High Court of KeralaSingle JudgeWrit Petition allowed

WP(C).No.29209 OF 2020(A)

Case / Petition Number:WP(C).No.29209 OF 2020(A)

Case Details & Bench

Court
High Court of Kerala
Hon'ble Judges
  • P.V.ASHA
Judgment Date
2021-01-04
Court Decision / Holding
Writ Petition allowed. Termination of the minor’s pregnancy is permitted; a competent medical team at Government Medical College, Kottayam is directed to perform the termination at the earliest possible time, with the Medical Board’s records, privacy maintained, and DNA tissue preserved for potential criminal proceedings; if the baby is born alive, ensure care and a focus on the child’s best interests.
Final Disposition
Writ Petition allowed

Parties to the Case

Appellants / Petitioners

  • XXX; YYY; ABC (15-year-old minor)

Respondents

  • State of Kerala represented by Secretary, Ministry of Women and Child Development, Thiruvananthapuram; Director of Medical Education, Directorate of Medical Education; Director of Medical Services, General Hospital, Thiruvananthapuram; District Medical Officer, Kottayam; Superintendent, Government Medical College Hospital, Kottayam; Union of India represented by its Secretary, Ministry of Women and Child Development.

Legal Representation & Advocates

Counsels for Petitioners

  • • Adv. Sri Adithya Rajeev

Counsels for Respondents

  • • Government Pleader

Case Synopsis & Summary

This writ petition concerns a 15-year-old rape victim alleging pregnancy of approximately 26 weeks and seeking permission for medical termination. The minor (3rd petitioner) was pregnant following sexual assault and faced mounting medical and emotional risk. A first information and a remand report were produced, with Exts.P3 and P5 indicating gestational age around 22 weeks 6 days on 09.12.2020 and substantial trauma to the victim. At the court’s direction on 29.12.2020, a medical board comprising obstetrics, anesthesia, pediatrics and forensic medicine was constituted to assess the pregnancy and determine whether termination should be undertaken under the Medical Termination of Pregnancy Act (MTP Act), 1971. The board’s report concluded that continuing the pregnancy carries high risk for both mother and baby—risk of preeclampsia, anemia, hemorrhage, potential hysterectomy, infection and fetal complications—and recommended termination at a highly equipped tertiary care center with ICU facilities, if necessary. Section 5 of the MTP Act provides for termination even when gestation exceeds permitted limits, if the doctor forms a good faith belief that termination is immediately necessary to save the pregnant woman’s life. The court cites several precedents (ABC v. Union of India; Ms. X v. State of Kerala; AV v. Union of India; Murugan Nayakkar; Sarmishtha Chakrabortty; Meera Santosh Pal; Neethu Narendran) and a Bombay High Court view emphasizing the child’s best interests when birth is a possibility. Consequently, the court allows termination, directing government doctors to perform it promptly, preserve the fetal tissue for DNA, protect privacy, and ensure appropriate post-procedure care for the child if born alive.

Provisions of Law Cited

Medical Termination of Pregnancy Act, 1971 – Sections 3, 4, 5

Legal Doctrines & Maxims

  • Best interests of the child must be the central consideration.
  • Duty to care for a live-born child; privacy considerations in sensitive cases.

Submissions & Arguments

Contentions of Appellants / Petitioners

The petition seeks termination of the minor’s pregnancy on grounds of risk to life and mental health, supported by medical board findings and the statutory provision in the MTP Act (Sec. 5) allowing late-term termination to save the life of the pregnant woman; reliance on established precedents permitting termination beyond the usual limits in rape cases.

Contentions of Respondents

Adherence to statutory framework and medical guidelines; ensure due process, privacy, and timely decision making; safety considerations in performing the termination.

Cited Precedents (8)

Case NameCitationTreatmentExplanation
ABC v. Union of India & others2020(4) KLT 279PositiveCourt relied on this precedent to permit late-term termination in rape victims not mentally prepared to deliver, aligning with the present case.
Ms. X v. State of Kerala and Others2016 (4) KLT 745PositiveSimilar reasoning supporting termination beyond standard gestational limits in trauma cases.
A V. Union of India(2018) 4 SCC 75PositiveApex Court permitted termination when gestation was around 25–26 weeks in life-threatening or trauma situations.
Murugan Nayakkar v Union of India2017 SCC online SC 1092PositiveAllowed termination in a case involving a minor, reflecting judicial willingness to consider maternal life risk.
Sarmishtha Chakrabortty v. Union of India(2018) 13 SCC 339PositivePermitted termination at 26 weeks with medical board support and life/psychological threat considerations.
Meera Santosh Pal v. Union of India(2017) 3 SCC 462PositivePermission granted beyond standard limits due to medical risks and reports.
Neethu Narendran v State of Kerala2020(3)KHC 157PositivePermitted termination when gestational age exceeded 23 weeks under medical report.
XYZ v. Union of India and Others(2019) 3 Bom. CR 400PositiveBombay High Court’s precautionary stance on best interests of a live-born child and related care.

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Extracted Judgment Text

Exact text extracted from official judgment records.

WP(C).No.29209 OF 2020(A) 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.29209 OF 2020(A)** ## **PETITIONER/S:** - **1 XXX AGED 37 YEARS X** - **2 YYY AGED 34 YEARS X** - **3 ABC AGED 15 YEARS MINOR BY ADV. SRI.ADITHYA RAJEEV** ## **RESPONDENT/S:** - **1 STATE OF KERALA REPRESENTED BY SECRETARY, MINISTRY OF CHILD WELFARE, THYCAUD, THIRUVANANTHAPURAM, PIN-695 014.** - **2 THE DIRECTOR OF MEDICAL EDUCATION DIRECTORATE OF MEDICAL EDUCATION,MEDICAL COLLEGE P.O., THIRUVANANTHAPURAM, PIN-695 011.** - **3 THE DIRECTOR OF MEDICAL SERVICES, GENERAL HOSPITAL JUNCTION, THIRUVANANTHAPURAM-695 035.** - **4 THE DISTRICT MEDICAL OFFICER KOTTAYAM DISTRICT, OFFICE OF THE DISTRICT MEDICAL OFFICER, KOTTAYAM-686 002.** - **5 THE SUPERINTENDENT OF MEDICAL COLLEGE HOSPITAL KOTTAYAM GANDHI NAGAR P.O., KOTTAYAM, PIN-686 008.** - **6 THE UNION OF INDIA REPRESENTED BY ITS SECRETARY, MINISTRY OF WOMEN AND CHILDREN DEVELOPMENT, SASTHRI BHAVAN, NEW DELHI, PIN-110 001.** WP(C).No.29209 OF 2020(A) 2 ## **OTHER PRESENT:** **SMT.PRINCY XAVIER,GP, 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:** WP(C).No.29209 OF 2020(A) 3 ## **JUDGMENT** Dated this the 4[th] day of January, 2021 An unfortunate minor rape victim girl aged 15 years, has approached this Court along with her parents, pointing out that the girl is carrying about 23 weeks of pregnancy and that continuation of her pregnancy would be contrary to her interest. Crime No.1171/2020 has been registered in Thrikodithanam Police Station, in respect of the incident. The Writ Petition is filed producing Exts.P3 and P5 medical reports dated 09.12.2020 and 15.12.2020. As per Ext.P3 report the gestational age was found to be 22 weeks and 6 days as on 09.12.2020. 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 the trauma of sexual assault. 2. When the matter came up for admission on 29.12.2020, this Court passed an interim order directing the District Medical Officer, Kottayam to constitute a medical board with all specialists required to conduct medical termination of pregnancy and file a report before this court traversing through the entire aspects. 3. The learned Government Pleader has made available the minutes of the Medical Board convened on 31.12.2020 with the WP(C).No.29209 OF 2020(A) 4 following members: _1. Dr.Shainimol A Thachankary (Consultant, Gynaecology) 2. Dr.Asha Sreedhar (Junior Consultant, Gynaecology)_ _3. Dr.Anju S.V. (Junior Consultant, Anaesthesia)_ _4. Dr.Leena Gem John, (Junior Consultant, Paediatrics)_ _5. Dr.Anjana Menon P. (Junior Consultant, Forensic Medicine)_ The opinion of the medical board is the following: ## _Opinion regarding continuation of pregnancy:_ _Continuation of pregnancy in teenage girls is having high risk of developing preeclampsia, anemia, post-partum haemorrhage, Hysterectomy, low birth weight for baby perinatal death, post-traumatic stress disorders._ _Opinion regarding the MTP:_ _Since the girl is 15 years and the pregnancy has advanced up to 26-28 were there is high risk for the life of the girl for the following reasons._ _1. Failure of expulsion of fetus by medical management for MTP may end up in hysterotomy and excessive hemorrhage and hysterectomy and may endanger her life._ _2. Incomplete expulsion of products of conception may lead to infection,bleeding and sepsis._ _3. Amniotic fluid embolism, pulmonary embolism may happen_ _4. Anesthetic complications during surgical procedures._ _Hence MTP should be done, if necessary, at a highly equipped tertiary care Centre with ICU facilities with incorporation of all specialities._ ## 4. From the report, it is seen that as on today the gestational age is 26 weeks 4 days+/-2 weeks. The medical board WP(C).No.29209 OF 2020(A) 5 has reported that the continuance of pregnancy is having high risk and post traumatic stress disorders. It is also stated that MTP has to be done in a hospital with highly equipped facilities. 5. 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 Section 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._ 6. 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 was 26 weeks, in view of the recommendation of the medical board and the medical report WP(C).No.29209 OF 2020(A) 6 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 pregnacny 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. 7. 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 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."_ 8. Therefore, petitioners 1 and 2 are permitted to subject 7 WP(C).No.29209 OF 2020(A) their daughter-3[rd] petitioner 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, Kottayam to see that the termination of pregnancy of the minor girl- the 3rd 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. 9. There will be a further direction to the doctors to take the tissue of the foetus for DNA identification and to 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. 10. As the minor girl is accommodated at Children's Home, WP(C).No.29209 OF 2020(A) **==> picture [7 x 8] intentionally omitted <==** Kottayam, there shall be a direction to the Superintendent of the Children's Home, Kottayam to produce the child victim before the Superintendent of the Government Medical College, Kottayam today itself. The Registry and all concerned, shall see that absolute privacy is maintained with respect to the identity of the petitioners 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** rkc **JUDGE** WP(C).No.29209 OF 2020(A) 9 ## **APPENDIX** ## **PETITIONER'S/S EXHIBITS:** **EXHIBIT P1** **A TRUE COPY OF THE BIRTH CERTIFICATE OF THE 3RD PETITIONER DATED 13.03.2006 ISSUED BY THE REGISTRAR ARPOOKARA GRAMA PANCHAYAT.** **EXHIBIT P2 A TRUE COPY OF THE REMAND REPORT IN CRIME NO.1171 OF 2020 OF THE THRIKODITHANAM POLICE STATION.** **EXHIBIT P3 A TRUE COPY OF THE ULTRASONOGRAPHIC REPORTOBS OF THE 3RD PETITIONER DATED 9.12.2020 ISSUED BY PRIME SCANS AND LABORATORIES.** **EXHIBIT P4 A TRUE COPY OF THE ORDER OF PLACEMENT OF A CHILD IN AN INSTITUTION DATED 14.12.2020 ISSUED BY THE CHILD WELFARE COMMITTEE KOTTAYAM.** **EXHIBIT P5 A TRUE COPY OF THE REPORT DATED 15.12.2020 ISSUED BY THE MEDICAL COLLEGE HOSPITAL, KOTTAYAM.**