Niketa with husband Haresh in Bombay High Court on Monday. (Fotocorp)

New Delhi, Aug. 4: Niketa Mehta may be paying a price for merely trying to stay on the right side of India’s 37-year-old abortion law, obstetricians and foetal medicine experts have said.

Bombay High Court today turned down her petition to abort her 25-week-old foetus after a panel of doctors predicted that it was unlikely to be born with any handicap. An earlier panel had predicted a heart problem.

The law that Niketa had challenged allows medical termination of pregnancy only up to 20 weeks, but a number of foetal abnormalities, including serious anomalies of the heart, can be detected only after 20 weeks.

The proliferation of ultrasound screening of foetuses in India over the past decade is likely to have led to the diagnosis of abnormalities in other women after the 20-week cut-off, doctors said.

“No one is going to go on record, but one option in such situations where the abnormality is detected after 20 weeks is the induction of labour,” said a senior obstetrician in Mumbai, who requested anonymity.

“This is allowed if the foetus is seen to pose a threat to the pregnant woman,” the doctor said. “But it is possible that induction of labour is also done when there is a serious foetal abnormality.”

The request for medical termination of pregnancy can come from a mother before 20 weeks, but after this cut-off date, a decision to induce labour in a woman is entirely the doctor’s, the obstetrician said. Foetuses between 20 and 24 weeks are unlikely to survive after the induction of labour.

“It’s a huge dilemma for doctors,” said Dilip Walke, head of the ethics committee of the Federation of Obstetric and Gynaecological Societies of India. “What do we do with women with severely malformed foetuses detected only after 20 weeks?”

A foetal medicine specialist said the law that Niketa had challenged might sometimes even lead to abortion of potentially healthy foetuses but, ironically, denied abortion when there was greater certainty about foetal abnormalities.

“This strict limit of 20 weeks can lead to haste in diagnosis which can lead to uncertainty in diagnosis,” said Puneet Bedi, a foetal medicine specialist at Indraprastha Apollo Hospital, New Delhi.

Bedi said ultrasound screening for foetal abnormalities was not definitive in certain conditions. A diagnosis made at 18 weeks may have far greater uncertainty than a diagnosis made at 22 weeks. “We could have some situations where the pregnancy is terminated only on a doubt (of an abnormality),” he said.

The difference in opinion by the medical panels in Mumbai, Bedi said, was not surprising. Sometimes, foetal screening was based on interpretation of test findings, and the results are delivered as probabilities.

One arm of the government has actively supported prenatal genetic diagnosis — with the goal of allowing parents to decide whether to continue the pregnancy or not. But genetic tests are done well before 20 weeks and do not come in conflict with the law.