Facts
The case A (Mother of X) v. State of Maharashtra & Anr., 2024, concerns a 14-year-old girl (‘X’) who became pregnant following a rape in September 2023. Due to trauma and fear of stigma, she did not disclose the incident or the pregnancy until she experienced irregular menstruation. When she informed her parents, she was already around 25 weeks pregnant.
An FIR was registered on 20th March 2024 at Turbhe MIDC Police Station under relevant IPC and POCSO provisions. Since the pregnancy had exceeded the 24-week legal limit under the Medical Termination of Pregnancy (MTP) Act, 1971, the family filed a petition before the Bombay High Court on 28th March 2024 seeking permission for medical termination.
A medical board from Grant Government Medical College and Sir J.J. Group of Hospitals initially found X fit for termination. However, without a fresh evaluation, it reversed its decision and denied permission on 3rd April 2024.
A Special Leave Petition was then filed before the Supreme Court on 19th April 2024. The apex court directed the formation of a new medical board, which reported on 22nd April that terminating the pregnancy posed no greater risk than continuing it and that continuation could negatively impact X’s mental health. However, on 26th April 2024, the Court held that the will of the pregnant person is paramount. Since X expressed the desire to continue the pregnancy, termination was not permitted.
Issues Raised
- Whether a pregnancy beyond 24 weeks can be legally terminated in exceptional circumstances under the Medical Termination of Pregnancy Act, 1971, particularly when the pregnancy is a result of rape.
- Whether the denial of termination by the medical board, without re-evaluation and in contradiction to the initial assessment, amounts to a violation of the minor’s rights under Article 21 of the Constitution.
- Whether the opinion and autonomy of the pregnant person even a minor should take precedence over medical, parental, or institutional opinions in matters of abortion.
- Whether fear of criminal liability under the MTP Act discourages registered medical practitioners from recommending or performing termination beyond the 24-week limit, even when medically justified.
- Whether the statutory limit of 24 weeks under the MTP Act should be absolute, or subject to flexible interpretation considering the physical and mental wellbeing of the pregnant person.
Contentions
Petitioner’s Side (Mother of X):
- The petitioners contended that compelling a 14-year-old rape survivor to carry a pregnancy beyond 24 weeks violated her fundamental rights under Article 21, especially her right to life, dignity, privacy, and bodily autonomy.
- They argued that the exceptional circumstances of rape and minorhood warranted an extension beyond the statutory 24-week limit prescribed under the MTP Act, 1971.
- The initial opinion of the medical board found the minor fit for termination, and its subsequent denial without re-examination was arbitrary and violated the minor’s best interests.
- The trauma of continuing the pregnancy would have severe psychological and physical consequences, and the law should prioritize the welfare of the pregnant person over procedural technicalities.
Respondents (State of Maharashtra & Others):
- The State relied on the statutory framework of the MTP Act, which generally does not permit termination beyond 24 weeks unless necessary to save the life of the pregnant person.
- They deferred to the final opinion of the medical board, which recommended against termination.
- It was also contended that the minor’s willingness to continue the pregnancy, as later expressed, could not be ignored and was in line with the principles of bodily autonomy and informed consent.
- The fear among medical practitioners about facing prosecution under the Act also surfaced as a practical obstacle in approving late-term abortions.
Rationale
The Supreme Court, while adjudicating this sensitive matter, emphasized that the right to reproductive autonomy is a fundamental aspect of the right to life under Article 21 of the Constitution. The Court acknowledged that while the Medical Termination of Pregnancy Act, 1971 sets a 24-week ceiling, this limit cannot be treated as absolute in cases involving rape survivors, minors, or those facing serious psychological trauma.
The apex court took into consideration the second medical board’s report dated 22nd April 2024, which confirmed that the risk of terminating the pregnancy was not greater than carrying it to term and highlighted the negative mental impact on the minor. However, in its final ruling on 26th April 2024, the Court underlined that the will of the pregnant person is the paramount factor. It clarified that no authority medical, legal, or parental could override the autonomous decision of the person carrying the pregnancy, even if the person is a minor, provided she is capable of making an informed choice.
The Court also held that fear of prosecution under the MTP Act should not prevent medical practitioners from acting in good faith where the termination is in the best interests of the pregnant person. The law must be interpreted in a liberal, rights-based framework, where the mental and physical wellbeing of the pregnant person outweighs rigid procedural limits.
Ultimately, since X expressed her desire to continue the pregnancy, the Court refused to permit termination asserting that her agency and decision must prevail.
Defects in Law
- Rigid Time Limit Under MTP Act:
The Medical Termination of Pregnancy Act, 1971, as amended, sets a 24-week ceiling for abortions with very limited exceptions. While this provision aims to balance medical safety and legal clarity, it fails to adequately account for cases of late discovery of pregnancy — especially among minors, rape survivors, and mentally ill persons, who may not even realize they are pregnant within that time. - Lack of Clarity for Medical Boards:
There is no consistent protocol guiding how medical boards should assess such cases. In this case, the first board reversed its decision without re-examining the minor, indicating serious procedural ambiguity and lack of accountability. The law lacks binding guidelines for board constitution, timelines, psychological evaluations, and re-consideration mechanisms. - Absence of Express Consent Framework for Minors:
While the Court rightly upheld X’s autonomy, Indian law still lacks a clear framework on informed consent for minors. There is confusion between parental consent and the minor’s will, especially when the minor is mature enough to express an independent, informed choice. - Fear of Prosecution Among Medical Practitioners:
The fear of facing criminal liability under the MTP Act discourages many doctors from recommending or performing terminations after 24 weeks even when it is in the best interest of the pregnant person. This has a chilling effect on medical decision-making, especially in borderline or exceptional cases. - Insufficient consideration of mental health
The Act’s wording often prioritizes “grave physical injury”, and only recently included mental health. But in practice, mental trauma is still undervalued. Cases like this highlight the urgent need to give equal legal weight to psychological impact, especially for survivors of sexual violence.
Inference
The case of A (Mother of X) v. State of Maharashtra & Anr., 2024, marks a significant moment in the evolving jurisprudence surrounding reproductive rights in India. While the Supreme Court ultimately upheld the minor’s decision to continue the pregnancy, it reinforced a crucial principle, the autonomy and will of the pregnant person must be the central consideration, irrespective of age, background, or external pressures.
This case exposed serious gaps in the implementation of the MTP Act, including the inflexibility of the 24-week limit, procedural inconsistencies in medical assessments, and the chilling effect of legal fear on doctors. It also highlighted the urgent need for reform to ensure that the law responds sensitively and swiftly in cases involving rape survivors and minors.
By grounding its judgment in Article 21 and the right to dignity and bodily autonomy, the Supreme Court reaffirmed that reproductive choice is not just a medical or legal issue, it is a human rights issue. However, until the statutory and institutional mechanisms are improved, many may still find themselves caught in the conflict between law, morality, and lived reality.
NAME- AKSHITA
COLLEGE NAME- PANJAB UNIVERSITY