Supreme Court: Reporting Pregnant Person's Health Regardless of Pregnancy Stage

Introduction

In a landmark decision, the Supreme Court noted that even in cases where there are no significant fetal abnormalities, a medical board established under the Medical Termination of Pregnancy (MTP) Act 1971 that examines a pregnant person with a gestational age over twenty-four weeks must provide an opinion regarding the individual's physical and mental health. The Chief Justice of India, DY Chandrachud, together with Justices JB Pardiwala and Manoj Misra emphasized the value of the medical board's report in assisting the Court in assessing a request for an abortion filed by an individual whose pregnancy has progressed beyond the 24-week mark.

However, under Section 3(2B) of the MTP Act, a pregnancy that is longer than 24 weeks may be ended if the medical board determines that the diagnosis of any significant fetal abnormalities warrants it.

In the present instance, the medical board expressed its opinion against terminating the pregnancy of a juvenile rape survivor who was 28 weeks along, citing the lack of diagnosis of significant prenatal abnormalities. The report did not include any board opinions about the little girl's physical or mental health.

Critiquing this strategy, the Court noted

The impact of the pregnancy on the expectant mother's physical and mental health was not addressed in the study. If a pregnant individual satisfies the requirements outlined in MTP Act Section 3(2-B), no judicial approval would be required. Therefore, the medical board must provide an opinion on the physical and mental health of every pregnant person who approaches the High Court or this Court.”

It was decided in XYZ v. State of Gujarat (2023 LiveLaw (SC) 680) that "the medical board or the High Court cannot refuse abortion merely on the ground that the gestational age of the pregnancy is above the statutory prescription." This ruling was recalled in the verdict in this respect.

The medical boards cannot simply refuse abortion by saying the condition under Section 3(2B) has not been met

According to the ruling, the courts consider all relevant factors when granting a request for a pregnancy termination and decide how best to safeguard the expectant party's bodily and emotional well-being. In doing so, the court draws its medical knowledge from the opinion of the medical board established under the MTP Act. The court would then consider the medical board's opinion with an open mind.

As a result, the medical board cannot only claim that the requirements outlined in MTP Act Section 3(2-B) are not satisfied. If the courts lacked access to the board's medical opinion about the risk to the expectant mother's physical and mental health, their ability to exercise their jurisdiction would be compromised. As a result, CJI Chandrachud stated in the ruling that a medical board had to assess the expectant mother and provide an opinion on the matter of the risk to her physical and mental health.

The right to choose and reproductive freedom is a fundamental right under Article 21 of the Constitution

"The right to choose and reproductive freedom is a fundamental right under Article 21 of the Constitution," the Court reaffirmed. In this instance, the minor and her mother changed their minds and chose to carry the pregnancy to term. In light of such, the Court rescinded its original ruling permitting pregnancy abortion. "The choice to continue pregnancy to term, regardless of the court having allowed termination of the pregnancy, belongs to the individual alone," the ruling noted.

Medical Termination of Pregnancy

The intentional ending of a pregnancy, usually done within the first 28 weeks of gestation, is known as an abortion. Depending on the stage of pregnancy and the wishes of the person seeking an abortion, it can be accomplished using a variety of medical procedures or drugs.

Abortion is a hotly contested and divisive issue that frequently involves moral, ethical, legal, and religious issues.

The bill was brought forth in response to concerns about the erosion of abortion rights globally, particularly highlighted by the US Supreme Court's decision in the Roe v Wade case to overturn long-standing abortion rights in 2022.

Legal Provisions Related to Abortion in India

• In India, abortion was illegal up until the 1960s, and violators faced jail time or penalties under Section 312 of the Indian Penal Code.
• In the middle of the 1960s, the Shantilal Shah Committee was established to look into the necessity of abortion laws.
• The Medical Termination of Pregnancy (MTP) Act, of 1971 was passed in response to its conclusions, protecting women's health, lowering maternal mortality, and permitting safe and authorized abortions.
• In a positive step for women's reproductive rights, the Supreme Court acknowledged marital rape as a basis for abortion, even if marital rape is not recognized as a crime.
• Under the MTP Act of 1971, a woman may have an abortion up to 20 weeks into her pregnancy if she consents and one registered medical practitioner (RMP) recommends it. On the other hand, the statute was revised in 2021 and 2002.
• With the consent of two doctors, the MTP Amendment Act, 2021 allows abortions up to 24 weeks gestation in certain situations, such as rape survivors.
• It establishes Medical Boards at the state level to determine whether or not a pregnancy may be ended at 24 weeks if there are significant fetal abnormalities.
• It allows unmarried women—who were formerly the only ones eligible for contraceptive clauses—to have abortions based on their personal preference, regardless of their marital status.
• Depending on the patient's age and mental health, different consent procedures apply to ensure physician supervision.
• Article 21 of the Indian Constitution gives every citizen the right to life and personal liberty. The Indian Supreme Court has construed this freedom to encompass women's autonomy and choice over their reproductive systems.
• In Justice K.S. Puttaswamy (Retd.) vs. the Union Of India Case, 2017, the Supreme Court recognized the constitutional right of women to make reproductive choices, as a part of personal liberty under Article 21 of the Indian Constitution.

Conclusion

The Supreme Court's recent ruling underscores the importance of thorough assessment in cases of late-term pregnancies under the Medical Termination of Pregnancy (MTP) Act. Despite no identified fetal abnormalities, the Court mandates the medical board to evaluate the physical and mental health of pregnant individuals beyond 24 weeks. This decision, emphasized by Chief Justice DY Chandrachud and Justices JB Pardiwala and Manoj Misra, recognizes the complexity of late-stage abortion requests. While the MTP Act allows termination if significant fetal abnormalities are detected, it's crucial to consider the overall well-being of the pregnant person. In a specific case involving a juvenile rape survivor at 28 weeks, the medical board's refusal to terminate solely based on absent fetal abnormalities highlights the need for a holistic approach to reproductive healthcare. This ruling signifies a significant step towards safeguarding the rights and health of pregnant individuals, particularly in sensitive and challenging circumstances.