Holding

The Supreme Court held that the petitioner is entitled to a medical termination of her pregnancy under Section 3(2)(i) and Section 5 of the MTP Act, as continuation endangers her life and the fetus is incompatible with extra‑uterine survival.

Summary

Mrs. X, a 22‑year‑old woman, was about 24 weeks pregnant when a medical board diagnosed her fetus with bilateral renal agenesis and anhydramnios, conditions that rendered the fetus non‑viable and posed a risk to the mother's physical and mental health. She filed a writ petition under Article 32 of the Constitution seeking permission to terminate the pregnancy under the Medical Termination of Pregnancy (MTP) Act, 1971. The Supreme Court, after examining the board’s report, held that continuation of the pregnancy endangered the mother's life and that the fetus could not survive outside the womb, thereby satisfying the criteria of Section 3(2)(i) and Section 5 of the MTP Act. The Court also addressed the procedural issue that the affidavit was sworn by a doctor rather than the petitioner, noting that a relator action is not permissible but that the petitioner’s competence was established by the board’s psychiatric evaluation. Consequently, the Court ordered that the termination be carried out by the hospital doctors under the supervision of the medical board, and directed that future similar actions be supported by the petitioner’s own affidavit.

Issues considered

The applicability of the MTP Act, 1971 for termination of pregnancy beyond 20 weeks when the mother's life is at risk and the fetus is non‑viable.
Whether the petitioner’s right to life and bodily integrity under Articles 21 and 32 of the Constitution entitles her to a termination.
The permissibility of a relator action when the affidavit is not sworn by the petitioner herself.

Legislation cited

Constitution of Indias. 21, s. 32
Medical Termination of Pregnancy Act, 1971s. 3(2)(i), s. 5

Subjects

Medical termination of pregnancyFetal anomalyBilateral renal agenesisAnhydramniosRight to lifeBodily integrityArticle 21Article 32MTP ActRelator actionAffidavitPregnancy beyond 20 weeks

Judgment

(2017] l S.C.R. 687

MRS. X AND ORS. A
v.
UNION OF INDIA AND ORS.
(Writ Petition (Civil) No. 81 of2017)
FEBRUARY 07, 2017 B

[S. A. BOBDE AND L. NAGESWARA RAO, JJ.]
Constitution of India - Arts. 32, 2 I - Medical termination of
24 weeks pregnancy - Sought by pregnant lady-petitioner no.I· -
Examination by medical board- Fetus suffering from bilalteral renal
agenesis (a/Jsence of kidneys) and anhydramnios (absence of
c
amniotic fluid/'- Risk of death within womb and no chance of long
term post natal survival and continuation of pregnancy could
endanger physical and mental health of the petitioner - Held: Mother
has a right to preserve her life in view of foreseeable danger in
case the pregnancy is allowed to run its fall course - Right of.bodily D
integrity calls for a permission to allow her to terminate her
pregnancy - Report of the Medical Board warrants inference that
the continuance of the pregnancy involves the risk to the life of the
petitioner and a possible grave injury to her physical or mental
health as well as death of fetus outside the womb - Thus, the
E
petitioner permitted to undergo termination of her pregnancy under
the provisions of the Act - Medical Termination of Pregnancy Act,
I97 I - ss.3(2)(i), 5.
Medical Termination of Pregnancy Act, I 97 I - Termination of
pregnancy - So!fght for by 24 weeks pregnant lady-petitioner No.
F
I -Affuiavit not sworn by petitioner no.I but by the doctor-petitioner
No. 3 - Effect of - Held: A relator action may not be permitted in a
case of this kind - In a given case petitioner no. I may be under
some misconception or under coercion - However, petitioner no. I
was examined by the Medical Board about her mental condition -
She did not have any psychiatric or emotional problems - Thus, G
petitioner no. I is allowed the relief - However, such action must be
supported by affidavits of the petitioner no. I herself - Hospital
would take her consent before terminating her pregnancy -Affidavit.
Suchita Srivastava and Anr. v. Chandigarh
Administration (2009) 9 SCC 1 - referred to. H
687
688 SUPREME COURT REPORTS [2017] I S.C.R.

A Case Law Reference
(2009) 9 sec i referred to Para8
CIVIL ORIGINAL JURISDICTION: Writ Petition (Civil) No. 81
of2017
B Under Article 32 of the Constitution oflndia.
Sneha Mukherjee, Satya Mitra, Advs. for the Petitioner.s.
Ranjit Kumar, S.G., Ms. Sadhana Sandhu, G. S. Makker, Nish,mt R.
Katneshwarkar, Advs. for the Respondents.
The following Order of the Court was delivered
c
ORDER
1. Application for non-disclosure ofnames and detail of petitioner
No. (and 2 is allowed.
2. The. P-etitioner No. 1- Mrs.Xis about 22 years' old.· She has
D approached this Court under Artilce 32 of the Constitution oflndia seeking
directions'to the respondents to allow her to undergo medical termination
of her pregnancy. According to her, fetus which is about 22 weeks old .
on the date of the petitio!l has a condition knowns as bilateral. re~al .
agenesis and anhydramnios. She apprehends that.the fetus has no chance
E of survival and the delievery may endanger her life.
3. In order to verify the condition of petitioner No: I, this Court by
order dated 03.02.2017 while issuing notice to the respondents directed
examination of the petitioner by a medical Board consisting of following
seven Doctors :
F I. Dr. Avinash N. Supe, Director (Medical Education & Major
Hospitals) & Dean (G&K)- Chairman
2. Dr. Shubhangi Parkar, Professor and HOD, Psychiatry, J(EM
Hospital
3. Dr. Amar Pazare, professor and HOD, Medicine, KEM Hosptial
G
4. Dr. Indrani Hemantkuinar Chincholi, Professor and HOD:
Anaesthesia, KEM Hospital .
5. Dr. Y.S. Nandanwar, Professor and HOD, Obstetrics, KEM
. Hospitals
H
MRS. X AND ORS. v. UNION OF INDIA AND ORS 689

6. Dr. Anahita Chauhan, Professor and Unit Head, Obstetrics & A
Gynecology, LTMMC and LTMG Hospitals
7. Dr. Hemangini Thakkar, Addi. Professor, Radiology, KEM
Hospital.
·" 4. By its reportdated 04.02.2017, the Medical Board as constituted
· bytflis Court has given its expert opinion upon reviewing the complete B
·· hist'ory as narrated by the petitimier No. l and her brother alongwith all
'"ttfe'piipei's:'The petitioner No. ·1 was examined by all the Board Members
'with' specific recourse to the specialty:
·... {.._ ··. •'
... r· : .5.,T~e learned Solicitor.General who appears on behalf of Union of
. J119ia had the ·report evalu.ated by ,Doctor Veena ·Dhawan from the c
0 /Vlipis.try of Health. The sai.d Doctor does not disagree with the.findings
".~yth~,\\,1edical Board &nd is also in agreement with the proposed action
,by th~ Medical Board. The salient features of the report are:
"'.. Ultrasonography diagnosis is single live fetus with gestational
age of24 weeks 3 days with bilateral renal agenesis with double D
. outlet right ventricle with ventricu Jar septa I defeat with t\'IO vessel
cord with anhydramnios ....
Opinion ofPediatric Surgeon in charge of Birth Defect Clinic:
There is risk of intrauterine fetal death/ sti ti birth and there is no
chance of long term post natal survival, and no curative treatment E
is available at present for bilateral rengal agenesis. '.
6. There is thus a clear diagnosis of the condition of the single live
fetus which is said to have bialateral renal agenesis wheich means the
fetus has no kidneys and anhydramnios which mean~ that th~re is an
absence of amniotic fluid in the womb. Further, there is a clear F
observation that there is a risk of intrauterine fetal death, i.e. death
wi)hin womb and there is no chance of a Jong term post natal survival.
What is .important is that there is no curative treatment available at present
for bilat.eral renaJ agenesis.
7 ;The Medical Board has opined that the condition of.the fetus is G
incompatible with extra-uterine life, i.e. outside the womb .•.because
prolonged absence of amniotic fluid results in pulmonary hypoplasia
leading to.severe respiratory insufficiency at birth. From the point of
vie~·of th~ petitioner the report ha~ observed. risk to the mother since
conti~iiatio~ of pregnancy can enda~ger her physical and oiental health.
H
690 SUPREME COURT REPORTS [2017] I S.C.R.

A 8. We have alreadyvide order dated 16.01.2017 upheld the right of
a mother to preserve her life in view of foreseeable danger in case the
pregnancy is allowed to run its full course. This Court in that case ~elied
upon the case of Suchita Srivastava and Anr. vs. Chandigarh
Administration [(2009) 9 SCC I], where a bench of three Judges held
"a woman's right to make reproductive choices is also a dimension of
B
'personal liberty' as understood under Article 21 of the Constitution". In
these circumstances we find that the right of bodily integrity calls for a
permission to allow her to terminate her pregnancy. The report of the
Medical Board clearly warrants the inference that the continuance of.
the pregnancy involves the risk to the life of the petitioner and a possible
c grave injury to her physical or mental health as required by Section 3
(2)(i) of the Medical Termination of Pregnancy Act, 197L It may be
noted that Section 5 of the Act enables termination of pregnancy where
an opinion ifformed by not less than two medical practitioners in a case
where opinion is for the termination of such pregnancy is immediately
necessary to save the life of the pregnant woman.
D
9. Though the current pregnancy of the petitioner is about 24'" weeks
and endanger to the life and inevitable to the death of the fetus outside
womb, we consider it appropriate to permit the petitioner to undergo
termination of her pregnancy under the provisions of the Medical
Termination of Pregnancy Act, 1971. We order accordingly.
E
10. The termination of pregnancy of petitioner no. I will be performed
by the Doctors of the hospital where she has undergone medical check-
up. Further, termination of her pregnancy would be supervised by the
above stated Medical Board who shall maintain complete record of the
procedure which is to be performed on petitioner No. I for termination
F of her pregnancy.
11. Shri Ranjit Kumar, learned solicitor General rightly poinls out
that the affidavit in the present case is not sworn by petitioner No. I
who seeks termination of her pregnancy and is sworn by a Doctor who
is petitioner No.3. We might note that a relator action may not be permitted
G in a case of this kind. There would be various circumstances about which
the Court must be assured of before the order is made. Conceivably, in
a given case petitioner No. 1 may be under some miscoriception or
under coercion. We do not find that to be case here because Petitioner
No. I has been examined by the Medical Board about her merital
H condition. In fact the Board has made a 'psychiatric evaluation of her

•
MRS. X AND ORS. v. UNION OF INDIA AND ORS 691

and has stated that the patient is co-operative and coherent and has no A
psychiatric or emotional problems. Hence we do not propose to deny
relief to petitioner No. I. It is however, made clear that such action
must be supported by affidavits of the petitioner No. I herself. Needless
to state that KEM Hospital will take her consent before terminating her
pregnancy.
B
12. With the aforesaid directions, the instant writ petition is allowed
in te1ms of prayer (a) seeking direction to the respondents to allow
petitioner no. I to undergo medical termination of her pregnancy.

Nidhi Jain Writ Petition allowed. c