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Case Name – Poonam Sharma vs UOI 2023 SCC OnLine SC 1333

Case Comment, Publications

Court – Supreme Court

Case number: Writ Petition (Civil) No. 1137/2023

  1. Facts of the Case:
  1. Petitioner – Poonam Sharma, 27, married woman with two sons aged 4 and 1. Both previous deliveries were C-sections.
  2. Respondents – Union of India & Others
  3. Petition Filed Under – Article 32 of the Indian Constitution 
  4. Relief Sought – Permission to terminate the pregnancy medically by the Medical Termination of Pregnancy (MTP) Act, 1971, specifically by Sections 3(2)(b)(i), 3(3), and 5, as well as Rule 3B of the MTP Rules, 2003.
  5. Background 
  • As the petitioner was using the lactational Amenorrhea Method (LAM) as contraception, she did not realise she was pregnant.
  • She also approached various doctors at different hospitals but was declined to terminate the foetus due to the pregnancy period going beyond the statutory period under the MTP Act.
  1. Medical Opinion 
  • AIIMS Medical board found out that the foetus was 25 weeks and five days of the Gestation period, having a weight of 886 grams and a reasonable chance of survival.
  • The Board advised against terminating the pregnancy because of the fetus’s viability and possible difficulties.
  1. Petitioner Circumstances 
  • Suffering from Depression
  • Was under treatment with strong medication
  • financially burdened since her husband, the family’s only provider, must also support his ageing parents and sister.
  1. Legal Arguments 
  • The lawyer who represented the petitioner emphasised the petitioner’s right to reproductive autonomy by arguing that carrying out the pregnancy constituted a substantial risk to her bodily and mental health.
  • Cited the famous precedent of the case X v. State (NCT of Delhi), (2023) 9 SCC 433 for the broader interpretation of “mental health” under the MTP Act.
  1. Court’s observation 
  • The court acknowledged the Petitioner’s physical, mental, financial, psychological, and socio-economic reasons raised by the Petitioner to seek termination.
  • The Court recognised the reproductive autonomy of women and also the importance of mental health in the cases of pregnancies.
  • The court also highlighted the significance of timely family planning and the need for awareness and education regarding contraception methods.
  1.  Outcome
  • The Supreme Court granted permission for the medical termination of the pregnancy.
  • The Supreme Court directed the AIIMS to operate at its earliest and also to take necessary steps while performing the termination of the petitioner and the foetus, if viable. 
  1. Issues Raised 
  2. Reproductive Autonomy and Rights
  • Right to Reproductive autonomy Is the primary issue in this case.
  • The petitioner argued for her right to make decisions on her own body, including the right to terminate an unwanted pregnancy.
  • The situation in this case raised a question about the extent to which a woman’s rights are protected under the MTP Act, especially when it comes to the future health of the foetus.
  1. Mental and Physical Health
  • Another issue raised by the petitioner was that continuing the pregnancy can pose a severe risk to her mental health. Also, she mentioned her history of depression and the current socio-economic stress.
  • The issue raised was whether the risk to mental health qualifies as a valid reason for termination of pregnancy under the MTP Act, significantly beyond the statutory period of 20 weeks.
  1. Interpretation of the MTP Act 
  • The issue raised was whether the court should consider the petitioner’s circumstances, as she highlighted that she wanted the termination under MTP Act,1971, Particularly Section 3(2)(b)(i) and Rule 3B of MTP Rules, 2003. These provisions allow abortion in some instances, including when there is a risk to a woman’s mental or physical health.
  1. Viability of Foetus 
  • The issue raised was that the Medical board at AIIMS found out that the foetus was 25 weeks and 5 days. They claimed there could be a reasonable chance of survival, which influenced their recommendation against the termination of that foetus.
  • The court had to consider both the petitioner’s rights and health concerns and the foetus’s viability.
  1. Socio-Economic Factors
  • The Petitioner also raised her Socioeconomic situation by mentioning the financial strain that they were facing as her husband was the sole breadwinner of the family, and they also had to take care of the extended family members, which also influenced the termination of pregnancy.
  • The petitioner’s Physical and mental health was affected by the socioeconomic conditions that she was facing, and the court had to take that into account.
  1. Precedents and Broader Legal Implications
  • The issues raised were about the broader legal implications and precedents; the court cited C v. Health & Family Welfare Department, recognising the importance of mental health in abortion cases and for the broader interpretation of the MTP Act.
  1. Contentions in the Case   
  2. Petitioner’s Contentions
  3. Right to Reproductive Contention 
  • The petitioner argued that reproductory autonomy is a fundamental right, and it is also protected under Article 21 of our Indian Constitution. 
  • She also highlighted her right to make decisions about her own body, including the right to terminate an unwanted pregnancy.
  1. Mental and physical health Risks
  • The petitioner contended that continuing the pregnancy posed a significant risk to her mental and physical health as she was undergoing ongoing treatment for depression.
  • She also highlighted the physical risks she could face while carrying a third child as in her previous 2 C-section deliveries.
  1. Interpretation of the MTP Act and Rules 
  • The petitioner argued that the provisions under the MTP Act should be interpreted broadly and should include risks to mental health as valid grounds for termination.
  • They cited Section 3(2)(b)(i)  of the MTP Act, which allows the termination of the pregnancy if the pregnancy involves a risk to the life of the pregnant woman.
  • Rule 3B of MTP Rules was also highlighted as it allows the termination of pregnancy after 20 weeks in certain circumstances; they argued that the petitioner’s mental health condition and socio-economic circumstances met these criteria.
  1. Socio-Economic Hardships
  • Another contention raised was her Socioeconomic situation, the financial strain that they were facing as her husband was the sole breadwinner of the family, and they also had to take care of the extended family members
  1. Precedent and Judicial Interpretation 
  • The Petitioner also highlighted previous judgements where the courts have adopted a broader interpretation and have recognised the importance of mental health in abortion cases.
  1. Respondent’s Contentions
  2. Viability of the Foetus 
  • The Respondent that represented UOI and others highlighted the report given by the Medical Board of AIIMS, which stated that the foetus is at 26 weeks and 5 days of gestation and has a reasonable chance of survival.
  • They argued that termination should not be permitted due to the period of 20 weeks being exceeded
  1. Medical Risks
  • The AIIMS Medical board was against the termination as potential complications could be there while terminating a viable foetus at such an advanced stage.
  • The Respondent also highlighted that the pregnancy won’t pose an immediate risk to the petitioner’s physical health, and thus, they cannot claim an exception under the MTP Act.
  1. Statutory Limitations
  • The respondents pointed out that the limitation period of termination of pregnancy under the MTP Act was 20 weeks, and also, the Petitioner did not fall under the exceptional circumstances criteria.
  1. Potential Alternative Solutions
  • The Respondents suggested that instead of termination, the petitioner could go for an alternate remedy like adoption.
  • They also argued that terminating a viable foetus should be the last option and should be seen only when there are no options left.
  1. Rationale
  2. Constitutional Rights and Reproductive Autonomy
  3. Right to Life and Personal Liberty (Artice21)
  • The Supreme Court emphasised Article 21, which includes a woman’s right to make reproductive choices and the right to term or terminate it.
  • The court also highlighted previous judgements that recognised reproductive rights as part of personal liberty.
  1. Reprodcutory Autonomy 
  • The court understood that reproductive autonomy is crucial to an individual’s dignity and privacy. The court also highlighted that the decision to terminate a pregnancy, especially when it affects a woman’s mental and physical health, should primarily rest with the woman.
  1. Mental and Physical Health
  2. Broad Interpretation of Health
  • The court accepted a broad interpretation of “Health” under the MTP Act, including both physical and mental health, and they also recognized that mental health is as important as physical health and can be impacted by different circumstances, including socio-economic factors.
  1. Mental Health and Socio-Economic factor
  • The court considered the Petitioner’s mental health, which was impacted by her Socio-Economic circumstances. The financial burden of raising another child with her existing mental issues was seen as sufficient grounds for termination.
  1. Interpretation of Medical Termination of Pregnancy (MTP) Act
  • The court broadly interpreted Section 3(2)(b)(i) of the MTP Act and Rule 3B of the MTP Rules and allowed the termination beyond the statutory limits of 20 weeks.
  • The court also relied on precedents that previously expanded the interpretation of mental health. 
  1. Holistic Approach 
  • The Judgement had a Holistic approach, considering the petitioner’s overall circumstances, including her mental health, socio-economic situation and reproductive rights.
  1. Defects of Law
  2. Gestational Limits
  3. Restrictive Statutory limits 
  • The Termination period of 20 weeks still applies to most women. However, the judgment extended the period to 24 weeks under certain circumstances. This limit is still restrictive, especially for those who discover their pregnancy late.
  • There is a lack of Flexibility under Indian Law to address cases related to mental health risks or socioeconomic risks. Thus, this limitation can force women to continue their pregnancies.
  1. Interpretation of Mental Health
  2. Narrow Interpretation 
  • The MTP Act includes the term Mental health during termination, but the applicability has always been narrowed as it has more focus towards physical risks and not mental risks
  • The petitioner’s mental health was caused by financial strain and depression, but these causes are not adequately addressed within the existing legal frameworks.
  1. Inconsistent Application 
  • There is inconsistent application of the mental health provisions by different medical and judicial boards across India. This inconsistency can lead to different outcomes in similar circumstances, creating uncertainty in accessing abortion services. 
  1. Medical Board’s Role 
  2. Lack of Standardized Guidelines 
  • There is a lack of Standardized guidelines for medical boards to follow and make recommendations in cases where advanced gestation and complex socio-economic factors are included. This limitation can lead to inconsistent decisions.
  1. Socio-economic Consideration
  • The law does not correctly mention factors like financial strain, responsibilities and socio-economic conditions that are crucial factors that impact mental health.
  1. Inferences Drawn from the Case 
  2. Recognition of Reproductive Autonomy 
  • This case observed that reproductive autonomy is a fundamental right under Article 21 of the Constitution. This includes women’s right to make decisions about their bodies.
  • The judgement highlighted the importance of women’s choices in reproduction.
  1. Mental Health as a valid consideration 
  • The judgement highlights the importance of considering mental health as a significant factor in cases of abortion when it is affected by financial and socio-economic problems.
  1. Need for Legislative Reform 
  • The case highlights the limitations of the MTP Act, particularly the restrictive period of gestation and the narrow interpretation of mental health provisions.
  1. Challenges in Accessibility
  • The case highlighted the practical challenges that women face while getting abortions, like bureaucratic hurdles, lack of awareness and infrastructures, etc.
  • To get better services for abortion, we should not have these systematic barriers.
  1. Need for Clear Guidelines 
  • When the Medical Board gets involved, the abortion is further delayed, clear and standardised guidelines should be there, which would not lead to inconsistent decisions or delays.

References 

  1. Poonam Sharma v. Union of India, 2023 SCC OnLine SC 1333, https://main.sci.gov.in/pdf/LU/11102023_044035.pdf
  2. Family Planning: Supreme Court Allowed Termination of Unplanned Pregnancy at 26 Weeks, SCC Online Blog (Oct. 13, 2023), https://www.scconline.com/blog/post/2023/10/13/family-planning-supreme-court-allowed-termination-of-unplanned-pregnancy-26-weeks/

By Shashank Singh

Symbiosis Law School, Pune