Madras High Court orders termination of 31-week pregnancy after fetal brain abnormalities despite medical board refusal

The petitioner, whose pregnancy had progressed beyond 24 weeks, sought termination after scans and fetal MRI indicated agenesis of the corpus callosum and bilateral moderate ventriculomegaly. The medical board declined approval, stating that the abnormalities were non-lethal and that prognosis was variable without genetic testing.

The petitioner challenged the refusal and sought an order directing termination.

Whether the medical board’s refusal to approve termination, despite reported fetal abnormalities and the petitioner’s request, should be quashed

Whether the Court could direct termination of a pregnancy beyond 24 weeks where the board had not approved termination

Section 3(2B) of the Medical Termination of Pregnancy Act, 1971 removes the gestational limit where termination is necessitated by substantial fetal abnormalities diagnosed by a Medical Board; Sections 3(2C)–(2D) provide for the constitution and composition of that Board.

Rule 3A of the Medical Termination of Pregnancy Rules, 2003 requires the Board, when considering termination beyond 24 weeks, to assess procedural safety and whether the fetal malformation presents a substantial risk of incompatibility with life or of serious physical or mental disability.

The Court also relied on Suchita Srivastava v. Chandigarh Administration, which recognises reproductive choice and consent as aspects of Article 21, and A v. State of Maharashtra and X v. Health & Family Welfare Department, which emphasise reproductive autonomy, dignity, privacy and the pregnant person’s bodily autonomy.

The Court considered the scan and MRI findings, which confirmed agenesis of the corpus callosum and ventriculomegaly, alongside the medical report describing risks of developmental and cognitive difficulties and stating that the degree of impairment could not reliably be predicted before birth.

It concluded that the reports disclosed substantial fetal abnormalities and that the board’s refusal did not warrant overriding the petitioner’s reproductive autonomy and decision to terminate.

On that basis, the Court held the refusal unsustainable, notwithstanding the pregnancy’s duration beyond 24 weeks and the absence of the board’s approval.

No costs were awarded.