Rhon­dor Dowlat

As the pub­lic de­bate on abor­tion con­tin­ues in T&T, Med­ical Chief of Staff of Mt Hope Women's Hos­pi­tal Dr Karen So­han says that the laws of T&T al­lows abor­tion for med­ical rea­sons.

Speak­ing with the T&T Guardian dur­ing a one-on-one in­ter­view on Tues­day at the hos­pi­tal, So­han said that such a preg­nan­cy can on­ly be ter­mi­nat­ed 12 weeks and over, not be­fore, as the or­gans are formed by 12 weeks.

Ex­plain­ing the dif­fer­ences be­tween so­cial ter­mi­na­tion and ter­mi­na­tion for med­ical health rea­sons, So­han said so­cial ter­mi­na­tion was il­le­gal in T&T.

"This is where the woman's health is well and so the ba­by's health. Where­as, we have to recog­nise that wher­ev­er pro­fes­sion­als prac­tices in a coun­try you have to stick to the laws of a coun­try. We are all fa­mil­iar with the law in T&T, that a woman is al­lowed a ter­mi­na­tion of preg­nan­cy if it af­fects her health and health means phys­i­cal, men­tal and psy­cho­log­i­cal well be­ing. And, this is a very broad cat­e­go­ry by de­f­i­n­i­tion," So­han said.

She said that even if a ter­mi­na­tion is ad­vised for med­ical rea­sons un­der the law, no woman can be bul­lied to make a de­ci­sion to go ahead with it. She said that it was up for the moth­er to make that fi­nal de­ci­sion.

Giv­ing a re­cent case as an ex­am­ple, So­han said a woman with stage 4 can­cer found out that she was preg­nant and the on­ly thing to save her life was for her to un­der­go chemother­a­py, how­ev­er, the woman de­clined be­cause if giv­en chemo it would have been a sure death sen­tence for the ba­by. So­han said that the woman was de­ter­mined to con­tin­ue with the preg­nan­cy.

"Can you imag­ine the emo­tions here? Some­times we too are drained in try­ing to coun­sel moth­ers like her. When I knew what would have been the end re­sult, this woman made a de­ci­sion and we re­spect­ed that," So­han said.

In the end, the moth­er gave birth to a healthy ba­by, how­ev­er, she died right af­ter.

Moth­ers like her, al­though ad­vised of in­duc­ing labour (ter­mi­na­tion for med­ical rea­sons), ac­cord­ing to So­han, are of­fered med­ical and spir­i­tu­al coun­selling.

"What we try to do is to sup­port them when they are in sit­u­a­tions like this as it is a high­ly emo­tion­al and sen­si­tive is­sue," So­han said.

So­han said that in such cas­es a con­fer­ence is held where ob­ste­tri­cians, gy­nae­col­o­gist's, Chiefs of Staff, car­di­ol­o­gists, spe­cial­ist doc­tors, re­li­gious lead­ers and fam­i­ly mem­bers are in­vit­ed for a de­lib­er­a­tion once a rec­om­men­da­tion is made.

"As a clin­i­cian I can give the woman op­tions. So, we usu­al­ly say to the woman 'Ma'am you have op­tions, ei­ther you can con­tin­ue the preg­nan­cy or the op­tion of in­duc­ing labour now be­cause we feel this preg­nan­cy car­ries a sig­nif­i­cant risk to health. At the end of the day it is the woman who makes the fi­nal de­ci­sion. I can­not bul­ly any woman to ac­cept ter­mi­na­tion," So­han said.

An­oth­er rea­son for le­gal abor­tion can be rape, which can af­fect the woman psy­cho­log­i­cal­ly and emo­tion­al­ly.

"Let's say a teen is raped, these are is­sues we don't talk about open­ly, so it is not brought to the at­ten­tion that we care­givers have to deal with this and make an as­sess­ment. If a child is in sec­ondary school and is raped by a fam­i­ly mem­ber how does that af­fect the psy­cho­log­i­cal well be­ing?"

In cas­es where foetal ab­nor­mal­i­ties oc­cur, in­clud­ing as a re­sult of mi­cro­cephaly and the Zi­ka virus, So­han said that much in­for­ma­tion and knowl­edge as pos­si­ble is be­ing ac­quired so that pa­tients can be giv­en ac­cu­rate in­for­ma­tion so that they can make their own de­ci­sions prop­er­ly.

She dis­closed that if a woman con­tracts the Zi­ka virus in the first trimester it does not mean that the same risk is pos­si­ble if an­oth­er woman con­tracts Zi­ka in the third trimester.

"We are be­gin­ning to un­der­stand that be­fore ten weeks the risk is the high­est and that is be­cause the brain cells formed in one area of the brain and have to mi­grate to an­oth­er area, they are (still con­sid­ered) most im­ma­ture and most sen­si­tive. If one gets in­fect­ed in the first and sec­ond trimester then by 20-24 weeks you will know what is hap­pen­ing with that brain and then its up to a foetal med­i­cine ex­pert to make an as­sess­ment as to how se­vere the brain is af­fect­ed," So­han said.

She al­so re­vealed that not all women who get the Zi­ka virus trans­mit it to their ba­bies and there­fore ad­vised on reg­u­lar qual­i­ty ul­tra sounds be­ing done.