Expert Talk

Senior Consultant, Obstetrics & Gynaecology, Indraprastha Apollo Hospital, New Delhi
Medical training in India needs more hands on experience in surgical fields...
Q. What are the various reasons for an abortion?
Any termination of pregnancy up to twenty weeks of gestation is called an abortion, and there are various reasons for an abortion. The most common reason is failure of a contraceptive leading to an unwanted pregnancy. Sometimes mother’s maternal health requires the termination of pregnancy as we find that the ongoing pregnancy jeopardizes her situation so we need to recommend her to opt for an abortion.

Q. What are the health risks involved with an abortion after 20 weeks of pregnancy?
If an abortion is done up to the first trimester, which means 10 to 12 weeks, in good hands with a clean setup and infection being avoided; abortions are quite safe. But when I say abortions are quite safe, a patient should not keep undergoing an abortion one after another because this has long term effects. When we do a second trimester abortion, after 12 weeks, when the fetus is well developed and bones are well formed, it is not so simple. The content just can’t be sucked out by an evacuation system. The blood loss is more and the process itself is longer. It also has a risk of haemorrhage and infection.

Q. What are the various techniques in which a normal abortion is carried out?
A lot of abortions are done through medical methods where a doctor’s guidance is required and individualised treatment is given. Drugs are given to the patients and abortion achieved. There are surgical methods where the contents (the fetus) can be sucked out.

Q. Abortion is done illegally in many private hospitals. What should be done about this?
In our country, we have liberalised abortion laws. If somebody gets an abortion done after 12 weeks pregnancy, two doctors have to give their endorsement for it and reasons have to be given. In our country, sex determination and female infanticide is very prevalent, but illegal – something to be condemned whole heartedly.

Q. Can abortions cause breast cancer?
Epidemiological studies have shown that the longer a woman breastfeeds her baby, the lesser would be her chances of breast cancer. So anybody who has not had many deliveries and has not breastfed for a long enough time is more prone to breast cancer.

Q. What, according to you, are the attributes of a good doctor?
According to me, a good doctor must have a good knowledge of the subject he is a specialist in. He/she must be empathetic, compassionate, accessible and communicative with his patients. It is important that he considers himself as a service provider and not talk from a position of authority to his patients. He must be honest and ethical in his way of handling patients.

Q. What is your opinion about medical training in India? Why are we not able to retain talent?
Medical training in India needs more hands on experience in surgical fields. Newer technologies are slow to reach government medical colleges. In order to retain talent, it is important that we provide the right opportunities and working ambiance for the doctors to stay back. Considering the long and arduous journey that an individual travels in medical line, he is nearly forty years of age by the time he gets a consultants job. It is important that in such situations, the remuneration that is offered to medicos is in keeping with the inflation and the prevalent economic situation so that he is comfortable.

Q. Do you think health information websites are useful? What are your views about our health website?
I strongly support the health information websites but also believe that one should always edge on the side of caution and not be dismissive of  so called frivolous symptoms as there are times when an ominous ailment may come without any major symptom. So, an examination by a clinician can never be replaced. Also a qualified doctor or a panel should wet the information provided on such sites.

Q. Why did you choose your present job?
I have been exposed to medicine from my childhood as my father was a doctor. I silently also at times wished that I could be a police officer after interacting with Ms. Kiran Bedi, who was my father’s patient. But as I grew, my passion for medicine grew and I fortunately managed to get into the prestigious All India Institute of Medical sciences and it is in this place and the kind of involved teaching that the faculty indulged in, I knew I would have not been happy if I had chosen to do anything else.

Q. Could you describe your typical working day?
My working day includes morning rounds of admitted patients, who are either awaiting surgery or are post operative cases. There is Out patient department, where I see patients everyday. I operate whenever I have surgeries posted. I attend the clinical meetings of the department and also at times other specialties, which are regularly held as CMEs .