A resident doctor at a government hospital says he sees at least two cases of rape-induced pregnancies every month. A closer look at this pattern reveals a concern. “In most cases, they come when they are 10 to 20 weeks pregnant and in some cases, even beyond 20 weeks. In the case of minors, they often do not understand when they miss a period, and do not know they are pregnant until the parents notice weight gain and bring them to the hospital. And in many cases, the girls do not report the rape to their parents, leave alone to the police,” he says.
The stigma and statistics of pregnancies resulting from sexual assault and the recent case of a Mumbai girl moving the apex court seeking to terminate her 24-week pregnancy (which was granted) has led to health activists pointing out that abortion in these cases should be viewed as a “right to treatment” and the service should be provided to girls immediately, which is also legally required.
Abortion in India is legal up to 20 weeks of pregnancy and the decision to terminate it rests with the medical practitioner and not the woman. The activists’ demand is rooted in a reality check — in many cases, survivors report rape late in their pregnancies and the legal formalities may cause further delay, making them ineligible for an abortion.
Treatment as priority
The Ministry of Health and Family Welfare guidelines have prioritised treatment and doctors in government hospitals now follow a drill when cases of fresh sexual assault are reported, which includes administering an emergency contraceptive to the survivor. If the survivor reports the crime after 72 hours, a urine test is done to check for pregnancy. But in cases where the survivor makes it to hospital much later, which is not rare going by observations of government hospital doctors, the police are informed first.
“Abortion must be provided immediately when the pregnancy is the consequence of sexual assault. Doctors still ask women to first file a police complaint in violation of the Criminal Law Amendment Act, 2013, or even demand a letter from the Child Welfare Committee (in the case of a minor) thus delaying the treatment in direct contravention of the law,” says Padma Deosthali, coordinator of Centre for Enquiry into Health and Allied Themes (CEHAT). She adds that monitoring must be introduced to ensure doctors offer this treatment to survivors.
As against married women who report their pregnancy in the first trimester, in rape cases, the pregnancy is more often than not reported in the fourth month — that is when the woman is 12 to 16 weeks pregnant. “Rape survivors worry about what society will say. They hope for a natural miscarriage (that delays their reporting the pregnancy and also the crime). I have a few cases where they have come even after seven months, but we cannot terminate such pregnancies. We keep them in such cases and then give the babies up for adoption,” says Dr. Rekha Daver, head of department of gynaecology at J J Hospital.
Dr. S M Patil, superintendent, Nagpada Police Station, says at least in the case of minors, much has changed after the Protection of Children from Sexual Offences Act (POCSO) was implemented. “If there were five to six cases (of rape-induced pregnancies being reported late) every month until four years ago, now only two to three such cases are reported,” he says, adding POCSO requires immediate diagnosis and treatment.
Girl’s wish should prevail
Given the pattern of late pregnancies in rape cases, legal experts say it is a concern that survivors are being driven to court to seek an abortion.
“The Medical Termination of Pregnancy Act needs to be amended to take into account the girl’s wish and also the opinion of medical experts. Also, the period of 20 weeks needs to be extended. In many parts of the world, pregnancies can be terminated up to 24 weeks,” says Jaya Sagade, vice principal of ILS Law College, Pune.
She added that the opinion of two doctors can be factored in for such cases.
CEHAT recommends that hospitals set up a panel or a committee or put in place any other mechanism to review cases that reach later than 20 weeks and take a decision factoring in the mental, social and physical trauma that a survivor will have to face if she is forced to continue an unwanted pregnancy.
Legal experts say it is a concern that survivors are being driven to court to seek an abortion
