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Supreme Court of India

XversusTHE PRINCIPAL SECRETARY HEALTH AND FAMILY WELFARE DEPARTMENT & ANR.

Citation
2022 INSC 740
Decided
21 July 2022
Disposal
Directions issued

Holding

The distinction between married and unmarried women is not supported by the purpose of the MTP Act; unmarried women are entitled to the benefit of Section 3(2)(b) and must be included within the ambit of Rule 3B.

Summary

The petitioner, an unmarried woman residing in Delhi, discovered she was 22 weeks pregnant after a consensual relationship ended and she lacked livelihood to raise a child. She filed a writ petition seeking permission to terminate the pregnancy under Section 3(2)(b) of the Medical Termination of Pregnancy (MTP) Act and to be included within Rule 3B of the MTP Rules, which at present listed only certain categories of women. The Delhi High Court rejected her relief, holding that Rule 3B did not cover unmarried women, and the matter was taken on special leave to the Supreme Court. The Supreme Court examined the statutory scheme, the 2021 amendment replacing "husband" with "partner", and held that the exclusion of unmarried women violated the purpose of the Act and the constitutional guarantees of equality (Art. 14) and personal liberty (Art. 21). Consequently, the Court modified the High Court's order, directing a Medical Board to consider the petitioner's request and allowing the termination, thereby granting the petition.

Issues considered

  • Whether an unmarried woman can be covered under Rule 3B of the MTP Rules for termination of pregnancy up to 24 weeks under Section 3(2)(b) of the MTP Act.
  • Whether the exclusion of unmarried women from Rule 3B violates Articles 14 and 21 of the Constitution.
  • Whether the phrase "change of marital status" in Rule 3B should be interpreted to include women whose relationship has ended without marriage.

Legislation cited

Subjects

Medical Termination of PregnancyUnmarried womanRule 3BSection 3(2)(b)Article 14Article 21Reproductive rightsAbortionConstitutional law

Judgment

246                     [2022]REPORTS
              SUPREME COURT   12 S.C.R. 246              [2022] 12 S.C.R.


A                                      X
                                       v.
          THE PRINCIPAL SECRETARY HEALTH AND FAMILY
                  WELFARE DEPARTMENT & ANR.
B              (Special Leave Petition (Civil) No. 12612 of 2022)
                                JULY 21, 2022
        [DR DHANANJAYA Y CHANDRACHUD, SURYA KANT
                   AND A S BOPANNA, JJ.]
             Medical Termination of Pregnancy Act 1971 – s. 3(2)(b), Rule
C
      3B – Medical Termination of Pregnancy Rules 2003 – Termination
      of pregnancy of an unmarried woman – Petitioner was in a
      consensual relationship and in month of June 2022 she learnt that
      she was pregnant (22 weeks) – Petitioner stated that in absence of
      source of livelihood, she would be unable to nurture a child –
D     Petitioner deserted by her partner – She decided to terminate the
      pregnancy – Writ petition before the High Court – High Court
      declined to grant relief – On appeal, held: Letting the petitioner
      suffer from an unwanted pregnancy would be contrary to the intent
      of law – Petitioner should not be denied the benefit of MTP Act on
      the ground that she is unmarried women – Distinction between
E
      married and unmarried women does not bear nexus to the basic
      purpose and object which is sought to be achieved by parliament
      especially through the provisions of Explanation 1 to s.3 of the
      MTP Act – Ad Interim order to carry out abortion safely was passed
      – Ad interim direction of High Court stands modified.
F
            Suchita Srivastava v. Chandigarh Administration (2009)
            9 SCC 1 : [2009] 13 SCR 989; Justice K.S. Puttaswamy
            (Retd.) and Anr. v. Union of India and Ors. (2017) 10
            SCC 1 : [2017] 10 SCR 569, (2016) SCC OnLine Bom
            8426; S Khusboo v. Kanniammal (2010) 5 SCC 600 :
G           [2010] 5 SCR 322 – relied on.
            High Court on its Own Motion v. State of Maharashtra
            2017 Cri LJ 218 (Bom HC) – referred to.
                            Case Law Reference

H     [2009] 13 SCR 989          relied on               Para 19
                                      246
X v. THE PRINCIPAL SECRETARY HEALTH AND FAMILY WELFARE                        247
                       DEPARTMENT

[2017] 10 SCR 569             relied on                 Para 19               A
[ 2010] 5 SCR 322             relied on                 Para 20
      EXTRA-ORDINARY APPELLATE JURISDICTION: Special
Leave Petition (Civil) No. 12612 of 2022.
      From the Judgment and Order dated 15.07.2022 of the High Court          B
of Delhi at New Delhi in C. M. Application No.30708 of 2022 in W. P.
(C) 10602 of 2022.
         Dr. Amit Mishra, Rahul Sharma, Advs. for the Petitioner.
     Ms. Aishwarya Bhati, ASG, Ms. Deepabali Datta, Ketan Paul,
Aman Sharma, B. L. N. Shibani, G. S. Makker, Advs. for the Respondents.       C
         The Judgment of the Court was delivered by
         DR DHANANJAYA Y CHANDRACHUD, J.
         1. Issue notice.
     2. Ms Aishwarya Bhati, Additional Solicitor General, with Mr G S         D
Makker, AOR, accepts notice on behalf of the second respondent.
       3. We have heard Dr Amit Mishra, counsel appearing on behalf
of the petitioner. We have requested Ms Aishwarya Bhati to assist the
Court on the interpretative aspects of Section 3(2)(b) of the Medical
Termination of Pregnancy Act 19711 and Rule 3B of the Medical                 E
Termination of Pregnancy Rules 20032.
       4. The petitioner is a permanent resident of Manipur and is stated
to be currently residing in Delhi. The petitioner has averred that she was
in a consensual relationship and, in the month of June 2022 she learnt
that she was pregnant. On 5 July 2022, an ultrasound scan revealed a          F
single intrauterine pregnancy of a term of twenty-two weeks. The
petitioner decided to terminate the pregnancy; her relationship has failed.
She has stated that she is the eldest amongst five siblings and her parents
are agriculturists. The petitioner has stated that she holds a BA degree
and, in the absence of a source of livelihood, she would be unable to         G
raise and nurture a child. She moved a writ petition before the High
Court of Delhi.


1
    “MTP Act”
2
    “MTP Rules”                                                               H
248               SUPREME COURT REPORTS                       [2022] 12 S.C.R.


A           5. The Division Bench of the High Court, by an order dated
      15 July 2022, issued notice restricted only to prayer C of the petition, in
      which the petitioner has sought a direction for the inclusion of an
      unmarried woman within the ambit of Rule 3B of the MTP Rules for the
      termination of pregnancy in terms of the provisions of clause (b) of sub-
      section (2) of Section 3 of the MTP Act.
B
            6. No notice has been issued by the High Court on prayer A or
      prayer B of the petition which effectively stand rejected.
            7. For convenience of reference, prayers A, B and C of the petition
      before the High Court are extracted below:
C           “A.     Permit the Petitioner to terminate her ongoing pregnancy
                    through registered medical practitioners at any approved
                    private or government center or Hospital before 15.07.2022
                    as her relief will be infructuous after that as the pregnancy
                    will be of around 24 Weeks by that time;
D           B.      Restrain the Respondent from taking any coercive action
                    or criminal proceedings against the Petitioner or any
                    Registered Medical Practitioner terminating the pregnancy
                    of the petitioner at any approved private center or hospital
                    registered by Govt NCT of Delhi;
E           C.      Direct the Respondent to include unmarried woman also
                    within the ambit of the Rule 3B of the Medical Termination
                    of Pregnancy Rules 2003 (as amended on 21.10.2021) for
                    termination of pregnancy under clause (b) of sub-section
                    (2) Section 3 of the MTP Act, for a period of up to twenty-
F                   four weeks;
             The petitioner has completed 24 weeks of her pregnancy on 18
      July 2022.
            8. Section 3 of the MTP Act reads as follows:
            “3. When pregnancies may be terminated by registered medical
G           practitioners.-
            (1)     Notwithstanding anything contained in the Indian Penal Code
                    (45 of 1860), a registered medical practitioner shall not be
                    guilty of any offence under that Code or under any other
                    law for the time being in force, if any pregnancy is
H
X v. THE PRINCIPAL SECRETARY HEALTH AND FAMILY WELFARE                       249
      DEPARTMENT [DR DHANANJAYA Y CHANDRACHUD, J.]

          terminated by him in accordance with the provisions of this        A
          Act.
    (2)   Subject to the provisions of sub-section (4), a pregnancy
          may be terminated by a registered medical practitioner,—
          (a) where the length of the pregnancy does not exceed
              twenty weeks, if such medical practitioner is, or              B

          (b) where the length of the pregnancy exceeds twenty
              weeks but does not exceed twenty-four weeks in case
              of such category of woman as may be prescribed by
              rules made under this Act, if not less than two registered
              medical practitioners are, of the opinion, formed in good      C
              faith, that—
          (i) the continuance of the pregnancy would involve a risk
              to the life of the pregnant woman or of grave injury to
              her physical or mental health; or
                                                                             D
          (ii) there is a substantial risk that if the child were born, it
               would suffer from any serious physical or mental
               abnormality.
          Explanation 1.—For the purposes of clause (a), where any
          pregnancy occurs as a result of failure of any device or
                                                                             E
          method used by any woman or her partner for the purpose
          of limiting the number of children or preventing pregnancy,
          the anguish caused by such pregnancy may be presumed
          to constitute a grave injury to the mental health of the
          pregnant woman.
                                                                             F
          Explanation 2.—For the purposes of clauses (a) and (b),
          where any pregnancy is alleged by the pregnant woman to
          have been caused by rape, the anguish caused by the
          pregnancy shall be presumed to constitute a grave injury to
          the mental health of the pregnant woman.
    (2A) The norms for the registered medical practitioner whose             G
         opinion is required for termination of pregnancy at different
         gestational age shall be such as may be prescribed by rules
         made under this Act.

                                                                             H
250               SUPREME COURT REPORTS                        [2022] 12 S.C.R.


A           (2B) The provisions of sub-section (2) relating to the length of
                 the pregnancy shall not apply to the termination of pregnancy
                 by the medical practitioner where such termination is
                 necessitated by the diagnosis of any of the substantial foetal
                 abnormalities diagnosed by a Medical Board.
B           (2C) Every State Government or Union territory, as the case
                 may be, shall, by notification in the Official Gazette,
                 constitute a Board to be called a Medical Board for the
                 purposes of this Act to exercise such powers and functions
                 as may be prescribed by rules made under this Act.
C           (2D) The Medical Board shall consist of the following, namely:—
                    (a) a Gynaecologist;
                    (b) a Paediatrician;
                    (c) a Radiologist or Sonologist; and
D                   (d) such other number of members as may be notified in
                        the Official Gazette by the State Government or Union
                        territory, as the case may be.
            (3)     In determining whether the continuance of a pregnancy
                    would involve such risk of injury to the health as is mentioned
E                   in sub-section (2), account may be taken of the pregnant
                    woman’s actual or reasonably foreseeable environment.
            (4)     (a) No pregnancy of a woman, who has not attained the
                    age of eighteen years, or, who having attained the age of
                    eighteen years, is a mentally ill person, shall be terminated
F                   except with the consent in writing of her guardian.
                    (b) Save as otherwise provided in clause (a), no pregnancy
                    shall be terminated except with the consent of the pregnant
                    woman.”
            9. Clause (a) of sub-section (2) of Section 3 permits the termination
G     of pregnancy where the length of pregnancy does not exceed twenty
      weeks. Clause (b) permits termination where the length of pregnancy
      exceeds twenty weeks but does not exceed twenty four weeks for such
      categories of women “as may be prescribed by Rules made under this
      Act”. However, an opinion must be formed by not less than two registered
H     medical practitioners that inter alia “the continuance of the pregnancy
X v. THE PRINCIPAL SECRETARY HEALTH AND FAMILY WELFARE                       251
      DEPARTMENT [DR DHANANJAYA Y CHANDRACHUD, J.]

would involve a risk to the life of the pregnant woman or of grave injury    A
to her physical or mental health”.
       10. Explanation 1 to Section 3 stipulates that for the purpose of
clause (a), where a pregnancy has occurred as a result of a failure of
any device or method used by any woman or her partner for the purpose
of limiting the number of children or preventing pregnancy, the anguish      B
caused by such pregnancy shall be presumed to constitute a grave injury
to the mental health of the pregnant woman. Explanation 1 evidently
qualifies clause (a) but not clause (b).
      11. Rule 3B of the MTP Rules has been made in pursuance of the
provisions of clause (b) of sub-section (2) of Section 3 of the MTP Act.     C
Rule 3B is as follows:
      “3B. Women eligible for termination of pregnancy up to twenty-
           four weeks.- The following categories of women shall be
           considered eligible for termination of pregnancy under clause
           (b) of sub-section(2) section 3 of the Act, for a period of up    D
           to twenty-four weeks, namely:-
             (a)   survivors of sexual assault or rape or incest;
             (b)   minors;
             (c)   change of marital status during the ongoing pregnancy
                                                                             E
                   (widowhood and divorce);
             (d)   women with physical disabilities [major disability as
                   per criteria laid down under the Rights of Persons
                   with Disabilities Act, 2016 (49 of 2016)];
             (e)   mentally ill women including mental retardation;          F
             (f)   the foetal malformation that has substantial risk of
                   being imcompatible with life or if the child is born it
                   may suffer from such physical or mental abnormalities
                   to be seriously handicapped; and
             (g)   women with pregnancy in humanitarian settings or          G
                   disaster or emergency situations as may be declared
                   by the Government.”
    12. The High Court held that since the petitioner is an unmarried
woman whose pregnancy arose out of a consensual relationship, her
                                                                             H
252             SUPREME COURT REPORTS                           [2022] 12 S.C.R.


A     case is “clearly not covered” by any of the above clauses of Rule 3B
      and, as a consequence, Section 3(2)(b) is not applicable.
             13. On the submission that Rule 3B, insofar as it excludes an
      unmarried woman, is violative of Article 14 of the Constitution, the High
      Court has issued notice on the writ petition. However, it held that as of
B     the date of its order, it was not open to itto traverse beyond the provisions
      of Rule 3B in the exercise of the jurisdiction under Article 226 of the
      Constitution.
            14. Prima facie, quite apart from the issue of constitutionality
      which has been addressed before the High Court, it appears that the
C     High Court has taken an unduly restrictive view of the provisions of
      clause (c) of Rule 3B. Clause (c) speaks of a change of marital status
      during an ongoing pregnancy and is followed in parenthesis by the words
      “widowhood and divorce”. The expression “change of marital status”
      should be given a purposive rather than a restrictive interpretation. The
      expressions “widowhood and divorce” need not be construed to be
D     exhaustive of the category which precedes it.
            15. The fundamental principle of statutory interpretation is that
      the words of a statute must be read in their entire context and in their
      grammatical and ordinary sense harmoniously with the scheme of the
      Act and the intent of the legislature. Parliament by amending the MTP
E     Act through Act 8 of 2021 intended to include unmarried women and
      single women within the ambit of the Act. This is evident from the
      replacement of the word ‘husband’ with ‘partner’ in Explanation I of
      Section 3(2) of the Act.
             16. Explanation 1 expressly contemplates a situation involving an
F     unwanted pregnancy caused as a result of the failure of any device or
      method used by a woman or her partner for the purpose of limiting the
      number of children or preventing pregnancy. The Parliamentary intent,
      therefore, is clearly not to confine the beneficial provisions of the MTP
      Act only to a situation involving a matrimonial relationship. On the contrary,
G     a reference to the expression “any woman or her partner” would indicate
      that a broad meaning and intent has been intended to be ascribed by
      Parliament. The statute has recognized the reproductive choice of a
      woman and her bodily integrity and autonomy. Both these rights embody
      the notion that a choice must inhere in a woman on whether or not to
      bear a child. In recognizing the right the legislature has not intended to
H
X v. THE PRINCIPAL SECRETARY HEALTH AND FAMILY WELFARE                          253
      DEPARTMENT [DR DHANANJAYA Y CHANDRACHUD, J.]

make a distinction between a married and unmarried woman, in her                A
ability to make a decision on whether or not to bear the child. These
rights, it must be underscored, are in consonance with the provisions of
Article 21 of the Constitution.
       17. In this case, the petitioner submits that she was deserted by
her partner at the last stage in June 2022 causing her immense mental           B
agony, trauma, and physical suffering. Excluding unmarried women and
single women from the ambit of the statute goes against the purpose of
the legislation. The Statement of Objects and Reasons of the MTP Act
seeks to “liberalise certain existing provisions relating to termination
of pregnancy … (1) as a health measure—when there is danger to
the life or risk to physical or mental health of the woman”.                    C

      18. A comparison between the two provisions before and after
the 2021 amendment is tabulated below:


                                                                                D




                                                                                E
       The above table shows that the phrase ‘married woman’ was
replaced by ‘any woman’ and the word ‘husband’ was replaced by
‘partner’. But evidently, there is a gap in the law : while Section 3 travels
beyond conventional relationships based on marriage, Rule 3B of the
MTP Rules does not envisage a situation involving unmarried women,
but recognizes other categories of women such as divorcees, widows,             F
minors, disabled and mentally ill women and survivors of sexual assault
or rape. There is no basis to deny unmarried women the right to medically
terminate the pregnancy, when the same choice is available to other
categories of women.
      19. A woman’s right to reproductive choice is an inseparable part         G
of her personal liberty under Article 21 of Constitution. She has a
sacrosanct right to bodily integrity. In Suchita Srivastava v Chandigarh
Administration3, this Court has recognized that a woman’s right to
reproductive autonomy is a dimension of Article 21 of the Constitution:
3
    (2009) 9 SCC 1                                                              H
254               SUPREME COURT REPORTS                           [2022] 12 S.C.R.


A              “22. There is no doubt that a woman’s right to make reproductive
               choices is also a dimension of “personal liberty” as understood
               under Article 21 of the Constitution of India. It is important to
               recognise that reproductive choices can be exercised to procreate
               as well as to abstain from procreating. The crucial consideration
               is that a woman’s right to privacy, dignity and bodily integrity should
B
               be respected. This means that there should be no restriction
               whatsoever on the exercise of reproductive choices such as a
               woman’s right to refuse participation in sexual activity or
               alternatively the insistence on use of contraceptive methods.”
            In Justice K.S. Puttaswamy (Retd.) and Anr v. Union of India
C     and Ors,4 the decision of a woman to procreate or abstain from
      procreating has been recognized as a facet of her right to lead a life with
      dignity and the right to privacy under Article 21 of the Constitution:
               “298. [p]rivacy of the body entitles an individual to the integrity of
               the physical aspects of personhood. The intersection between one’s
D              mental integrity and privacy entitles the individual to freedom of
               thought, the freedom to believe in what is right, and the freedom
               of self-determination. When these guarantees intersect with
               gender, they create a private space which protects all those
               elements which are crucial to gender identity. The family, marriage,
E              procreation and sexual orientation are all integral to the dignity of
               the individual. Above all, the privacy of the individual recognises
               an inviolable right to determine how freedom shall be exercised.”
            The Bombay High Court in High Court on its Own Motion v.
      State of Maharashtra,5 observed as follows:
F              “14. A woman’s decision to terminate a pregnancy is not a frivolous
               one. Abortion is often the only way out of a very difficult situation
               for a woman. An abortion is a carefully considered decision taken
               by a woman who fears that the welfare of the child she already
               has, and of other members of the household that she is obliged to
G              care for with limited financial and other resources, may be
               compromised by the birth of another child. These are decisions
               taken by responsible women who have few other options. They
               are women who would ideally have preferred to prevent an

      4
          (2017) 10 SCC 1
H     5
          2017 Cri LJ 218 (Bom HC); (2016) SCC OnLine Bom 8426
X v. THE PRINCIPAL SECRETARY HEALTH AND FAMILY WELFARE                         255
      DEPARTMENT [DR DHANANJAYA Y CHANDRACHUD, J.]

         unwanted pregnancy, but were unable to do so. If a woman does         A
         not want to continue with the pregnancy, then forcing her
         to do so represents a violation of the woman’s bodily
         integrity and aggravates her mental trauma which would
         be deleterious to her mental health”
                                                   (Emphasis Supplied)         B
       20. Denying an unmarried woman the right to a safe abortion
violates her personal autonomy and freedom. Live-in relationships have
been recognized by this Court. In S Khusboo v. Kanniammal,6 this
Court observed that criminal law should not be weaponized to interfere
with the domain of personal autonomy. It was observed:                         C
         “46. While there can be no doubt that in India, marriage is an
         important social institution, we must also keep our minds open to
         the fact that there are certain individuals or groups who do not
         hold the same view. To be sure, there are some indigenous groups
         within our country wherein sexual relations outside the marital       D
         setting are accepted as a normal occurrence. Even in the
         societal mainstream, there are a significant number of
         people who see nothing wrong in engaging in premarital
         sex. Notions of social morality are inherently subjective
         and the criminal law cannot be used as a means to unduly
         interfere with the domain of personal autonomy. Morality              E
         and criminality are not co-extensive.”
                                                   (Emphasis Supplied)
       21. On the above premises, we are inclined to entertain the Special
Leave Petition. In the meantime, we are of the view that allowing the          F
petitioner to suffer an unwanted pregnancy would be contrary to the
intent of the law enacted by Parliament. Moreover, allowing the petitioner
to terminate her pregnancy, on a proper interpretation of the statute,
prima facie, falls within the ambit of the statute and the petitioner should
not be denied the benefit on the ground that she is an unmarried woman.
The distinction between a married and unmarried woman does not bear            G
a nexus to the basic purpose and object which is sought to be achieved
by Parliament which is conveyed specifically by the provisions of
Explanation 1 to Section 3 of the Act. The petitioner had moved the

6
    (2010) 5 SCC 600                                                           H
256                   SUPREME COURT REPORTS                        [2022] 12 S.C.R.


A     High Court before she had completed 24 weeks of pregnancy. The delay
      in the judicial process cannot work to her prejudice.
               22. In the above background, we pass the following ad interim
      order:
               (i)      We request the Director of the All India Institute of Medical
B                       Sciences, Delhi to constitute a Medical Board in terms of
                        the provisions of Section 3(2D) of the Act, extracted in the
                        earlier part of this order, during the course of 22 July 2022;
                        and
               (ii)     In the event that the Medical Board concludes that the fetus
C                       can be aborted without danger to the life of the petitioner, a
                        team of doctors at the All India Institute of Medical Sciences
                        shall carry out the abortion in terms of the request which
                        has been made before the High Court and which has been
                        reiterated both in the Special Leave Petition and in the
D                       course of the submissions before this Court by counsel
                        appearing on behalf of the petitioner. Before doing so the
                        wishes of the petitioner shall be ascertained again and her
                        written consent obtained after due verification of identity.
             23. The report shall be furnished to this Court after compliance
E     with this order within a period of one week thereafter.
            24. For considering the report of the Medical Board, list the Special
      Leave Petition on 2 August 2022.
             25. The ad interim direction of the High Court of Delhi declining
      to grant interim relief shall stand modified in the above terms.
F
      Ankit Gyan                                                       Directions issued.
      (Assisted by : Aarsh Choudhary, LCRA)

      .

G




H


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