The right to terminate a pregnancy with substantial abnormalities is upheld under the Medical Termination of Pregnancy Act, emphasizing women's rights and health considerations.

J U D G M E N T The petitioners are the husband and wife, who have been seeking medical termination of 26 weeks plus four days old pregnancy, after having found that the foetus is suffering from holoprosencephaly and a few other complications. The pregnancy of the first petitioner was discovered lately in a scan done on 31.12.2025 at MDC Diagnostic Centre, Thodupuzha as directed by Dr.Sibimol Aji from District Hospital Thodupuzha. Finding anomalies, she was referred to Medical College, Kottayam on 03.01.2026. Ext.P1 is the scan report. The first petitioner went for consultation at Medical College, Kottayam. After going through the reports, the petitioners were informed that the foetus is showing a condition of holoprosencephaly and other complications which may cause the baby, if born alive, to have severe physical and mental disabilities and also serious risk to mother in labour. The petitioners, therefore, seek for a direction to the respondents to permit the first petitioner to undergo medical termination of pregnancy.

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

3. When the writ petition came up for consideration on 09^th January, 2026, this Court directed the second 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 13.01.2026, the learned Government Pleader made available to this Court the report of the Medical Board dated 12.01.2026 comprising of Professor & HOD, Professor (CAP) of OBG department, Assistant professor of Pediatric Department, Assistant Professor of Radio Diagnosis, Associate Professor of Neuro Surgery, Professor of Neuro Medicine, Assistant Professor of Psychiatry Department of the Government Medical College Hospital, Kottayam. The conclusion and final opinion of the Medical Board are as follows:-

6. Opinion by Medical Board for termination of pregnancy;

a) Allowed : Allowed b) Denied:

Justification for the decision: The above anomaly will adversely affect the physical and neurological development of fetus and the child will suffer from such physical or mental abnormalities as to be seriously handicapped. Hence MTP is allowed.”

4. The termination of pregnancy is governed by the Medical Termination of Pregnancy Act, 1971 (‘Act’, in short) and the rules framed thereunder. The Act is a progressive legislation that regulates how pregnancies can be terminated.

5. Section 3 of the Act spells out the conditions to be satisfied to terminate a pregnancy, which reads as follows:

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S.3 - When pregnancies may be terminated by registered medical practitioners.—

(1) Notwithstanding anything contained in the Indian Penal Code (45 of 1860), a registered medical practitioner shall not be guilty of any offence under that code or under any other law for the time being in force, if any pregnancy is terminated by him in accordance with the provisions of this Act.

(2) Subject to the provisions of sub-section (4), a pregnancy may be terminated by a registered medical practitioner, ―

(a) where the length of the pregnancy