Harking back to 1990.
A small seaside town in South India.
A bunch of medical students in their final year Labour Room posting.
We had 3 weeks where we manned the labour room, along with the members of the Obstetrics & Gynaecology department. We had hands-on experience with monitoring women in labour, watching, conducting deliveries, giving and suturing episiotomies (sometimes a cut is needed to widen the final passage as the baby is being born), watching how forceps and ventouse deliveries are being done, assisting in Caesarean sections etc.
An extremely busy 3 weeks we had, with bare sleep and no other classes or activities.
We accompanied the PGs and Senior Residents (S/R) when they went to the Emergency Room (ER) when patients came there.
One morning, there was this very personable S/R who was chuffed by the presence of five receptive female faces hanging on to his every word, so he took the lot of us with him when an emergency call came.
Who was the call for?
It was a young girl, barely 16/17 years old. She was in shock and receiving some IV fluids when we arrived. She was conscious, oriented and talking.
The S/R (not a Tamilian, but had learnt enough to get by) – Peru yenna? Muniamma? (What’s your name- Muniamma? (Muniamma was a very common name in those days))
She – suddenly bright- Aama saar
S/R – Yentha ooru (Where are you from?)
She – Kallakurichi, saar (a semi-rural town about 100 kms away, where we used to get a lot of patients from.)
S/R – Mariaatha Kovil Theruvaa?( Is your address Mariamman Kovil Street? Somehow almost all patients seemed to use that address, who would come from from any of the dusty little towns and villages of the South Arcot district)
She, now eyes wide open – Aama, saar. Ungalukku eppidi theriyum (Yes, Sir – how do you know that?)
And with this introduction, now having got all of her (and our attention) he proceeded to ask her what had happened.
S/R – Ungalukku Enna aayidichu, amma? (So what has happened to you?)
She – Kucchi pottaange saar! (They inserted a stick, sir)
And as we lifted the sheet covering her, laid almost two feet of intestine outside her vagina.
During this small talk, he had ensured that her BP was stable, that the required blood samples were sent, consent was taken and he had also arranged to take her to the theatre for emergency surgery as well as ensuring that General surgical colleagues would be also present during the surgery since there clearly was bowel injury.
Did she make it?
No, she did not.
A young girl from conservative Tamil Nadu, whose mama (uncle) had gotten too eager too early, and the consequences were not his, but of course, hers. The shame of an unwed pregnancy and possibly some difficulty in accessing abortion services locally made her family take her to an illegal abortionist who performed a “kucchi operation” what we in medical parlance call “septic induced abortion”. His “kucchi” went in a little too deep, though.
Those days, I used to think that such fates were of poor uneducated young girls from unprivileged backgrounds in developing or underdeveloped countries.
Has it changed over the years?
Then I saw the Savita Halapannavar case in Ireland – but that at least opened debate and created reform in a country that had refused to see light and reason in this context.
And now I see the US Supreme Court where four men and a woman sentence the women in that country to a similar fate once again.
ProChoice is the only reasonable stance.
The right to abortion is a basic fundamental right.
By Dr Suma Balan
Dr Suma Balan is a Pediatric Rheumatologist by profession.
She can be contacted at sumabalan@googlemail.com.
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