More questions than answers
Kabra SG. Abortion in India: myth and reality. Rajasthan: Rawat Publications; 2013. Hardcover, pp 189 ISBN 978-81-316-0564-6 INR 595
In this book, Dr SG Kabra aims at presenting the medical, legal and social dimensions of induced abortions. More specifically, he is concerned about the misuse, and even disregard, of the Medical Termination of Pregnancy (MTP) Act by medical professionals as well as pharmaceutical companies. As a senior professor from Jaipur, with degrees both in medicine and law, he has written extensively on medical ethics and medical audit.
The author has made a thorough attempt to list the studies pertaining to the male–female ratios in Rajasthan and India, and has also given estimates of the number of MTPs conducted. The appendices provide the complete MTP Act and the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, as well as the amendments to it, for the interested reader.
Unfortunately, the book does not fulfil its promise of being a fund of knowledge for “women activists . . ., medical professionals and policy-makers.” In addition, it does not live up to the claim on the inner cover that it is a must-read for “pro-abortion and pro-life groups.” This arises from the strong feelings of the author which prevent a balanced discussion on abortion. The use of terms like “pro-abortion” rather than “pro-choice”, “culling of the female” (see page 89), and “Abortion pills: Murder marketed” (see page 63) reflects the deep conviction of the author regarding the social and medical aspects of MTP. This is further underlined by the detailed description of the development of the foetus in layman’s terms, which is probably unnecessary in such a technical tome.
The description of the various surgical and medical procedures used covers only the barbaric methods which were employed in the past, but which have largely been abandoned by medical professionals. The author would have done well to explain that if these practices continue to be used, it is because the government has not yet managed to reach every woman through the provisions of the MTP Act. It would also have been worthwhile to mention that due to patriarchy and the deep-rooted disregard for women’s reproductive rights, women are still forced into illegal MTP instead of opting for a medically safe procedure. The fear of stigmatisation and compulsion to fulfil the family’s desire for a male child are some of the important social factors. While there are detailed discussions on the right to life of the unborn foetus versus the right of a woman over her own body, there is no mention of the fact that the rights both of children and women are secondary to the perceived rights of men and the family in Indian society.
The book also digresses into discussions of diverse topics, such as medical transgressions against patients in laparoscopy deaths, the role of the state in violations of human rights, including the Nuremberg trials, and the question of whether female foeticide is the actual cause of the change in the gender ratio in India. While these issues merit attention, discussing them in this book does not help to accomplish the objectives of the book.
Chapter 9, which deals with the ethics of assisted reproductive techniques and what constitutes medical professional misconduct, is useful for medicos but clouds the topic of abortion in India, which is a sufficiently “multidimensional issue”.
I read this book with interest as it covers a wide variety of ethical issues involving the medical professional and the state with respect to the subject of abortion. However, the author leaves us with more questions than answers. Considering the author’s long years of experience in this field, I would have been happier if he had provided us with a detailed analysis of the steps that can be taken to ensure an ethical and non-stigmatising way of helping women win their reproductive rights and fight gender discrimination.