Mandatory reporting of teen pregnancies by obstetricians to cops comes under question
a year ago
Local study recommends case conferences to decide on a case-by-case basis
By Ruwan Laknath JayakodyObstetricians taking the decision to report cases of pregnant teenagers to the Police for medico-legal purposes so as to safeguard the best interests of child victims should be done on a case-by-case basis upon taking a holistic view of all aspects of each such pregnancy separately, noted local medical practitioners. In this regard, the College of Forensic Pathologists of Sri Lanka should formalise the procedure pertaining to the said reporting to the Police.This recommendation was made in an original article on the “Study on pregnant teenagers referred by obstetricians for medico-legal examination” authored by M. Vidanapathirana (attached to the University of Sri Jayewardenepura Medical Sciences Faculty’s Forensic Medicine Department), R.H.A.I. Rathnaweera (attached to the Office of the Galle Judicial Medical Officer of the Karapitiya Teaching Hospital), K.R. Munasinghe and L.K.G. Sanjeewanee (both attached to the University of Ruhuna Medical Faculty’s Forensic Medicine Department) and published in the Medico-Legal Journal of Sri Lanka 1 (1) in August 2014.Teenage pregnancy is the pregnancy in girls who are 19 years of age or below.All pregnant teenagers must be mandatorily reported by the obstetricians to the Police. This mandatory reporting however, Vidanapathirana et al. noted, comes into conflict on many occasions, with the best interest principle in the management of such children. That said, per the Health Ministry, a few members of the Ministry have been summoned to the courts in the recent past over not reporting teenage pregnancies to the Police.According to the Marriage Registration (Amendment) Act No. 18 of 1995, a child below 18 years of age is not allowed to marry unless specially permitted. Further, sexual intercourse with a girl below 16 years of age is considered as statutory rape.Hence, clinicians routinely report such pregnant teenage girls to the Police for medico-legal purposes, irrespective of the conditions under which the teenagers became pregnant, thereby undermining the best interests of some of the pregnant teenagers, Vidanapathirana et al. claimed.Therefore, Vidanapathirana et al. conducted a descriptive cross-sectional study with all the pregnant teenagers (19 in total) referred to the University of Ruhuna Medical Faculty’s Forensic Medicine Department, from June 2009 to June 2010. For the purpose of data collection, an interviewer-administered questionnaire and face-to-face interviews were used in order to interview all the pregnant teenagers and their parents or guardians. Case conferences were conducted in all the cases.Nine of the pregnant teenagers were living together with their partners while one was married but not lawfully. They were living either with the girl’s mother or mother-in-law. Eleven of the pregnant teenagers belonged to nuclear families while eight were from extended families. Fifteen were from rural areas and four were from urban areas. Twelve fathers of the pregnant teenagers used to take alcohol regularly. One mother was addicted to drugs. Two parent families were divorced and two were on their second marriage. Seven were 17 years of age, five were 16 years of age, three were 15 years of age, two were 14 years of age, and two were 18 years of age. Fourteen incidents had taken place outside while five incidents had taken place at home. Ten perpetrators were husbands, five were boyfriends, and four were relatives. One teenage mother was sent to a home for pregnant mothers (Ma-Sevana) until delivery. Three babies who were delivered were handed over to probationary homes while the other delivered babies were handed over to the teenage mothers under the supervision of the probation officers.As B. Banerjee, G. Pandey, D. Dutt, B. Sengupta, M. Mondal, and S. Deb’s “Teenage pregnancy: A socially inflicted health hazard” noted, in the Indian subcontinent, especially in rural regions, the rate of teenage pregnancy is much higher than it is in urbanised areas. In the instant study, it was found that the majority of pregnant teenagers hailed from nuclear families living in rural areas. In the families of pregnant teenagers, the majority of the fathers were consuming alcohol on a regular basis and a significant number of these families were either divorced or in their second marriage. The majority of the victims were between 16 to 17 years of age. In the study of “Teenage pregnancies in the estate sector”, L. Dissanayake found that the number of victims increases with age from 13 to 18 years.The majority of the incidents had taken place outside the home and had been perpetrated by non-relatives, with a considerable number of perpetrators being husbands or boyfriends. The majority of the pregnant teenagers were living together with their husbands. Vidanapathirana et al. noted that a significant number of these pregnancies were not a result of sexual abuse. In rural backgrounds, as Dissanayake observed, such marriages or living together situations are arranged with the consent of the parents. Vidanapathirana et al. also narrated from personal experience where certain groups such as gypsies, traditionally get married at a very early age, but owing to the mandatory reporting to the Police, these husbands and wives are separated for a considerable period of time.Section 5 (2) of the International Covenant on Civil and Political Rights (ICCPR) Act No. 56 of 2007 decrees that in all matters concerning children, whether they are undertaken by public or private social welfare institutions, courts, administrative authorities, or legislative bodies, the best interests of the children should be of paramount importance, as it is the doctrine used by most courts to determine a wide range of issues relating to the wellbeing of children.Vidanapathirana et al. explained that having to undergo interrogation by the Police due to the mandatory reporting of all teenage pregnancies by the obstetricians, may therefore, inhibit pregnant teenagers from seeking treatment from qualified medical personnel, which in turn may lead victims to seek treatment from quacks, thereby placing their lives in harm’s way. This is problematic as I.M. Goonewardene and R.P. Deeyagaha Waduge noted in “Adverse effects of teen pregnancy”, because pregnancies in those below 17 years of age, have a significantly higher risk of adverse outcomes. Moreover, Dissanayake also found that a substantial number of such pregnancies are subjected to criminal abortions.However, the fact of the matter is, offences which are legally required to be reported to the Police, as mentioned in Section 21 of the Code of Criminal Procedure Act No. 15 of 1979, do not include teenage pregnancy. Hence, Vidanapathirana et al. argued that unless otherwise indicated, considering the best interest of the child involved, it is sufficient to hold an institutional case conference concerning the teenage pregnancy in question, as the conduct of a case conference protects the best interest of the pregnant teenage child.Since teenage pregnancy itself constitutes a burden to the child’s family, litigations arising from the indiscriminate reporting of all teenage pregnancies to the Police, Vidanapathirana et al. pointed out in conclusion, only serve to make such a burden worse.