Dilemma in court: Should ‘viable’ foetus be aborted or given life support?

First, termination at an advanced stage of pregnancy can still lead to postpartum psychosis, a severe condition where the mother experiences hallucinations and delusions.

Second, the mother had undergone a cesarean section during her two previous pregnancies, increasing the risk of complications. And, most importantly, the baby is already viable and has a “reasonable chance of survival”.

However, on October 9, the bench allowed the abortion.

But on Wednesday, after one of the members of the medical board sought clarification from the court, the two-judge bench failed to reach an agreement regarding the woman’s request for abortion.

In the present case, four key medical issues have been raised in the clarification sought by the doctor. First, the doctor has highlighted that the baby is currently viable, which means it will show signs of life and has a strong possibility of survival. Hence, the doctor has sought a directive on whether foeticide, the stopping of the foetal heart, can be performed before termination. “We perform this procedure for a foetus which has abnormal development, but generally not done in a normal foetus,” the doctor wrote.

Second, the doctor has highlighted issues in a scenario if the foeticide is not performed. The doctor has said that a baby who is born preterm and with low birth weight will have a long stay in the intensive care unit, with a high possibility of “immediate and long term physical and mental disability”, “…which will seriously jeopardise the quality of life of the child”.

“In such a scenario, a directive needs to be given as to what is to be done with the baby. If the parents agree to keep the child this will take a major physical, mental, emotional, and financial toll on the couple,” the doctor has said. Third, the doctor has highlighted if the case has to go for adoption, the process needs to be spelt out clearly.

“It is also to be kept in mind that the consequences of delivery which have happened in the previous two babies can happen at this time also, with a delivery now at this time,” the doctor has said.

Specialists, meanwhile, highlighted that in general practice a saline injection is given to stop the heart of a foetus, usually in cases where one of the twins is not developing appropriately and can damage the other foetus as well.

Reiterating this, Dr Maruti Sinha, senior consultant of gynaecology at Delhi’s Kasturba Hospital, said: “It is also used in the case of IVF pregnancies where several foetuses might start developing. Only one or two foetuses are allowed to grow and thrive. This is not usually done in the case of abortion.”The current Medical Termination of Pregnancy law allows abortion up to 20 weeks if there is a risk to life for the woman, affects her physical and mental well-being, if the foetus has abnormalities or the pregnancy resulted from a failure of contraception.

Abortion up to 24 weeks is allowed on the opinion of two doctors to women who are survivors of sexual assault or incest, minors, women with physical or mental disabilities or change in marital status among others. Abortion beyond this period may also be allowed based on the advice of a medical board.