In a significant legal development, the Kerala High Court has determined that the duration of pregnancy should not impede the termination process when substantial fetal abnormalities are identified. This ruling emerged from the case of a woman seeking to terminate her pregnancy beyond the 32-week mark due to severe fetal anomalies.
The case was presided over by a Division Bench comprising Justice A. Muhamed Mustaque and Justice P. Krishna Kumar. They addressed an appeal from a mother whose pregnancy had advanced beyond 32 weeks. The appellant had previously approached the High Court during her 31st week of gestation, but her initial petition was dismissed by a single judge. The dismissal was based on concerns that, given the advanced gestational age, the baby might be born alive. Challenging this decision, the appellant sought relief through an appeal.
The appellant's pregnancy commenced in July 2024, with all medical evaluations indicating normal fetal development until February 2025. However, an ultrasound conducted on February 10, 2025, revealed significant abnormalities. Specifically, the fetal brain was underdeveloped, suggesting that, if carried to term, the child would face severe mental and physical disabilities. This prognosis caused the appellant considerable mental and physical distress, leading her to seek a termination. She expressed concerns about the challenges her family would face in caring for a child with profound disabilities.
The Medical Board's assessment corroborated the appellant's concerns, indicating that the baby, if born alive, would likely suffer from neurological abnormalities. This evaluation played a pivotal role in the court's deliberations.
Under the Medical Termination of Pregnancy Act of 1971, Section 3(2)(a) permits medical termination if the gestation period does not exceed twenty weeks. Furthermore, Section 3(2)(b) allows for termination between 20 to 24 weeks if two registered medical practitioners believe that continuing the pregnancy poses a risk to the woman's life or could result in severe physical or mental health issues. However, the Act does not explicitly address situations where substantial fetal abnormalities are detected beyond the 24-week threshold.
In their judgment, the Division Bench emphasized that the length of pregnancy should not be a determining factor when substantial fetal abnormalities are present. They stated, "The length of pregnancy is not a matter for termination if the Medical Board opines that a substantial fetal abnormality exists." This perspective underscores the court's prioritization of the pregnant woman's well-being and autonomy, especially when faced with the prospect of bringing a child with severe impairments into the world.
Consequently, the court granted the appellant permission to terminate the pregnancy. They directed the Medical Board to issue a certificate confirming the substantial fetal abnormality. Armed with this certificate, the appellant was authorized to approach a hospital of her choice to proceed with the termination, specifically through a procedure known as iatrogenic fetal demise.
This ruling sets a noteworthy precedent, highlighting the judiciary's recognition of the complexities surrounding late-term pregnancy terminations due to fetal abnormalities. It reflects a compassionate approach, acknowledging the profound emotional and physical challenges faced by expectant mothers in such distressing circumstances. By deeming the gestation period irrelevant in these specific contexts, the Kerala High Court has reinforced the importance of individualized medical assessments and the rights of women to make informed decisions about their pregnancies.
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