A (Mother of X) v. State of Maharashtra (2024)

Introduction 

This is a landmark judgment which addresses the constitutional rights of pregnant persons, particularly minors who are victims of sexual assault, and establishes comprehensive guidelines for medical boards in late-term abortion cases beyond the statutory limit of twenty-four weeks. 

Facts 

• A fourteen-year-old minor girl, 'X', was a victim of sexual assault in September 2023.  
• The pregnancy was discovered on March 20, 2024, at approximately 25 weeks gestation, and an FIR was registered under the IPC and POCSO Act, 2012. 
• The initial Medical Board at JJ Group of Hospitals deemed 'X' fit for termination but required High Court permission due to exceeding the 24-week limit.  
• A subsequent 'clarificatory' opinion denied termination citing advanced gestational age and absence of fetal abnormalities. The Bombay High Court dismissed the petition on statutory time limit grounds. 
• The Supreme Court intervened and directed a fresh medical board at Sion Hospital, which reported that continuation would negatively impact the minor's health. The Court initially ordered termination on April 22, 2024.  
• However, the parents subsequently expressed preference to continue the pregnancy to term for adoption. Given the advanced stage (nearing 31 weeks), the parents decided against termination. 

Issues Involved 

• Whether the High Court was justified in refusing permission for medical termination solely on the basis of gestational age exceeding the statutory limit, without considering the impact on the physical and mental health of the minor victim of sexual assault? 
• What is the mandatory scope of opinion that must be provided by a medical board in cases involving termination beyond the prescribed gestational limit, particularly concerning the comprehensive evaluation of the pregnant person's physical and emotional well-being? 
• Whether the Court should recall its order allowing termination based on the subsequent decision of the minor and her guardians to continue the pregnancy, thereby upholding the paramountcy of reproductive autonomy and the welfare of the minor? 

Court's Observations 

Primacy of Consent and Autonomy: 

• The Court emphasized that the decision to terminate or continue pregnancy is deeply personal, rooted in fundamental rights under Article 21. The choice to continue pregnancy belonged to the individual alone and must be respected, prioritizing the minor's safety and welfare. 

Mandatory Scope of Medical Board Opinion: 

• Medical boards must not restrict opinions to verifying fetal abnormalities under Section 3(2-B) of the MTP Act. When pregnancy exceeds 24 weeks, boards must comprehensively evaluate the physical and mental health impact on the pregnant person. 

Judicial Obligation: 

• Courts cannot refuse abortion merely on gestational age grounds if continuation is detrimental to health. In cases involving minors with divergence between minor and guardians, the minor's view must be an important factor. 

Accountability of Medical Boards: 

• The Court criticized contradictory medical opinions issued without re-examining the patient, noting such uncertainty causes undue trauma. 

Ratio Decidendi: 

• The judgment established that medical boards have a mandatory duty to comprehensively evaluate the physical and mental health impact on pregnant persons in late-term abortion cases, and courts cannot deny termination solely on gestational age grounds when health is at risk. 

Conclusion 

The Court recalled its order dated April 22, 2024, respecting the revised choice of the minor and her parents to continue the pregnancy. Sion Hospital was directed to bear all expenses for ongoing care and delivery. The State Government was directed to facilitate adoption if desired. This judgment reinforces constitutional rights of pregnant persons and establishes mandatory duties for medical boards in late-term abortion cases under the MTP Act, 1971.