claims to have given Anju clomiphene citrate tablets to induce ovulation. He denies giving her any injections. Anju, however, says she was given three injections costing Rs 1,500 each at Dr Singh’s clinic, apart from tablets. Santosh claims tests showed he didn’t require any fertility treatment.
Anju never realised that she had conceived. “I thought I had a swelling in my abdomen,” she says. When she started feeling uneasy sometime later in September, Dr Singh directed her to go to National Hospital in Jabalpur, more than 200 km away. Dr Singh says he referred Anju there as a lot of water had built up in her abdomen.
The Jabalpur doctor suggested sonography, which revealed that Anju was carrying multiple foetuses. “The hospital staffers laughed, saying they had never heard of or seen six or more foetuses,” she says.
Dr Singh says she did not visit him after going to Jabalpur, but Anju claims she did. “He told me he was very busy. We returned and did not go back.” She was advised to take a “tonic”, the name of which the couple can’t recall.
On December 15 afternoon, Anju suddenly started bleeding. The family first took her to a primary health centre in Kothi, then to a doctor in Satna, and finally to Rewa, more than 50 km away.
Anju’s mother-in-law Vidyavati says the doctor in Satna threw up his hands on seeing Anju’s condition. “If we try to assist her in delivering so many babies, she will die,” he told them.
When Anju finally arrived at the Gandhi Memorial Hospital in Rewa around 11 pm, the doctors had no option but to carry out an abortion. “Multiple gestation. Inevitable abortion,” a doctor wrote on her file. Nine foetuses were aborted in one go and the tenth a few hours later.
Dr Singh, who reiterates that Anju underwent no IVF treatment, explains it as a case of ovarian hyper-stimulation, when too many eggs are produced and can result in multiple pregnancies if all eggs fertilise. “One in a thousand cases has such an abnormal response,” he says, refuting allegations of faulty treatment.
He adds that multiple pregnancies are common in IVF treatment and doctors go in for selective abortion. “In her case, doctors were probably left with no choice but to abort all foetuses,” he says.
Dr Meena Bhargava, a gynaecologist at Gandhi Memorial Hospital, says Anju must have been on medication to induce ovulation. When she was discharged 10 days later, Dr Bhargava asked her to return for follow-up treatment.
But Anju hasn’t gone back. The physical discomfort has gone, and she has had “enough” of treatment, which was funded by mortgaging part of their land. “Mere paas paise nahin hain. Kuch nahin karenge, Bhagwan ki marzi, jo hoga vahi sahi (I don’t have money. We will not go for any further treatment. We will accept whatever is God’s wish),” she adds.
Now an object of neighbourhood curiousity — “her eggs broke”, one reasons, convinced the Kushwahas have profited from the freakish nature of the pregnancy — Anju admits to the “mental, physical and financial” troubles.
She didn’t even see the foetuses, she adds. “I did not ask, and the doctors did not volunteer.” Vidyavati says each was roughly the size of a human palm, and weighed about 200 gm.