High Court of KeralaSingle JudgeWrit Petition allowed; termination of pregnancy...

W.P.(C) No.29230 of 2020-C

Case / Petition Number:W.P.(C) No.29230 of 2020-C

Case Details & Bench

Court
High Court of Kerala
Hon'ble Judges
  • P. V. Asha
Judgment Date
2021-01-04
Court Decision / Holding
The writ petition is allowed; the minor’s pregnancy may be terminated medically under the supervision of competent doctors at Government Medical College, Kannur, Pariyaram, at the earliest possible time. The Medical Board’s report and the psychiatric assessment are on record; termination is permitted beyond the usual gestational limits in light of the minor’s health risks and mental trauma. The order requires strict privacy measures, records of the procedure, preservation of the fetal tissue for DNA analysis in connection with the pending criminal case, and, if born alive, duty of care to the child in the best interests of the child.
Final Disposition
Writ Petition allowed; termination of pregnancy permitted; privacy protections and mandated medical supervision; DNA tissue preservation for potential future proceedings.

Parties to the Case

Appellants / Petitioners

  • XXX victim, a 14-year-old rape victim, represented by her mother and natural guardian

Respondents

  • Union of India represented by the Under Secretary, Ministry of Women and Child Development, New Delhi
  • State of Kerala represented by the Secretary, Department of Women and Child Development, Thiruvananthapuram
  • Station House Officer, Chakkarakkall u Police Station, Kannur
  • Director, Department of Gynecology, Government Medical College Hospital, Pariyaram, Kannur
  • Superintendent, Government Medical College Hospital, Pariyaram, Kannur
  • The Child Welfare Committee, Thiruvananthapuram
  • Addl R7: The Child Welfare Committee, Kannur (Suo Motu Impleaded)

Legal Representation & Advocates

Counsels for Petitioners

  • • Sri. Ramesh P., Advocate

Counsels for Respondents

  • • Smt. Vinitha B., Government Pleader
  • • Sri. P. Vijayakumar, Additional Special Government Pleader

Case Synopsis & Summary

The writ petition is filed by the mother of a 14-year-old rape victim seeking medical termination of pregnancy (MTP) as the minor’s gestational age crosses the period at which continuation would risk her health and mental well-being. A crime (Cr. No. 628/2020) was registered, and Ext.P4 medical reports show gestation around 22 weeks, escalating to over 23 weeks by the time of the medical board’s report. The court, by an interim order, directed the Government Medical College Hospital, Pariyaram, Kannur, to constitute a medical board to consider MTP and submit a report. The medical board concluded that the victim is 23 weeks plus 4 days pregnant, and at age 14 continuation would be physically and mentally detrimental. It noted that standard MTP methods are effective up to about 20 weeks and beyond that induction may be required with surgical risks, including potential neonatal survival issues. Psychiatric evaluation indicated severe trauma from continuing the pregnancy. The court cites multiple precedents (A v. UoI; ABC v. UoI; Meera Santosh Pal; Neethu Narendran; Sarmishtha Chakrabortty; Murugan Nayakkar) recognizing termination beyond 20 weeks in cases of rape where the victim is not prepared to be a mother, to safeguard the life and health of the woman. The court ultimately permits termination, directs urgent action by the GMC Kannur doctors under the MTP Act, directs privacy protections, and mandates DNA tissue preservation for potential future proceedings.

Provisions of Law Cited

Medical Termination of Pregnancy Act, 1971 – Section 3Medical Termination of Pregnancy Act, 1971 – Section 4Medical Termination of Pregnancy Act, 1971 – Section 5(1) (and related guidance allowing termination beyond gestational limits in certain circumstances)

Legal Doctrines & Maxims

  • Best interests of the child
  • Duty of care to a child born alive
  • Right to privacy of the petitioner and the minor
  • Judicial pragmatism in medical termination cases involving rape victims

Submissions & Arguments

Contentions of Appellants / Petitioners

The petitioner’s mother argued for urgent termination of pregnancy on the ground that continuing would seriously endanger the health and life of the minor, who is not mentally prepared for motherhood. The medical board’s findings (gestation ~23 weeks) and the psychiatrist’s opinion supported termination. Reliance was placed on statutory provisions of the Medical Termination of Pregnancy Act, 1971, and on precedents recognizing termination beyond 20 weeks in rape victims where the continuation would cause grave harm, including risks of irreversible mental trauma and complex medical consequences. The argument emphasized safeguarding the victim’s health and future welfare, along with ensuring appropriate medical care and privacy.

Contentions of Respondents

The respondents’ counsel anchored on compliance with the MTP Act and the need to preserve the fetus’s life and the privacy of the minor. They canvassed the medical board’s report and the gravity of ensuring a medically supervised termination under existing legal frameworks, while underscoring privacy protections and adherence to procedure.

Cited Precedents (8)

Case NameCitationTreatmentExplanation
ABC v. Union of India & Others2020(4) KLT 279PositiveJudgments in ABC v. Union of India and similar cases permitted termination beyond 20 weeks in rape victims not prepared to deliver, to safeguard life/health.
Ms. X v. State of Kerala and Others2016 (4) KLT 745PositiveEstablished precedent allowing late-gestation termination to protect life/health in rape cases.
A v. Union of India(2018) 4 SCC 75PositiveSC held termination permissible at gestations around 25-26 weeks in certain circumstances.
Murugan Nayakkar v. Union of India2017 SCC online SC 1092PositiveAllowed termination for a minor in special circumstances.
Sarmishtha Chakrabortty v. Union of India(2018) 13 SCC 339PositivePermitted termination at 26 weeks given medical reports and risk factors.
Meera Santosh Pal v. Union of India(2017) 3 SCC 462PositiveConsent and medical reports supported permissive termination beyond 24 weeks.
Neethu Narendran v. State of Kerala2020 (3) KHC 157PositivePermitted termination when gestational age crossed 23 weeks in Kerala context.
XYZ v. Union of India and Others(2019) 3 Bom. CR 400PositiveNoted duty of care and best interests for a child born alive after attempted termination.

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Extracted Judgment Text

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W.P(C).No.29230/2020-C 1 ## **IN THE HIGH COURT OF KERALA AT ERNAKULAM** ## **PRESENT** ## **THE HONOURABLE SMT. JUSTICE P.V.ASHA** **MONDAY, THE 04TH DAY OF JANUARY 2021 / 14TH POUSHA, 1942** ## **WP(C).No.29230 OF 2020(C)** ## **PETITIONER:** **XXX VICTIM, AGED 14 YEARS REPRESENTED BY THE MOTHER AND THE NATURAL GUARDIAN. BY ADV. SRI.RAMESH .P** ## **RESPONDENTS:** - **1 UNION OF INDIA REPRESENTED BY THE UNDER SECRETARY, MINISTRY OF WOMEN AND CHILD DEVELOPMENT, SASTHRI BHAVAN, NEW DELHI-110 001.** - **2 STATE OF KERALA, REPRESENTED BY THE SECRETARY, DEPARTMENT OF WOMEN AND CHILD DEVELOPMENT, SECRETARIAT, THIRUVANANTHAPURAM-695001.** - **3 STATION HOUSE OFFICER, CHAKKARAKKALLU POLICE STATION, KANNUR POST, KANNUR-670 007.** - **4 THE DIRECTOR, DEPARTMENT OF GYNECOLOGY, GOVERNMENT MEDICAL COLLEGE HOSPITAL, PARIYARAM, KANNUR-670503.** - **5 SUPERINTENDENT, GOVERNMENT MEDICAL COLLEGE HOSPITAL, PARIYARAM, KANNUR-670 503.** - **6 THE CHILD WELFARE COMMITTEE, THIRUVANANTHAPURAM, GOVERNMENT CHILDREN'S HOME, POOJAPPURA,THIRUVANANTHAPURAM-695012, REPRESENTED BY THE CHAIRPERSON.** - **7 ADDL R7: THE CHILD WELFARE COMMITTEE, KANNUR. (ADDL.R7 IS SUO MOTU IMPLEADED AS PER ORDER DATED 29-12-2020 IN WP(C)29230/2020)** - **SMT.VINITHA.B, GOVERNMENT PLEADER, ASGI SRI.P.VIJAYAKUMAR** **THIS WRIT PETITION (CIVIL) HAVING COME UP FOR ADMISSION ON 04.01.2021, THE COURT ON THE SAME DAY DELIVERED THE FOLLOWING:** W.P(C).No.29230/2020-C 2 ## **P.V.ASHA J.** ## **---------------------------------** ## **W.P.(C) No.29230 of 2020-C** **---------------------------------** Dated this the 4[th] day of January 2021 ## **JUDGMENT** The mother of a minor girl, aged 14 years, who is an unfortunate rape victim, has approached this Court pointing out that the girl is carrying 22 weeks of pregnancy and continuation of her pregnancy would be critical to her health and contrary to her interest. A Crime no.628/2020 has been registered in Chakkarakkal Police Station, in respect of the incident. The Writ Petition is filed producing Ext.P4 medical report dated 18.12.2020, which found the gestational age as 22 weeks. It is stated that victim girl is not mentally prepared to accept the pregnancy and that there is high risk in the event of continuation of her pregnancy as she has been subjected to sexual assault. 2. When the matter came up for admission on 29.12.2020, this Court passed an interim order directing the Superintendent of Government Medical College Hospital, Pariyaram, to constitute a medical board with all specialists required to conduct medical termination of W.P(C).No.29230/2020-C 3 pregnancy and file a report before this Court in respect of the medical condition of the child and all other related aspects for conducting the procedure of medical termination. 3. The learned Government Pleader has made available the minutes of the Medical Board convened on 29.12.2020 pursuant to the interim order passed by this Court in which it is stated as follows: _“Minutes of the Medical Board Convened on 29.12.2020 reg. the POCSO, Cr.no.628/2020 of Chakkarakkal Police Station and W.P.(C) No. 29230 of 2020-P of Hon'High Court of Kerala._ _Members Present:_ _1. Dr.K.M. Kuriakose, Principal & Chairman_ _2. Dr. Sudeep K, Medical Superintendent_ _3. Dr Ajith S. HOD OBGYN_ _4. Dr Beena George, Professor, OBGYN_ _5. Dr Dhruhin A V. Professor, Psychiatry_ _Based_ _on the report of the medical officer, Dr Beena George, Professor, Dept. Of Obstetrics and Gynaecology, after examination of the victim of POCSO case, crime no: 628/2020 of Chakkarakkal Police Station who was brought to Government Medical College, Kannur on 18/12/2020 the Medical Board examined the case and came to the following conclusions._ _1. The victim is now having a pregnancy of period of gestation 23 weeks plus 4 days._ _2. As she is only 14 years old, continuation of pregnancy may be detrimental to the physical and mental health of the victim._ W.P(C).No.29230/2020-C 4 _3. The usual means of termination of pregnancy involves oral medication followed by mechanical induction with a view towards vaginal expulsion of products of conception._ _4. The Medical board felt that the available methods of MTP are effective only upto 20 weeks of gestation. Beyond 20 weeks, pregnancy is to be induced as per induction of normal pregnancy._ _5. In view of the gestational age of 23 weeks plus 4 days, in addition to the usual risks like haemorrhage, sepsis, risk of blood transfusion etc, due to the present gestational age, there is a possibility that the uterus may not respond to the usual methods of medical induction. In that situation we may have to resort to surgical methods(hysterotomy) which involves anaesthesia and surgical risks._ _6. There is a possibility that the child may be born alive, however the chances of survival is remote._ _7. As per National Resuscitation Programme Guidelines - India and American Academy of Paediatrics, resuscitation is considered only after completion of 24 weeks of pregnancy. If the baby is born before 24 weeks gestational age, resuscitation need not be considered._ _8. Dr. Dhruhin A V, Professor, Dept. of Psychiatry after examination of the victim, opined that continuation of pregnancy may result in severe psychiatric trauma. Hence it was suggested that termination of pregnancy could be considered._ _9. Moreover, the victim and her mother are requesting for termination of pregnancy.”_ From the report, it is seen that as on today the gestational age is 25 weeks and 3 days. The Psychiatrist, who examined her has reported that the continuance of pregnancy will result in serious psychiatric trauma to the minor. W.P(C).No.29230/2020-C 5 4. As per section 5 of the Medical Termination of Pregnancy Act, termination of pregnancy is permissible even in cases where the period of gestation exceeds the period prescribed in Sections 3 and 4 of the Act, which reads as follows: _“5. S.3 and S.4 when not to apply. - (1) The provisions of S.4 and so much of the provisions of sub-section (2) of S.3 as relate to the length of the pregnancy and the opinion of not less than two registered medical practitioner, shall not apply to the termination of a pregnancy by the registered medical practitioner in case where he is of opinion, formed in good faith, that the termination of such pregnancy is immediately necessary to save the life of the pregnant woman.”_ ## 5. This Court has in the judgments in _**ABC v. Union of**_ _**India & others**_ : 2020(4) KLT 279, _**Ms. X v. State of Kerala**_ _**and Others**_ : 2016 (4) KLT 745, etc, have ordered termination of pregnancy exceeding 20 weeks in the case of rape victims who were not mentally prepared to deliver the child, in order to save their lives. The Apex Court has in the judgment in _**A v. Union of India**_ : (2018)4 SCC 75 permitted termination in a case where the gestational age was 25-26 weeks. In _**Murugan Nayakkar v. Union of India**_ : 2017 SCC online SC 1092 allowed termination of pregnancy in the case of 13 year old child and in _**Sarmishtha Chakrabortty v. Union of India**_ : (2018) 13 SCC 339, permitted termination of pregnancy when the gestational age W.P(C).No.29230/2020-C 6 was 26 weeks, in view of the recommendation of the medical board and the medical report revealing the threat of severe mental injury to the woman and to the multiple complex problems to the child, if born alive, involving complex cardiac corrective surgery stage by stage after birth, in the event of continuation of the pregnancy **.** In _**Meera Santosh Pal v. Union of India**_ : (2017) 3 SCC 462 also permission was granted when the pregnancy crossed 24 weeks, in view of the medical reports pointing out the risk involved. In the judgment reported in _**Neethu Narendran v.**_ _**State of Kerala**_ : 2020 (3) KHC 157 also this Court permitted termination of pregnancy when gestational age crossed 23 weeks. As found in those cases the minor victim in this case is also not prepared to deliver a child in the situation. In view of the trauma that the minor girl has undergone and taking note of the opinion of the Psychiatrist coupled with the report of medical board, I am of the view that the Writ Petition can be allowed permitting termination of pregnancy. 6. In the event the baby is born alive, it has to be taken care of as observed by the Bombay High Court in the judgment _**XYZ v. Union of India and Others**_ (2019 (3) Bom. CR 400), as follows: _"If a child is born alive, despite attempts at the_ W.P(C).No.29230/2020-C 7 _medical termination of pregnancy, the parents as well as the doctors owe a duty of care to such child. The best interests of the child must be the central consideration in determining how to treat the child. The extreme vulnerability of such child is reason enough to ensure that everything, which is reasonably possible and feasible in the circumstances, must be offered to such child so that it develops into a healthy child."_ 7. Therefore, the petitioner is permitted to subject her daughter to medical termination of pregnancy. As any delay in undertaking the termination will involve serious consequences affecting the girl as well as the life of the baby in the womb, there shall be a direction to the Superintendent of Government Medical College, Kannur, Pariyaram to see that the termination of pregnancy of the minor girl-the daughter of the petitioner is undertaken by competent Doctors under his/her supervision, at the earliest point of time, if possible, today itself in accordance with the provisions of the Medical Termination of Pregnancy Act, 1971, its rules and all other rules, regulations and guidelines prescribed for the purpose. The Medical Board shall maintain a complete record of the procedure which is to be performed on the girl for termination of her pregnancy. 8. There will be a further direction to the Doctors to take the tissue of the foetus for DNA identification and to W.P(C).No.29230/2020-C 8 maintain the same intact for future purposes, especially due to the fact that a criminal case is pending in the instant case. If the child is born alive, despite the attempts at medical termination of the pregnancy, the Doctors shall ensure that everything, which is reasonably possible and feasible in the circumstances and in contemplation of the law prescribed for the purpose, is offered to such child so that he/she develops into a healthy child. 9. The petitioner is accordingly directed to report with her minor daughter before the Superintendent of the Government Medical College, Kannur, Pariyaram today itself. 10. The Registry and all concerned, shall see that absolute privacy is maintained with respect to the identity of the petitioner and that of minor girl while issuing the certified copy of the judgment or otherwise. There shall be a direction that copy of the Writ Petition, affidavit, the documents annexed to it and the medical report shall not be issued to any third person without obtaining orders from this Court. The Writ Petition is allowed accordingly. ## _**Sd/-**_ **(P.V.ASHA, JUDGE)** _**rtr/**_ W.P(C).No.29230/2020-C 9 ## **APPENDIX** ## **PETITIONER'S EXHIBITS:** ## **EXHIBIT P1** **TRUE COPY OF THE RECOMMENDATION LETTER FROM THE LEARNED SECRETARY(SUB JUDGE) OF DLSA, KANNUR DATED 21/12/2020.** **EXHIBIT P2** **TRUE COPY OF THE LETTER FROM KERALA MAHILA SAMAKHYA SOCIETY,AN AFFILIATE OF CHILD WELFARE COMMITTEE, DATED 21/12/2020.** **EXHIBIT P3** - **TRUE COPY OF THE FIR IN CRIME NO.0628/2020 DATED 15/12/2020.** **EXHIBIT P4 TRUE COPY OF THE MEDICAL REPORTS FROM THE RESPONDENTS 4 AND 5 DATED 18/12/2020.** **EXHIBIT P5 TRUE COPY OF THE CONSENT LETTER FROM THE VICTIM AND THE MOTHER OF THE VICTIM DATED 21/12/2020.**