The court affirmed reproductive autonomy and the legality of terminating pregnancies with substantial fetal abnormalities under the Medical Termination of Pregnancy Act.

J U D G M E N T The petitioners, who are the wife and husband, have been seeking medical termination of 27 weeks plus 2 days old pregnancy, after having found that the foetus suffers congenital abnormalities of the brain and head, including features suggestive of microcephaly, carrying a high likelihood of serious and lifelong physical and neurological disability. According to the petitioners, Exts.P4 Chromosomal Microarray Cytoscan Optima test report revealed that a gain of 33091 kbp on chromosome consistent with Trisomy 21 or Down’s Syndrome, - the common genetic cause of mental retardation and is associated with several clinical traits including congenital heart disease, Duodenal stenosis or Atresia, Imperforate anus, Hirschsprung disease, Muscle Hypotonia, Immune system deficiencies, Increased risk of childhood Leukaemia and early onset Alzheimer’s disease and Genomic Amauplory. 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, the learned CGC and the learned Government Pleader.

3. When the writ petition came up for consideration on

09.02.2026, this Court directed the fifth respondent to constitute a Medical Board for the purpose of assessing the following:-

(i) whether continuance of the petitioner's pregnancy will 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 is born, it will 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?

Today, the learned Government Pleader made available this Court the report of the Medical Board dated 11.02.2026 comprising of Professor (CAP) of OBG department, Associate Professors of Department of Neuro Medicine, and Assistant Professors of Department Radio Diagnosis and Cardiology, Paediatrics, Psychiatry Department, of the Government Medical College Hospital, Kottayam. The conclusion and final opinion of the Medical Board are as follows:-

FORM D (See sub-clause (ii) of clause (b) of rule 3A)

Report of the Medical Board for Pregnancy Termination Beyond 24 weeks.

Details of the woman seeking termination of Pregnancy:

1 Name of woman : PRISKILLA K. BABY

2. Age 33 Years

3. Registration /Case Number : W.P.(C) No.4996 OF 2026 (Y)

4. Available report and investigations:

6. Opinion by Medical Board for termination of pregnancy:

a) Allowed: Allowed b) Denied.:

Justification for the decision:As the baby is having chromosomal anomaly Trisomy 21, which is likely to affect the physical and mental health seriously. Hon. High Court may please grant permission to induce iatrogenic foetal demise as per recommendations of the Royal College of Obstetricians and Gynecologists (RCOG) and the FOGSI-

ICOG guidelines (2017).

7. Physical fitness of the woman for the termination of pregnancy:

a) Yes : Yes b) No.

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 regist