When a pregnancy is unwanted, a safe abortion is vital in ensuring a woman’s health and well-being. Unsafe abortions remain one of the prime causes of maternal death and disability. An abortion under medical supervision is one of the safest procedures.
I perform abortions because I believe that this is something that all doctors who care for women should be providing — to protect and promote women’s health. It is a matter of pride that over 98.6% of members of the Federation of Obstetric and Gynaecological Societies of India (FOGSI) provide abortion as an inherent component of the care they deliver. This is in marked contrast to the global experience.
I also believe that unconditional support of a woman’s decision to have an abortion is a statement, acknowledging and supporting this most difficult reproductive right of her that society has been and remains so reluctant to give her.
I am pro-life and pro-choice — I am “pro” a woman’s life, to protect her from the disruptive consequences, risks and dangers of an unwanted pregnancy. I am also “pro” a woman’s choice for her to decide what she wishes to do with her mind, her body and her life.
Every woman who makes a decision not to continue with her pregnancy has her own history and reasons. Here are the stories of three remarkable women that I have been privileged to care for. The first was a daughter of my friends. These friends are anti-choice by virtue of their religious belief. The girl came to me on her own with no possibility or hope of her family understanding her predicament. She told me that she had thought long and hard and decided that an abortion was her only choice. It saddened me to see that she felt so alone and that her decision was tearing her apart. I was touched and humbled by her quiet strength and her trust in me. As I looked after her I thought of my own daughter. I hoped that if she ever found herself in a similarly distressing situation, I could be there for her without condition or passing judgment. And if for some reason I could not be there for her, I prayed that she would find a doctor who would be her confidante, her support and her protector and treat her with skill and sensitivity.
The second was a corporate executive going through a challenging divorce. She was distraught at finding that emergency contraception had failed her. She would have experienced a legal setback had her husband and opposing counsel known that she was pregnant. Courts have been known to have double standards for men and women. While it was impossible to prove the husband’s infidelity, her pregnancy could have been used to tarnish her image and weaken her case. She requested confidentiality and help to terminate her pregnancy. By helping her I was privileged to stand by a brave woman who was preparing to face the world on her own terms, as a single mother with a daughter.
The third was an uneducated housemaid. She had two children and a failed sterilisation. Her husband was uncaring and unsupportive and prone to drinking. She worked hard to put her children through school to achieve a life she could never have and knew that a larger family to provide for would have impacted her children’s future. She was desperate and abortion was her only option. She has continued to exercise her reproductive freedom by being on long-acting, injectable contraceptives. Her elder daughter is now an accountant. I realise the wisdom of this uneducated mother’s selfless choice made back then.
While these three stories seem so different, they are really the same. Women wanting to exercise their right to make their own choices about their bodies, their fertility, their families and their future. Despite their very different circumstances it was unfortunate, but commendable that each one from a completely different background, faced up to this challenge on her own and made her decision with great responsibility. I salute these three women. What they did was difficult and courageous and honest. There can be no doubt that for them it was the right thing to do. For me it was an opportunity to fulfil my responsibility as a physician, my oath, to care and comfort, help and relieve.
An estimated 70,000 young women die each year undergoing an unsafe abortion. And this silent tsunami reaches doorsteps day after day, year after year, claiming the lives of young women, daughters, sisters, wives and mothers. A safe abortion can save almost all these lives. So where is the controversy — moral, ethical, political or religious — in the provision of a life-saving, health-protecting technology or option?
If all the women who had an induced abortion in just the last 10 years came together to live in one country, their united sisterhood would have a population of over half a billion. This country would be the third most populous country behind China and India and ahead of the U.S. How then do people and societies dare judge, stigmatise and condemn these women and what they choose to do? With these numbers, it should be obvious that abortions should remain safe and easily available.
While India has legalised abortion by the Medical Termination Of Pregnancy (MTP) Act, this privilege is clouded by the fact that unsafe abortions remain the third highest cause of pregnancy-related deaths. We need to urgently address this and I have a wish list. First, recognise a woman’s right to exercise her choice and protect her by amending the Indian Penal Code to decriminalise abortion for the woman. Second, support and provide last-mile access and availability of safe abortion by widening the provider base as proposed by the pending amendments to the MTP Act. Third, acknowledge the termination of pregnancies with major abnormalities as a part of standard medical care any time in pregnancy as was traditional practice, without having to seek legal exception for each case. Finally, identify and avoid potential conflation of the MTP Act with the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act that results in stigmatisation of all doctors providing abortions to ensure women are not denied abortion.
The women who come to me for an abortion, do so with great thought and responsibility. Even so they tend to look to others, often their doctor to support and validate their decision. I tell every one of them that there is no way that something that 56 million women choose to do each year, can ever be immoral or wrong. Somehow I find this reasoning usually works for them. As a doctor and someone who does abortions I know that it always works for me.
Dr. Nozer Sheriar is a consulting obstetrician and gynaecologist and past Secretary General of the Federation of Obstetric and Gynaecological Societies of India (FOGSI).