THE GIRL CHILD . . .

With each succeeding year, having a girl child in the family becomes a very unpopular event in many parts of the country . This has been reflected in the fall of the sex ratio in quite a lot of regions within India. The government has been trying to do its bit – but there have been quite a number of loopholes and there are glaring instances of how the law has turned a blind eye to the practice of female infanticide. The birth of a baby is a quite happy event in any family – but of late I’ve had quite a many instances when the happiness becomes quite subdued when the family learns that the baby is a girl.

The last instance of the same happening occurred just about couple of hours ago. As mentioned in my previous blog (http://jeevankuruvilla.blogspot.com/2011/09/duty-diary-thursday.html), Dr Nandamani is on duty – but I had to cover him for a possible complicated delivery which was taking place in labour room as he was busy operating. The patient RD was post-dated for about 1 week and she had been leaking for the last 5 days. She was admitted elsewhere and most probably they were trying to induce her – which they had failed and had asked permission for a Cesarian section. The family was not happy for the same and brought her to us today morning.

To have leaking in a term patient for 5 days and her not having gone into labour was a bit tricky – and I told them that I would also want to do a Cesarian section. But they would not have anything of it. After getting a risk form signed for the baby, I went ahead and induced her with oral misoprostol. I was a bit concerned that they had not much care for the baby. I guessed that they would have known earlier about the sex of the baby. And I was right. By God’s grace, RD responded to induction and she delivered a healthy girl baby. The mother was very glum after the delivery. I asked her the reason. She told me that everybody knew that it was going to be girl baby – but she was just hoping that the ultrasound would be wrong.

I met the father and the grandfather of the baby. They were quite ecstatic about the normal delivery. Later, as I hovered around in the wards – I overheard the grand-father talking to someone. He was making a long distance call and he was shouting – it was easy to overhear. In Hindi, he was telling – ‘The doctors here are too good. We were asked for a Cesarian in Daltonganj. We knew it was not a boy. How can we spend so much for delivering a girl baby? If it a boy, it is worth spending some money. Anyway, the mother and the baby are fine…’  

1 week back, while I was on duty, I had a mother who was G3P2L2 – the first two were home-deliveries. The family was quite well off. The present baby looked a bit on the bigger side. As she came in, I asked about the history – I realized that both her previous babies were small, the first one 2 kilograms and the second one 2.2 kilograms.

I thought she must have had diabetes. Then, I realized that she had quite a good ante-natal care including multiple visits to good obstetricians in the nearby town of Daltonganj and Ranchi. The blood sugar levels were quite normal. Even tests like Thyroid Stimulating Hormone was done. She had quite an uneventful time of labour. However, the accompanying relatives were quite finicky. They were quite hovering over the lady and were quite obtrusive and frequent enquiries about the progress.

Sometime during the period of labour I happened to go for a per-vaginal examination and found out that the liquor had become a bit meconium stained. I met the bystanders and told them the same. The response was immediate. 'Please do a Cesarian and get the baby out as soon as possible.'

I explained that she was progressing well and should deliver without any problems within couple of hours. They would have nothing of it. They wanted a Cesarian section immediately. As I called my theatre team, I told them about this – they suggested that during the surgery we ask the lady whether she knew that the baby was a boy. The answer was the same. She had got a ultrasound scan in Mumbai for Rs. 3000 where they told her that the baby was a boy. And that explained the relatives’ eagerness to get the baby out as soon as possible.

There is a law called the Pre-Natal Diagnostic Techniques Act (www.pndt.gov.in ) which bans telling of the sex of the unborn fetus – however, it is very evident that there are scan centres all over the country who flout the laws. Recently, I met one of the activists who campaign for saving the girl child. The stories she told me were very sad. She told me that many doctors in our region told the expecting mother about the sex of the baby. One doctor told her that he just tells his patients to keep a particular sweet ready when the baby is delivered. It seems that in communities here, it is customary to give jelebis if it is a girl and laddoos if it is a boy. So, the doctor tells the patient to keep jelebis ready for him when the delivery happens if it is a girl and vice versa if it is a boy.

Not all the scans turn out to be correct. About a year back, we had a patient with septic abortion attempted at 7 months gestational age. They had obviously attempted the abortion as they had found out that the fetus was a girl child. But, the sonologist got it all wrong. It was a boy. One should have seen the grief of the relatives when we got the dead fetus out.

There has to be change of heart among us if we have to resolve the issue of this terrible genocide which is going on. I’m sure that RD’s relatives would not have minded if the baby was lost during delivery.  Isn’t it a big paradox that in a country which have looked to women to give leadership (Late Mrs. Indira Gandhi, Present President Mrs. Pratibha Patil, Mrs Sonia Gandhi – the Congress Chairperson, Ms. Mamta Banerjee – the Bengal Chief Minister, Ms Jayalalitha – the Tamil Nadu Chief Minister), there is no value for the girl child?