Mumbai’s Miss X Case:
Mumbai’s Miss X has taken India’s Medical Termination of Pregnancy Act, 1971 by a storm. Recently, The Supreme Court gave permission to terminate her 24-week old foetus, owing to its severe abnormalities and incompatibilities with life. This triggered a nationwide debate, with experts and ethicists arguing that India really needs to re-examine its 20-week restriction on abortions.
Dr Nikhil Datar, Mumbai-based gynaecologist, who was intricately involved with Miss X case, wrote about his experiences with similar incidents in the past. While the heated debates about the structure of our legal system are absolutely in place, it is also important to address the issues that arise because of lack of education and awareness about antenatal care among Indian women.
Failure to Educate:
In Miss X case that Dr Datar described as the turning point in his life and his inspiration to pursue a law degree, the woman failed to conduct her ultrasound in the 16th week as Miss X was advised. Therefore, by the time she learned of her fetus’ abnormality, she had crossed 20 weeks and beyond the limit imposed by the Indian Law.
The ultra sound in the second trimester of pregnancy is extremely important to monitor fetal growth. Ultrasound scans in the second trimester give valuable insights with respect to the development of the fetus’ vital organs, heartbeat, limbs, etc. Therefore, correctly timing this procedure is crucial to understand if the fetus suffers from any abnormality and to give the mother time to think about the decision she wishes to make.
However, in a country with too many births and too few obstetricians, it becomes difficult for doctors to explain the crucial nature of this exercise to women in an impactful manner. The conditions are more so worsened in rural India. The health workers struggle with time and information to convey the importance of monitoring fetal growth to pregnant women. This often means that women in rural India are denied the resources and autonomy that their counterparts in metropolitans and big cities have.
The Status of Women's Health:
Women’s health awareness, especially antenatal care is extremely neglected and must be our prime focus. In the age of the internet, it is no longer necessary for this information to be delivered physically or in person. While most aspects of our lives have conveniently transitioned to the digital world, healthcare has been left behind. It is imperative to introduce systems in urban, but more urgently in rural healthcare to put women’s health in their own hands.
A structured set of instructions for pregnant women, validated by their own doctor, along with the necessary information about why these details are important will go a long way in saving them the mental and physical trauma that occurs in cases where no information is relayed. The woman’s doctor must be within her reach at all times. Her updated records must be accessible to any doctor who might attend to her in the case of an emergency. While this sounds like a daunting and overwhelming task, it has been made a reality at Doc N Me.
The Doc N Me Impact:
Doc N Me has successfully integrated itself as a part of antenatal care in urban as well as rural regions. The introduction of technology based healthcare in rural India is often met with resistance, citing low levels of digital literacy. Our study in 2015, however, proved exactly the opposite. ASHA workers (Accredited Social Health Activists) in rural parts of Vijayawada adopted and preferred the digital medium over their conventional practice. A software based solution allowed them to give better counselling to the pregnant women, and standardize their work. It proved to have a huge impact and eased the burden of the ASHA workers.
Digital platforms have repeatedly proven to be the way forward in Indian Healthcare. To make sure that women receive the best health care and information that they deserve. So that their physical and mental well-being, as well as the health of their child, is guarded, innovation, efficiency and collaboration is key.