FACTS
Poonam Sharma, a married homemaker, 27 years old, approached the Supreme Court of India under Article 32, seeking permission from the court to terminate her ongoing pregnancy. Even though she was utilizing the Lactational Amenorrhea Method (LAM), she conceived a 26-week fetus. She is the mother of two boys, aged four years and one year respectively. She was not aware that she was pregnant, it came out as an utter shock for her as she was in an on-going pregnancy. She adopted LAM (Lactational Amenorrhea Method), which relies on the absence of menstrual cycles due to continuous breastfeeding, as a contraceptive method after delivering her second child. It was considered rare amongst breast feeding women with Lactational Amenorrhea, but the petitioner’s case is an exception. She had previously had C-sections to deliver her children. The also petitioner claims that she is experiencing emotional and mental distress as an effect of postpartum depression, given her delicate physical, mental, and psychological condition, the petitioner seeks permission from the court to terminate her pregnancy and the statutory bar under the Medical Termination of Pregnancy (MTP) Act has forbidden her and her husband from obtaining a medical termination of the pregnancy.
ISSUES RAISED
1] Whether the Supreme Court should entertain the petition under Article 32 when an alternative remedy is available under Article 226.
2] Whether the petitioner’s right to terminate her pregnancy is questioned in considering the Medical Termination of Pregnancy (MTP) Act’s statute of limitations and her advanced gestational age of 26 weeks.
3] Whether the petitioner’s financial, socioeconomic, psychological, mental, and physical circumstances being taken into account as grounds for termination.
CONTENTION
1] PETITIONER
A) Failure of contraceptives
The petitioner explains that she has relied on the (LAM) or Lactational Amenorrhea Method, which is a natural contraceptive method that relies on breastfeeding to prevent pregnancy during the postpartum period. The court noted that LAM is an informed use of breastfeeding as a contraceptive method by a woman who is still Amenorrheanic and not feeding her baby with supplements for up to a period of six months after delivery. Medical reports estimate that LAM users have over 95% protection from pregnancy. However, in this particular case, it happened to be a rare exception that the petitioner conceived even with the LAM method. The petitioner contends that punishing her for this failure would be unfair because the MTP act is designed to protect women’s health and that doing so would be wrong for her.
B) Risks to the Physical and Mental Health
The petitioner, who delivered both children via C-section is currently undergoing psychiatric treatment due to postpartum depression. She has been on continuous medication for a year due to her precarious physical, mental, and psychological condition and has been prescribed strong medication, which could have had an adverse impact on the health of the fetus that brings risk to the unborn baby. Her history of two previous C-section deliveries increases the complexity and risks associated with a third C-section that would impact her health condition.
C) Social and financial constraints
The petitioner and her husband, a homemaker and graduate, argue that their financial constraints make it unviable to support another child. They already support their elderly parents and sister with a paltry salary, putting a heavy burden on the petitioner’s husband. Despite their satisfaction with their current family, they find it difficult to afford another child. The husband’s limited income complicates the situation, and moreover, the petitioner’s mental health challenges further increase the difficulty.
D) Reproductive right
The petitioner argued that she should have the option to terminate the pregnancy given the significant risks to her health and well-being. She also reaffirmed her right to reproductive autonomy, a right that enables her to freely make decisions about her health and choices on reproductive without interference from entities other than herself. She argued that making her carry out the pregnancy would violate her right to bodily autonomy and overly burden her with her responsibilities as the mother of her already-born children.
2] RESPONDENT-
A) Effective Alternative
A petition under Article 32 of the Indian Constitution is often not entertained by the court if there is an equally effective remedy available through the State High Court. The petitioner in this instance a long-term inhabitant of the Delhi National Capital Territory, was able to request redress from the Delhi High Court. The petitioner’s attorney recommended that, prior to seeking relief under Article 226 of the Indian Constitution which grants the High Courts in India the power to issue certain writs, the petitioner should have first filed a plea with the High Court. However, the court chose to entertain the petition due to time constraints and the potential for a new petition to be filed. Under normal circumstances, the court would be hesitant to consider a petition under Article 32.
B) Family planning and marital obligations
The petitioner who had two children must ought to have undertaken greater caution during her second pregnancy, the respondents underlined. Planned family and proper measures are important for married couples since unplanned pregnancies can lead to physical, psychological, and socioeconomic problems. Unplanned pregnancies put the fetus and the family at risk by resulting in unintended children, anxiety, and uncontrollable health problems. Hence, the petitioner and her spouse ought to have exercised greater caution. Married couples contemplating a family are obligated by the courts to exercise precaution and adopt appropriate precautions to prevent ending pregnancies after the critical period has passed, as in the case of the 26-week case.
C) Statutory Limitations and Medical Board
The AIIMS Medical Board has verified that a fetus at 25 weeks and 5 days is viable and has a reasonable chance of survival outside the womb, which raises moral and health issues. The Medical Board also expressed concerns about potential health risks from late-term abortions, such as infection and haemorrhaging. Respondents argued that the MTP Act in India does not allow termination of pregnancy beyond 24 weeks, except in severe fetal abnormalities or danger to the mother’s life. They suggested the court should respect the Act’s intent and restrictions, as abortions after 24 weeks are typically forbidden due to increased risks to the mother’s health.
RATIONALE
“We allow the present writ petition with a direction issued to the petitioner to visit the Obstetrics and Gynaecology Department, AIIMS, New Delhi tomorrow morning, i.e., on 10th October 2023. AIIMS shall admit the petitioner for her to undergo the procedure of termination of her pregnancy at the earliest with follow-up as may be advised by the treating doctors.”
The Supreme Court has ruled in favour of Poonam Sharma’s termination of her pregnancy, the Court has recognized the fact that one of the grounds on the basis on which a pregnancy may be permitted to be terminated is when continuing with the pregnancy could seriously imperil the mental health of the women. As observed in the case of X vs. Principal Secretary, Health and Family Welfare Department, Govt. of NCT of Delhi, the expression ‘grave injury to her physical and mental health’ in Section 3(2)(b) of the MTP Act is used in an overarching and all-encompassing sense. Courts have been liberal in interpreting Section 3 of the MTP Act that permits RMPs to terminate pregnancy beyond 20 weeks in circumstances where continuing with the pregnancy would involve a risk to the life of the pregnant woman or grave injury to her physical or mental health. This Court has also recognized the fact that the expression ‘mental health’ has a broader connotation vis-à-vis what is considered as “mental illness”, strictly in medical parlance.
The court also highlighted broader societal needs for improved family planning education and services to prevent similar situations in the future. It also acknowledges the petitioner’s bodily autonomy and recognizes her right to terminate her pregnancy. She explains her physical, mental, psychological, financial, and socio-economic backgrounds. If an unwarranted pregnancy results in a child, the responsibility of raising the child falls on her as a mother and primary caregiver. However, she is not fit to shoulder this onerous responsibility. Her mother-in-law supports her in raising the children, as her health has remained indifferent after her second pregnancy.
Having regard to the aforesaid facts and circumstances, it is deemed appropriate to grant permission to the petitioner to terminate her unwanted pregnancy. Necessary steps shall be taken by the AIIMS to admit the petitioner for her to undergo the process at the earliest. In the event, that the foetus is alive, then the process of incubation and any other procedure as may be advised medically, shall be adopted. The court concluded that the case was urgent and had particular facts, so it decided to directly intervene rather than refer it to the High Court.
DEFECTS OF LAW
1. Restrictive Conceptual Limits:
Pregnancies that are terminated after 20 weeks are prohibited by the MTP Act, with very few exceptions for rape or grave risk. This strict act does not take into account complicated situations in which late-term abortions may be required for medical, psychological, or financial reasons. The absence of standards in the law regarding the consideration of mental health as a valid reason for termination after 20 weeks results in ambiguity and uneven implementation.
2. Inadequate Attention to Socio-Economic Factors:
The current legal framework fails to adequately consider socio-economic factors justifying abortion, such as financial instability or inability to support an additional child, as valid reasons for termination under the MTP Act.
3. Inadequate Family Planning Education and Services:
The case highlights a broader systemic issue of inadequate family planning education and services. Lack of awareness and access to effective contraceptive methods can lead to unintended pregnancies, necessitating abortions that fall outside the rigid legal framework.
INFERENCE
The Medical Termination of Pregnancy (MTP) Act of 1971 an Act to provide for the termination of certain pregnancies by registered medical practitioners and for matters connected therewith or incidental thereto it was enacted in India to provide a legal framework for the termination of certain pregnancies by registered medical practitioners. It was a progressive step aimed at reducing maternal mortality due to unsafe abortions. Under the Act, a woman may have an abortion up until 20 weeks gestation, but in some circumstances—such as when the pregnancy endangers her life or seriously impairs her physical or mental health—this limit may be extended to 24 weeks. Fetal abnormalities are another example of such circumstances.
The MTP Act, in spite of its progressive intentions, has come under condemnation for its restrictive pregnancy limits, insufficient concern for women’s mental health, and absence of procedures for late-term abortions in situations where contraception fails or other extraordinary circumstances arise. This rigidity frequently pushes women to ask the courts for help, as demonstrated by the ruling that has garnered recognition of the Supreme Court’s ruling in “Poonam Sharma vs. Union of India & Anr.” underscores the importance of reproductive autonomy, recognizing the right of women to make decisions about their bodies. The decision emphasizes how important mental health is to reproductive rights, taking into account the petitioner’s past history of depression as well as the possibility of postpartum depression
DEEYA ANIL DANI
RAMAIAH INSTITUTE OF LEGAL STUDIES