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.