Meera Santosh Pal and Ors. v. Union of India and Ors. (2017)

Introduction 

This landmark judgment addresses the constitutional right to reproductive autonomy under Article 21, establishing that a woman's right to bodily integrity and preservation of life includes the right to terminate pregnancy when the fetus is non-viable and continuation poses grave danger to her physical and mental health, even beyond the statutory gestational limits prescribed under the Medical Termination of Pregnancy Act, 1971. 

Facts 

• Meera Santosh Pal, a 22-year-old woman, approached the Supreme Court under Article 32 of the Constitution seeking permission to undergo medical termination of her pregnancy. 
• Her fetus was diagnosed with Anencephaly, a severe congenital defect characterized by unformed skull bones, which is both untreatable and invariably fatal, causing the infant's death during or shortly after birth. This condition also endangered the mother's life. 
• As of January 12, 2017, the petitioner was in her 24th week of pregnancy, which exceeded the statutory limit under the MTP Act for termination without special permission. 
• The Supreme Court issued notice to respondents and directed examination by a seven-member Medical Board from KEM Hospital, Mumbai, consisting of specialists in medical education, psychiatry, medicine, anesthesia, obstetrics and gynecology, and radiology. 
• The Medical Board conducted comprehensive evaluation on January 12, 2017, including general medical, radiological, psychiatric, and anesthetic assessments, along with obstetric evaluation by two obstetricians and ultrasonography. 
• The Board's findings confirmed a 24-week pregnancy with a single live fetus suffering from anencephaly with mild polyhydramnios and hypotelorism. The fetus was without a skull and would not survive outside the uterus. 
• Psychiatric evaluation revealed that the petitioner was coherent, possessed average intelligence with good comprehension, understood the abnormality of her fetus and the high risk of fetal mortality, and had her husband's support in decision-making. 
• The Medical Board concluded that the fetus's condition was incompatible with extra-uterine life, and continuation of pregnancy would gravely endanger the petitioner's physical and mental health, while termination risks remained within acceptable limits with institutional backup. 

Issues Involved 

• Whether the petitioner has a constitutional right under Article 21 to terminate her pregnancy beyond the statutory gestational limit when the fetus is diagnosed with a fatal abnormality incompatible with life and continuation poses grave danger to her physical and mental health? 
• Whether the right to bodily integrity and reproductive autonomy permits a woman to make an informed choice to terminate pregnancy when medical evidence establishes that the fetus cannot survive outside the uterus? 
• Whether the circumstances satisfy the requirements under Section 3(2)(i) of the Medical Termination of Pregnancy Act, 1971, which permits termination when continuation involves risk to the life of the pregnant woman or grave injury to her physical or mental health? 

Court's Observations 

Reproductive Rights as Fundamental Rights: 

• The Court relied on the precedent established in Suchita Srivastava and Anr. v. Chandigarh Administration (2009), which held that a woman's right to make reproductive choices constitutes a dimension of personal liberty under Article 21 of the Constitution. The Court emphasized that reproductive choices encompass both the right to procreate and to abstain from procreating. 

Right to Privacy, Dignity, and Bodily Integrity: 

• The Court recognized that reproductive rights include respecting a woman's right to privacy, dignity, and bodily integrity.  
• These rights mean there should be no restriction on the exercise of reproductive choices, including decisions about continuation or termination of pregnancy. 

Right to Life and Self-Preservation: 

• The Court focused on the petitioner's right to preserve her life against foreseeable danger, noting that since the fetus could not survive outside the uterus without a skull, there was no medical or legal justification for requiring the pregnancy to continue to full term.  
• The Court emphasized that the petitioner had made an informed choice after understanding the medical realities of her situation.  

Application of MTP Act Provisions: 

• While acknowledging that the pregnancy had reached the 24th week, the Court held that the Medical Board's report clearly warranted the inference that continuation involved risk to the life of the pregnant woman and possible grave injury to her physical or mental health, satisfying the requirements of Section 3(2)(i) of the Medical Termination of Pregnancy Act, 1971. 

Conclusion 

This judgment reinforces the constitutional protection of reproductive rights and establishes that preservation of a woman's life and health takes precedence when pregnancy involves a non-viable fetus and poses grave danger to her wellbeing, recognizing the fundamental importance of informed consent and decisional autonomy in reproductive choices.