B T Pavithra Kumari vs THE SECRETARY

WP No. 42910 of 2026
IN THE HIGH COURT OF JUDICATURE AT MADRAS
DATED: 15-10-2026
CORAM
THE HON'BLE MS. JUSTICE P.T. ASHA
WP No. 42910 of 2026
CNR:{HCMA012526052026}
B T Pavithra Kumari
..Petitioner(s)
Vs
1. The Secretary
Health and Family Welfare Department,
Government of Tamil Nadu,
Namakkal Kavignar Maaligai,
Fort St.George, Secretariat,
Chennai
2. The Registrar
Tamil Nadu Medical Council,
No. 959 and 960, Poonamallee High Road,
Purasaiwakkam,
Chennai 84
3. The Chairman
Institute of Obstetrics and Gynaecology and
Government Hospital for Women and Children,
No.2, Pantheon Road,
Egmore,
Chennai 08
..Respondent(s)
Prayer: This writ petition is filed under Article 226 of the Constitution of
India, seeking writ of certiorarified mandamus calling for the records relating to
the impugned order passed by the 3rd respondent in Form D on 13.10.2026
quash the same and consequently directing the respondents to terminate the
medical pregnancy of petitioner as per the medical records and consider the
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petitioner’s representation dated on 13.10.2026.
For Petitioner(s): Mr.N.Manokaran
For Mr. A.Kanakavelappan
For Respondent(s): Mr.J.V.Sakthi Balakrishnan
Government Advocate
R1 & R3
Mr.V.Bharanidharan
Standing Counsel
R2
Order
This writ petition is filed for the following relief:
“To call for the records relating to the impugned order passed by
the 3rd respondent in Form D on 13.10.2026 quash the same and
consequently directing the respondents to terminate the medical
pregnancy of petitioner as per the medical records and consider the
petitioner’s representation dated on 13.10.2026.”
2. The petitioner married one Vignesh on 14.12.2022. After the marriage,
they were blessed with a male baby, namely, Elaija on 15.02.2024. The
petitioner would submit that in the beginning of 2026, the petitioner conceived
for the second time and regularly took treatment. The case of the petitioner is
that in her TRIMESTER SCAN REPORT, it revealed that there was mild fetal
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ventriculomegaly. The petitioner took a second opinion and the second opinion
also confirmed the same. Therefore, the petitioner and her husband expressed
rd
their consent to terminate the petitioner’s pregnancy. However, the 3
respondent refused and asked the petitioner to take genetic test. Therefore, the
petitioner is before this Court.
3. Heard the learned counsels on the either side and perused the records.
4. It is challenging the refusal to grant approval for the termination of
pregnancy, the petitioner is before this Court.
5. A reading of the affidavit would indicate that the petitioner and her
husband are already blessed with son, Elaija, who was born on 15.02.2024. The
petitioner had conceived for the second time in the beginning of 2026. On
01.03.2026, when she had taken a scan at Scan India, the impression has been
recorded as follows:
“SINGLE VIABLE INTRAUTERINE GESTATION OF
GESTATIONAL AGE APPROXIMATELY CORRESPONDING TO
19 - 20 WEEKS DURATION.
NORMAL LIQUOR
PRESENT EXPECTED FETAL WEIGHT 301 +/- 100 GMS
DOPPLER STUDY OF THE UMBILICAL ARTERY SHOWS
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WP No. 42910 of 2026
SATISFACTORY SYSTOLIC AND DIASTOLIC FLOW.
MATERNAL:
CERVIX ---- 3.0 CM.
INTERNAL OS CLOSED
The petitioner was directed to have a follow up scans at 28 weeks of
gestation. The expected date of delivery was given as 06.12.2026.
6. The OB – 2/3 TRIMESTER SCAN REPORT threw up the following
impression:
“Single live intra uterine gestation corresponding to 28 Weeks 2
days GA.
Liquor- Adequate
Mild fetal ventriculomegaly
7. In the light of the impression of mild fetal ventriculomegaly, the
petitioner had undergone ultrasound scan on 05.10.2026. The scan report would
show that an extended neurosonography was done with reference to the head
and the impression generated was as follows:
“Single intrauterine gestation corresponding to a gestational age of
30 weeks 3 days gestational age assigned as per biometry (CRL) on
05.06.2026 (previous scan) Menstrual age 31 weeks 1 Day
Corrected EDD 11.12.2026
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Presentation – Cephalic
Liquor – Normal
Estimated fetal weight according to BPD, HC, AC, FL: 1379 + / -
137.9 gms
Growth, liquor and fetal activity – Normal”
8. Further, a detailed finding was given which would read as follows
“Today scan findings explained to the patient and her mother
In today’s scan the growth, liquor and activity is normal. On
extended neurosonography. We have noted agenesis of corpus
callosum. Bilateral moderate ventriculomegaly noted. Rest of the
fetus appears structurally normal for the period of gestation.
Detailed neurosonogram done which shows otherwise normal
intracranial anatomy. We have advised Fetal Brain MRI to rule out
other cerebral abnormalities (Cortical development, neuronal
migration disorders) not detectable on ultrasound.
This condition is associated with chromosomal / genetic
abnormality. To ascertain the etiology, we have advised direct
testing – Amniocentesis – QFPCR / CNGenome / WES / DNA store.
QF – PCR reports will be available 1 week and CNGenome / WES
will be available in 4 weeks time. Considering the advanced
gestational age at testing the results may not have a bearing on
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WP No. 42910 of 2026
pregnancy decision making. Alternatively the above test need to be
done postnatally after evaluation by a clinical geneticist.
Fetuses with Agenesis corpus callosum even, apparently isolated,
have an increased risk of developmental difficulties compared to
general population – speech language delay learning difficulties
cognitive dysfunction, behavioral difficulties, social communication
problem, epilepsy, intellectual disability. The degree of impairment
cannot be reliably predicted before birth. The presence of
additional cerebral abnormalities or genetic abnormality increase
the risk signifiantly.
9. On 06.10.2026, the petitioner had approached Sri Ramachandra
Medical Centre Radiology & Imaging Sciences for Fetal MRI, which had been
advised in the report dated 05.10.2026. The findings of the MRI was as
follows:
“A single live intrauterine gestation is seen in longitudinal lie
with cephalic presentation. The placenta Is posterior. There is no
previa. The cervix appears closed. Amniotic fluid volume is normal.
A three-vessel cord Is seen.
The sulcation pattern is appropriate for the gestation.
Subarachnoid space is appropriate for gestational age. The
lamination pattern is well maintained in bilateral cerebral
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hemispheres.
Cavum septum pellucidum and corpus callosum are not
visualised. Colpocephaly noted bilateral lateral ventricles are
dilated (right = 16mm; left = 15mm).
Cisterna magna measures 13 mm”
10. Corpus callosum agenesis in simple words is described as the
following condition:
“The bridge of nerve fibers that lets the left and right sides of
the brain talk to each other does not form correctly during early fetal
development (typically between 8 to 12 weeks of pregnancy). Instead
of crossing the midline, these fibers form separate vertical tracts
called Probst bundles.
Ventriculomegaly is a condition where the lateral ventricles
enlarge.”
11. Since the reports clearly indicated that the unborn would be born with
abnormalities, the petitioner and her husband had taken a heart-rending decision
to terminate the pregnancy medically on 13.10.2026. Therefore, the petitioner
st
had made a representation to the 1 respondent with a copy to the respondents 2
and 3, wherein, she submitted that only after September 2026, she had come to
learn about the abnormality of the fetus. Therefore, she requested for
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WP No. 42910 of 2026
termination of pregnancy. The condition with which the fetus has been
associated will result in an increased risk of developmental difficulties,
including speech and language delays, learning difficulties, cognitive
dysfunction, behavioral difficulties, lack of communication skills, epilepsy, and
intellectual disability. The petitioner has clearly expressed that her desire was
not to complete her period of pregnancy as a child with abnormalities would be
subject to ridicule in the society. The petitioner was referred to the medical
board which has not approved the request for termination on the ground that the
neurological abnormalities were not lethal. Further, they had stated that in the
absence of genetic testing isolated corpus callosal agenesis carries variable
prognosis and it is non lethal. A genetic test would not serve the purpose as the
genetic test would only trace the genetic history of the fetus in question.
12. The second report dated 05.10.2026 shows the abnormalities and the
Fetal MRI confirms the same. The termination of the pregnancy is governed by
the Medical Termination of Pregnancy Act, 1971, herein after called the MTP
Act and the Medical Termination of Pregnancy Rules, 2003, herein after called
the MTP Rules. Section 3 of the MTP Act deals with the conditions that are
required to be satisfied for terminating pregnancy and the same would read as
follows:
“When pregnancies may be terminated by registered medical
practitioners.-
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(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 terminated by him in accordance with the
provisions of this 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) 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
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
(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 method used
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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.
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 opinion
is required for termination of pregnancy at different gestational age
shall be such as may be prescribed by rules made under this Act.
(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.
(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.
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WP No. 42910 of 2026
(2D) The Medical Board shall consist of the following, namely:— (a) a
Gynaecologist; (b) a Paediatrician; (c) a Radiologist or Sonologist;
and (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 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 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.”
13. Rule 3 A of the MTP Rules would read as follows:
“3A. Powers and functions of Medical Board.--For the purposes of
section 3 ,-- (a) the powers of the Medical Board shall be the
following, namely:- (i) to allow or deny termination of pregnancy
beyond twenty-four weeks of gestation period under sub-section (2B)
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WP No. 42910 of 2026
of the said section only after due consideration and ensuring that the
procedure would be safe for the woman at that gestation age and
whether the foetal malformation has substantial risk of it being
incompatible with life or if the child is born it may suffer from such
physical or mental abnormalities to be seriously handicapped"
14. A reading of the MTP Act and MTP Rules would indicate that
pregnancy of the woman can be terminated only by a registered medical
practitioner. If the pregnancy is over 20 weeks but less than 24 weeks, it shall
be terminated subject to the opinion of the two registered medical practitioners
as per Section 3 (2) read with Rule 3 B. If the pregnancy length is beyond 24
weeks and where the termination is required to save the life of the pregnant
woman then opinion of one registered medical practitioner in terms of Section 5
would suffice. In case, the period is beyond 24 weeks and it is found that there
are substantial foetal abnormalities, then pregnancy can be terminated with the
approval of the medical board as per Section 3 (2B) read with Rule 3 A (a) (i).
In the instant case, the pregnancy has crossed 24 weeks and the Board has not
granted its approval.
15. In Suchita Srivastava V. Chandigarh Admn. – 2009 (9) SCC 1 , a
three judges Bench of the Hon’ble Supreme Court has held that the right to
make reproductive choices rests entirely with the woman. In the aforesaid
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WP No. 42910 of 2026
judgement, the judges have opined that “ the right to make reproductive choices
is a facet of Article 21 of the Constitution and the consent of the pregnant
person in matters of reproductive choices and abortion is paramount”.
16. The Hon’ble Supreme Court has also dealt with the termination of
pregnancy beyond the statutory period prescribed for terminating pregnancy in
A Vs. State of Maharashtra – 2024 (6) SCC 327. The learned Judges have
after discussing the MTP Act expressed as follows:
“32. This highlights the need for giving primacy to the fundamental
rights to reproductive autonomy, dignity and privacy of the pregnant
person by the Medical Board and the courts. The delays caused by a
change in the opinion of the Medical Board or the procedures of the
court must not frustrate the fundamental rights of pregnant people.
We therefore hold that the Medical Board evaluating a pregnant
person with a gestational age above twenty-four weeks must opine
on the physical and mental health of the person by furnishing full
details to the court"
17. The Delhi High Court in the case of X Vs. GNCTD and another
reported in 2022 SCC Online Del 4274, has discussed the substantial foetal
abnormalities by drawing definitions of various statutes as follows:
27. The MTP Act, 1971 does not define as to what constitutes
"substantial foetal abnormalities" and thus the Court is required
to take the assistance of external material for interpreting the
said expression. The definitions of the following expressions in
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WP No. 42910 of 2026
various statutes across jurisdictions are set out below:
S.No. Country / State Statute Terminology Definition
1 Abortion Act, 1967
(United Kingdom)
Physical or mental
abnormalities as to
be seriously
handicapped
1(1)(d) That there is a
substantial risk that if
the child were born it
would suffer from
such physical or
mental abnormalities
as to be seriously
handicapped
2 Northern Ireland, The
Abortion (Northern
Ireland) (No.2)
Regulations, 2020
Grounds for
Termination : Cases with
no gestational limit
severe fetal impairment
or fatal fetal abnormality
7.(1) A registered
medical
professional may
terminate a
pregnancy where
two registered
medical
professionals are of
the opinion, formed
in good faith, that
there is a
substantial risk that
the condition of the
fetus is such that -
(a) the death of the
fetus is likely before
during or shortly after
birth or
(b)if the child were
born it would suffer
from such physical or
mental impairment as
to be seriously
disabled.
3 USA / Florida, Title XXIX
Public Health, Chapter
390 Termination of
Pregnancies
Fatal fetal
abnormality
Means a terminal
condition that, in
reasonable medical
judgment, regardless
of the provision of life
saving medical
treatment, is
incompatible with life
outside the womb and
will result in death
upon birth or
imminently thereafter.
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18. The learned judge had also referred to the case of Suchita Srivastava
supra and held that from the judicial decision it was apparent that courts have
permitted termination of pregnancy even at the advanced stage i.e., ninth month
if substantial foetal abnormalities are detected in the foetus.
19. The Hon’ble Supreme Court in the case of A Vs. State of
Maharashtra and others in Civil Appeal No.827 of 2026 , had held that where
the mother did not want to bear the child her interest have to be taken note of
and her reproductive autonomy must be given sufficient emphasis and the court
cannot compel to complete her pregnancy. The Court had relied upon the
earlier judgement of the Hon’ble Supreme Court in the case of X Vs. Health &
Family Welfare Department - 2022 SCC Online SC 1321 , wherein it was
observed as follows:
“The right to reproductive autonomy is closely linked with the right
to bodily autonomy. As the term itself suggests, bodily autonomy is
the right to take decisions about one’s body. The consequences of an
unwanted pregnancy on a woman’s body as well as her mind cannot
be understated. The foetus relies on the pregnant woman’s body for
sustenance and nourishment until it is born. The biological process
of pregnancy transforms the woman’s body to permit this. The
woman may experience swelling, body ache, contractions, morning
sickness, and restricted mobility, to name a few of a host of side
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effects. Further, complications may arise which pose a risk to the
life of the woman. A mere description of the side effects of a
pregnancy cannot possibly do justice to the visceral image of
forcing a woman to continue with an unwanted pregnancy.
Therefore, the decision to carry the pregnancy to its full term or
terminate it is firmly rooted in the right to bodily autonomy and
decisional autonomy of the pregnant woman.
20. In the instant case, the scan reports clearly show substantial fetal
abnormalities. The mother has the right to take a decision as to whether she
would like to bring such a child into the world, particularly when the child is not
going to lead a normal life. Therefore, this Court has to bow down to the
decision of the petitioner / mother who has taken a painful and extreme step by
taking note of the considerable risk involved in this child's chance of leading a
dignified and self-sustained life.
21. It is the parents who would have to watch, day in and day out, the
suffering that such a child would have to undergo. The parents have taken this
decision to ensure that the child is not brought into this world to lead a life of
indignity. Further, the unborn child also has the right to live a life of dignity and
not be a subject of ridicule. This Court also has to consider the life of this child
after the lifetime of the parents.
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22. Therefore, in the light of the above judicial pronouncements and
taking note of the scan reports which clearly shows the possibility of the child
rd
being born with abnormalities, the impugned order of the 3 respondent cannot
be sustained and is accordingly quashed and the respondents are directed to
terminate the medical pregnancy of the petitioner as per medical records and the
termination shall be done by the registered medical practitioner, forthwith.
23. With the above observation and direction, this writ petition is
allowed. No costs.
15-10-2026
Index: Yes/No
Speaking/Non-speaking order
Neutral Citation: Yes/No
KAN
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WP No. 42910 of 2026
To
1. The Secretary
Health and Family Welfare Department, Government of Tamil Nadu,
Namakkal Kavignar Maaligai,
Fort St.George, Secretariat,
Chennai
2. The Registrar
Tamil Nadu Medical Council,
No. 959 and 960, Poonamallee High Road,
Purasaiwakkam,
Chennai 84
3. The Chairman
Institute of Obstetrics and Gynaecology and Government Hospital for
Women and Children,
No.2, Pantheon Road,
Egmore,
Chennai 08
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WP No. 42910 of 2026
P.T.ASHA J.
KAN
WP No. 42910 of 2026
15-10-2026
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