The court affirmed the right to terminate a pregnancy with substantial foetal abnormalities, emphasizing the importance of medical opinion and reproductive autonomy under Article 21.

JUDGMENT :

(SHOBA ANNAMMA EAPEN, J.)

The petitioners are wife and husband, who have been seeking medical termination of 31- weeks- old pregnancy, after having found that there is a high possibility that the foetus suffering from a rare genetic disorder, tuberous sclerosis, especially after the scan at the 30 weeks of gestation revealed that multiple tumours have developed in the heart and brain of the foetus. The petitioners are also parents of an 18 months old boy. According to the petitioners, as per Exts.P5 and P6 scan reports, the doctors stated that the condition is fatal and has poor prognosis, and according to them, even if the foetus survives, it is highly likely to develop conditions such as seizures, intellectual disability, developmental delay, behavioural problems, lung disease and kidney disease. The petitioners, therefore, seek for a direction to the respondents to permit the 1^st petitioner to undergo medical termination of pregnancy.

2. Heard the learned counsel for the petitioners, the learned DSGI and the learned Government Pleader.

3. When the writ petition came up for consideration on 20th May,2025, this Court directed the fifth respondent to constitute a Medical Board for the purpose of assessing the following:-

(i) whether continuance of the first petitioner's pregnancy would involve risk to her life or grave injury to her physical or mental health,

(ii) whether there is a substantial risk that if the child was born, it would suffer from such physical or mental abnormalities as to be seriously handicapped and if so, the nature of abnormalities and

(iii) whether, having regard to the advanced stage of pregnancy, there is any danger (other than usual danger which arises even in spontaneous delivery at the end of full term) if the pregnant mother is permitted to terminate her pregnancy.

On 23.05.2025, the learned Government Pleader made available this Court the report of the Medical Board dated 22.05.2025 comprising of Assistant Professor of Obstetrics and Gynaecology Department, Associate Professor of Radiodiagnosis Department, Assistant Professor of Paediatrics Department and Assistant Professor of Psychiatry Department of the Government Medical College Hospital. The conclusion and final opinion of the Medical Board are as follows:-

Conclusion:

I. The continuation of pregnancy does not add any grave injury to the physical and mental health of the mother in the current examination other than what occurs in a normal pregnancy. The mother can have psychological distress regarding the baby’s anomalies which is expected.

II. If the pregnancy is terminated at this gestational age there is very high possibility that the baby is born alive and will undergo all the complications of prematurity. According to the present USG Scan of the foetus and foetal Medicine opinion this is highly suggestive of Tuberous Sclerosis which can cause substantial neurological deficit including severe recurrent seizure and its sequelae and neurodevelopmental disorders to the baby if born alive.

III. There is danger to the life of pregnant mother if permitted to terminate the pregnancy preterm.

Final Opinion

Considering the added risk for the mother and baby if pregnancy is terminated preterm, the board is of collective opinion that there is no definite medical indication for termination of pregnancy at this gestational age. The pregnancy may be followed up with regular antenatal check up and serial ultrasound scan.

On 26.05.2025 also, this Court further found that it is necessary to obtain a report from Neuro Surgeon as well. Accordingly, the Medical Board was directed to file an additional report and on 27.05.2025, when the case was taken up, the learned Government Pleader made available to me the additional report of the Neuro Surgeon wherein the opinion of the Doctor is as follows:-

“History and antenatal scan findings are noted. USG Scan findings (12/05/2025); multiple echogenic cortical tubers in the fetal brain and multiple Cardiac rhahdomyomas.

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