XXXXXXXXXX vs Union Of India

P.V.Kunhikrishnan, J

The above writ petition is filed by the petitioner with the following prayers:

“a. issue a writ of mandamus or any other appropriate writ, direction or order directing the respondents 1 to 6 to allow the petitioner’s daughter to undergo Medical Termination of Pregnancy at the earliest at the 7th respondent.

b. issue a writ of mandamus or any other appropriate writ, direction or order directing the Respondents 3 to 6 to take immediate steps to examine the Petitioner’s daughter and to permit her to undergo Medical Termination of Pregnancy at the 7th respondent hospital, at the earliest.

c. grant such other reliefs which this Honourable Court may deem fit and proper in the interest of justice.”

Petitioner is the father of a minor child aged 15 years. It is stated that, in an unfortunate situation, petitioner came to know that his daughter is 27 weeks pregnant. Petitioner wants to terminate the pregnancy of his daughter. Since 27 weeks is over, the petitioner has to obtain appropriate orders. Hence this writ petition.

When this writ petition came up for consideration, this Court directed the Superintendent, Government Medical College, Kalamassery, to constitute a medical board to examine the petitioner’s daughter and submit a report before this Court in a sealed cover. Now a report is submitted, which is extracted as follows:

Medical board held on 18.07.2023 in the CCM Hall of Government Medical College Hospital, Ernakulam as per the High Court order W.P.C. No.23231 of 2023(D)

To examine the patient and advise on the list of queries as per the above order.

According to the ultrasound report at the private hospital at Kochi on 13/7/23 foetus is of 28 weeks gestation. The patient is also suffering from severe anaemia (Hb=7.2g%) and has O negative blood group. Hence continuation of pregnancy may cause significant risk to her physical health since she has severe anaemia and can develop pre eclampsia, cardiac failure, infections during pregnancy and can develop severe postpartum haemorrhage after delivery.

She also has adjustment disorder with prolonged depressive reaction after knowing about her condition and continuation of pregnancy may cause exacerbation of her present mental distress.

As the pregnancy has reached 28 weeks and is a live foetus, now it is possible that baby may be born alive and may require prolonged ICU admission. As the baby will be born premature, can have complications due to prolonged ventilation including neurological disability, chronic lung disease and intraventricular haemorrhage. These complications explained to parents in detail and they seemed to understand the risks to the baby.

The process of MTP at 28 weeks will be more prolonged as the uterus is not ripe enough for delivery. She may require multiple doses of drugs, both oral , vaginal and parenteral. There are risks of premature rupture of membranes, chance of infections, haemorrhage, multiple blood transfusions, retained placenta, failure of uterine contractions and even chance of surgical evacuation (Hysterotomy). There is also risk of uterine rupture and may need caesarean delivery, both of which carry risks of anaesthesia including cardiac arrest. There are also risks for future pregnancy which include scar rupture, repeated caesarean delivery, risk of scar ectopic, placenta praevia and placenta accreta and may also need hysterectomy in next pregnancy in case of associated massive uncontrolled haemorrhage.

Medical process best suited is induction of labour using PGE 1, oral or vaginally and use of oxytocin drip parenterally. If this method fails or if complication arises, may have to proceed to hysterotomy/caesarean delivery under anesthesia. There is high possibility that the child be born alive.

since the patient is having adjustment disorder with prolonged depressive reaction, she requires counselling during the process and after.

Conclusion: In view of the age (15 years) and associated medical problems (severe anaemia) both 2nd trimester termination (MTP) and continuation of pregnancy can cause significant risks to the patient, which has been explained in details to the parents.

From the above report, it is clear that the medical board also suggested termination of pregnancy. In the light of the above medical board report, I am of the view that the prayer in this writ petition can be allowed.

Learned Counsel for the petitioner submitted that the petitioner may be allowed to conduct the termination of the pregnancy in the 7th respondent hospital. In the light of the medical board report, there will be a direction to the 7th respondent hospital to conduct the termination of pregnancy of petitioner’s daughter. If the baby is born alive, the State Government shall take necessary steps in accordance with law to protect the baby. Accordingly, the writ petition is disposed of with the following directions:

I. There will be a direction to respondent Nos. 1 to 6 to allow the petitioner’s daughter to undergo medical termination of pregnancy at the 7th respondent hospital.

II. If the baby is born alive, the 7th respondent hospital will inform the authority concerned and the authority concerned will do the needful in accordance with law.