The court reaffirmed the right to terminate a pregnancy based on substantial fetal abnormalities impacting health under the Medical Termination of Pregnancy Act.

JUDGMENT :

M.B. Snehalatha, J.

The petitioner is seeking medical termination of her 29 weeks old pregnancy, after having found that the foetus is having aneuploidy involving specific markers of Chromosome 21, indicative of a serious chromosomal abnormality. On 21.01.2026, a detailed anomaly scan was done at CIMAR, Hospital, Edappal confirmed the above findings. The petitioner’s amniotic fluid was collected on 18.02.2026 and after perusing the report the doctor informed that the petitioner has chromosomal abnormality involving Chromosome 21. According to the petitioner, on 26.02.2026, she approached the Government Medical College, Thrissur seeking a second medical opinion and the doctor informed that the foetus is likely to be affected with Down Syndrome (Trisomy 21). Thereafter, on 04.03.2026, the petitioner consulted Aster Medicity Hospital, with all relevant medical records for a further expert opinion. The specialist doctors therein after perusing the reports including the chromosomal analysis, advised that the detected chromosomal abnormality is irreversible and not amenable to any curative treatment. The petitioner, therefore, seek for a direction to the 4^th respondent to permit the petitioner to undergo medical termination of pregnancy.

2. Heard the learned counsel for the petitioner and the learned Government Pleader.

3. When the writ petition came up for consideration on 05.03.2026, this Court directed the fourth respondent to constitute a Medical Board for the purpose of assessing the following:-

(i) whether continuance of the 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.

4. Today, i.e., on 11.03.2026, the learned Government Pleader made available to this Court the report of the Medical Board dated 07.03.2026, comprising the Associate Professor in OBG department, Assistant professor in Paediatrics and Assistant Professor in Radiodiagnosis of the Government Medical College Hospital, Thrissur. The conclusion and final opinion of the Medical Board are as follows:-

Conclusion:

Smt. Jamshiya Ajmal, 33 Years old, G5 P2 L2 A2 Previous two cesarean sections with Last Menstrual Period on 12.08.2025, and expected date of confirement on 19/05/2026 Gestational Age of 29 weeks 4 days as of today. Trisomy 21 was detected by QF-PCR test of amniotic fluid at 27 weeks 1 day which is not a confirmatory test (Confirmatory test is Karyotyping). Trisomy 21 (Down's Syndrome) is an irreversible chromosomal anomaly with varying severity. The child may have varying irreversible intellectual disability and other comorbidities.

However, considering the fact that gestation has reached 29 weeks 5 days and the baby being viable, the chance of baby being born alive is very high if MTP is done at this gestational age. The baby is likely to have possible complications of prematurity such as Respiratory distress syndrome, Intraventricular hemorrhage, sepsis, necrotizing enterocolitis, retinopathy of prematurity etc. Hence if at all medical termination of pregnancy is to be considered, all neonatal complications have to be kept in mind. and consider giving ante natal corticosteroids for lung maturity and Magnesium sulphate for neuroprotection prior to delivery.

At the same time, continuation of this pregnancy can pose