‘Reproductive Choice of Women: Tale of Two Nations Revisited’: Our Response

Dear Sir We are happy that the editorial has stimulated a discussion on the subject of reproductive choice. We thank the author of the letter to the editor titled 'Reproductive choice of women: tale of two nations revisited' for insightful comments from another perspective and also for raising a few questions. It is true that the genesis of abortion laws has been propelled by different circumstances in the US and India. Emancipation is a corollary to the educational and economical independence of women in a developed country. Such environment not only brings awareness of right and need but also strengthens their voice to fathom the gap between the two. In a developing country, less fortunate women are hardly aware of even their need. Raising a demand is a far cry in that social structure. What matters in any nation is the political will of those who are empowered to enact. In India, it was a matter of being sensitive to people's need perse whereas in the US it was in response to judicial nudge. Therefore, indulgence in that pat may be permitted. Now we will attempt to address the three questions raised in the letter under reference. Firstly, viability exists as a function of biomedical and technological capacities, which are variable in different parts of the world. As a consequence, it is difficult to have a uniform gestational age that defines viability. Though WHO recommends 20 weeks, ACOG survey maintains that obstetricians' judgment of the viability threshold is consistent with that of 24 weeks.1 It is felt that following law of the land in the matter will be safer. Secondly fate of the baby if born alive. There are two different categories of viability limits, one from biological survival limits and another from the social agreement of providing active medical intervention.2 Also, a distinction between spontaneous expulsion and induced termination would be logical here. The intention and will of the parents would be the guiding factor and intention in termination is abundantly clear. Thirdly, the question of survival. Increasing the permissible gestational limit has been to mainly facilitate dealing with late diagnosis of anomalous fetus where chances of survival would be minimal. For earlier period there is no doubt about scientific feats of survival of even pre-viable.3 But that is highly unlikely without aggressive and intensive intervention which possibly no parent opting for termination within the legal frame work would be willing to accept. In case of late reporting without anomaly and beyond the legal limitation, waiting a little more and offering for adoption is a choice. As a matter of fact, while the legal battle went on, Norma McCorvey (Jane Roe of Roe vs. wade) delivered and followed that path. Author contribution Sudhanshu Rath: Concept and drafting, Asima Das: Concept and referencing, Mohini Mohini: Editing. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.