1. Petition under Article 32 for termination of advanced pregnancy under the Medical Termination of Pregnancy Act, citing mental health, financial hardship, and failure of contraceptive method. (Para 3 , 4 , 5 , 6 , 10 , 11 )
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2023 Supreme(SC) 1795
SUPREME COURT OF INDIA
HIMA KOHLI, B.V. NAGARATHNA, JJ.
X - Petitioner
Versus
Union Of India & Anr. – Respondents
Writ Petition (Civil) No. 1137 of 2023
Decided on : 09-10-2023
Advocates:
Advocate Appeared:
For the Petitioner: Dr. Amit Mishra, Adv., Mr. Rahul Sharma, AOR.
For the Respondents: Ms. Aishwarya Bhati, Ld.ASG, Ms. Sthavi Asthana, Adv., Ms. Ameya Thanvi, Adv., Ms. Manisha Chava, Adv., Mr. Abhijeet Singh, Adv., Ms. Shreya Jain, Adv., Ms. Chitrangda Rastravara, Adv., Ms. Shagun Thakur, Adv., Mr. Nithin Chowdhary Panduri, Adv., Mr. Uday Bhan Singh, Adv., Mr. G.S. Makker, AOR
Advocate Appeared:
For the Petitioner: Dr. Amit Mishra, Adv., Mr. Rahul Sharma, AOR.
For the Respondents: Ms. Aishwarya Bhati, Ld.ASG, Ms. Sthavi Asthana, Adv., Ms. Ameya Thanvi, Adv., Ms. Manisha Chava, Adv., Mr. Abhijeet Singh, Adv., Ms. Shreya Jain, Adv., Ms. Chitrangda Rastravara, Adv., Ms. Shagun Thakur, Adv., Mr. Nithin Chowdhary Panduri, Adv., Mr. Uday Bhan Singh, Adv., Mr. G.S. Makker, AOR
Mental health risks of the petitioner justified the medical termination of pregnancy beyond the statutory limit, emphasizing the court's recognition of bodily autonomy.
Headnote:(A) Medical Termination of Pregnancy Act, 1971 - Sections 3(2)(b)(i), 3(3), 5 - Writ petition seeking permission for medical termination of pregnancy at 26 weeks due to health and psychological concerns - Court recognized bodily autonomy and mental health risks of the petitioner in granting relief - Previous pregnancies by C-section and history of depression considered crucial in decision-making. (Paras 4, 12, 14, 19)
(B) Article 32 of the Constitution of India - Our Court's reluctance to entertain petitions directly under Article 32 where alternative remedies exist, emphasized while considering the urgency of the situation. (Paras 16)
(C) The importance of family planning measures to avoid unwanted pregnancies highlighted, with recommendations for public dissemination of related information. (Paras 19, 20)
Facts of the case:
The petitioner, a 27-year-old married woman with two children, sought medical termination of her pregnancy after developing unexpected symptoms and facing significant mental health issues, compounded by financial strain.
Findings of Court:
Permission granted for the medical termination of pregnancy, highlighting both physical and psychological health considerations of the petitioner.
Issues: The primary issues addressed included the implications of the petitioner’s mental and physical health on her ability to continue the pregnancy and the statutory limitations of the MTP Act.
Ratio Decidendi: The court held that mental health considerations, interpreting 'grave injury' in a broad sense, warrant termination of pregnancy when continuance poses risks.
Result: Writ petition allowed; petitioner to undergo termination procedure at AIIMS without delay.
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2. Petitioner seeks termination due to physical, mental, and financial inability to continue pregnancy; respondents' statutory bar based on gestational age limits under the MTP Act. (Para 3 , 4 , 5 , 6 )
3. The court emphasized reproductive autonomy and interpreted grave injury to mental health broadly, including post-partum depression and failure of the Lactational Amenorrhea Method. (Para 12 , 13 , 14 )
4. Termination of pregnancy beyond 20 weeks is permissible if continuing the pregnancy would cause grave injury to the woman's physical or mental health, including reproductive autonomy. (Para 12 , 14 )
5. Petition allowed; directions issued for the medical termination of pregnancy at a government hospital. (Para 15 , 21 )
6. How is the term grave injury to physical and mental health interpreted under Section 3(2)(b) of the MTP Act?
It is interpreted in an overarching and all-encompassing sense, where mental health has a broader connotation than mental illness in strict medical parlance, allowing termination if continuing pregnancy imperils the woman's mental well-being. (Para 12 )
7. Under what circumstances can a pregnancy be terminated beyond 20 weeks under the MTP Rules?
Termination is permitted beyond 20 weeks in cases of risk to the woman's life, grave injury to physical or mental health, delay in recognizing pregnancy, or critical material changes in life circumstances. (Para 12 )
8. What role does reproductive autonomy play in the decision to terminate an unwanted pregnancy?
The court recognizes a woman's bodily and reproductive autonomy, including the right over her own body and the consideration of her ability to shoulder the responsibility of rearing a child. (Para 14 )
9. Can a petitioner approach the Supreme Court under Article 32 directly for MTP relief when a High Court remedy exists?
While generally reluctant to entertain Article 32 petitions when an efficacious alternative remedy under Article 226 exists, the court may do so in urgent cases where time is critical. (Para 16 )
ORDER :
1. Rule Nisi.
2. Both the sides are represented.
3. The present petition has been filed by the petitioner under Article 32 of the Constitution of India praying inter alia for issuing directions to the respondents to permit the medical termination of her on-going pregnancy under Section 3 (2)(b)(i) and Sections 3 (3) and 5 of the MTP Act1[Medical Termination of Pregnancy Act, 1971] read with Rule 3B of the MTP Rules2[]Medical Termination of Pregnancy Rules, 2003], in any Government hospital, preferably at AIIMS, New Delhi3[All India Institute of Medical Sciences, New Delhi] on a plea that she is neither physically, mentally, psychologically or financially prepared to continue with the unwanted pregnancy.
4. Learned counsel appearing for the petitioner submits that the petitioner is a married lady aged 27 years. She has two children (both sons, aged four years and one year respectively). The earlier deliveries of the petitioner were C-section deliveries and both she and her husband were satisfied that their family is complete. Her current pregnancy has come as an utter shock to the petitioner for the reason that she did not realise that she has an on-going pregnancy since she had adopted LAM4[Lactational Amenorrhea Method] which implies absence of menstruation due to continuing breast feeding as a contraceptive method after delivery of the second child.
5. Learned counsel for the petitioner states that the petitioner did not have any symptoms of pregnancy till very recently and immediately on the same being revealed by the Doctor, she has rushed to this Court and instituted the present petition. He further submits that the petitioner is a home maker and her husband is a graduate, working in a private company. The petitioner’s husband has the responsibility of supporting not only his own family, but also to maintain his aged parents and a sister with a paltry salary. It is, therefore unviable for the couple to feed one more mouth.
6. The petitioner has averred that she and her husband have approached several doctors and hospitals for medical termination of her pregnancy but the same has been declined due to the statutory bar imposed under the MTP Act that permits medical termination of pregnancy through a RMP5[Registered Medical Practitioner] upto 20 weeks and only in the case of a forced pregnancy, termination is permitted upto 24 weeks.
7. Having regard to the aforesaid submissions made by learned counsel for the petitioner on 05th October, 2023, notice was issued on the present petition and Ms. Aishwarya Bhati, learned Additional Solicitor General was requested to enter appearance and accept notice on behalf of the respondent No.1-Union of India. In view of the urgent nature of the matter, it was deemed appropriate to obtain the opinion of a Medical Board directed to be constituted by AIIMS and the case was deferred for today to await the report.
8. We are informed today that the petitioner had appeared before the Medical Board, AIIMS on 06th October, 2023. The report dated 06th October, 2023 forwarded by the Medical Board, AIIMS states as under:
“Details of the woman seeking termination of pregnancy:
1. Name of the woman : X
2. Age : 27 years.
3. Registration/Case Number: UHID – 107060237.
4. Additional review done at AIIMS:
S.No. Investigations done Key finding
1 Ultrasound done at AIIMS on 20.09.2023 Ultrasonography suggest: Single live intra uterine fetus of 25 weeks 5 days POG. Estimated Fetal Weight – 886 gm. Placenta upper segment
5. Opinion by Medical Board for termination of pregnancy:
(a) Allowed (X)
(b) Denied (?)
Justification for the decision:
The case has been reviewed by the medical board. The weight of the baby by the scan done on 06/10/2023 is 886gm with gestational age of 25 weeks 5 days.
As per the current status, the baby is viable and has a reasonable chance of survival.
The chances of post partum psychosis of which the couple is worried of, are present even at this gestation following delivery.
The mother is a previous
