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MTP act- where and when pregnancies can be terminated

IN THE HIGH COURT OF JUDICATURE AT BOMBAY
BENCH AT AURANGABAD
WRIT PETITION NO. 956 OF 2018

“ABC” .. Petitioner
Through her Guardian
Versus
1. The State of Maharashtra .. Respondents
Through its Secretary,Mantralaya, Mumbai­32.
2. Chief Medical Officer,
Government Hospital, Latur.
Mr.Sujit A. Patil h/f. Mr. V.D.Salunke, Advocate for the petitioner.
Mr.A.B.Girase, Government Pleader for respondent/State.

CORAM :  S.S.SHINDE
S.M.GAVHANE,JJ.
RESERVED ON : 01.02.2018
PRONOUNCED ON : 02.02.2018
J U D G M E N T [PER : S.M.GAVHANE,J.] :­

1. Rule.  Rule made returnable forthwith and heard finally   with   the   consent   of   learned   Counsels   appearing for the respective parties.

2. The minor victim girl who is physically abused and mentally tortured has approached this Court through her father – the guardian for seeking directions in the nature   of   writ   of   mandamus,   thereby   directing   to terminate   her   pregnancy   by   following   the   procedure   as described under the Medical Termination of Pregnancy Act, 1971   [hereinafter   referred   as   to   “the   MTP   Act”]   and further directions to conduct DNA test of unborn foetus, so as to determine natural parents of it.

3. The guardian father of the victim contends that he has four daughters and one son.  The victim is minor daughter aged about 16 years.   She is studying in 10th standard.  As per her bona fide certificate issued by the school, her date of birth is 05.01.2001.  It is further contended   that   his   elder   daughter   has   married   on 06.01.2013   with   one   Vikas   Rathod   and   he   is   not maintaining his wife.   Vikas drove his wife out of his house.   Therefore, she is residing with the petitioner. Some complaints were filed against the matrimonial family members of elder daughter of the petitioner and therefore there was grudge in the mind of that family.

4. According to the petitioner on 27.11.2017 when victim went in the morning to answer the nature’s call outside the house, she did not return.   The petitioner tried to search her.   However,  he could not find her. The   petitioner   suspected   that   his   son­in­law   Vikas   and his   family,   who   had   grudge   in   the   mind,   must   have kidnapped the victim to pressurize the petitioner for not filing any complaint.  When the petitioner could not find the   victim,   he   lodged   the   First   Information   Report   in Kingaon   Police   Station   bearing   No.144   of   2017   on 30.11.2017 under section 363 read with section 34 of the Indian Penal Code.  After the said crime was registered, the son­in­law of the petitioner brought the victim in the   police   station   on   04.12.2017.     At   that   time, statement of the victim was recorded wherein she did not allege any overtact on the part of Vikas and she refused for   any   medical   examination.     On   this   count,   she   was remanded in Child Rehabilitation Home at Latur.   In the said Home, statement of the victim under section 164 of Code   of   Criminal   Procedure   came   to   be   recorded   on 11.12.2017 by the PSI attached to Gandhi   Chowk Police Station, Latur, in which she narrated the entire incident and   made   accusation   against   Vikas   Rathod   of   committing rape by threatening her to her life, and against him and his father of inserting some substance in her mouth and of   putting   a   handkerchief   in   her   mouth.   Thereafter, offence punishable under section 376 of the IPC was added in the above said crime.

5. The   petitioner   contends   that   after   recording statement   as   above   of   the   victim,   she   was   referred   on 20.12.2017 to the Government Hospital, Latur for medical examination.  Upon medical examination, it was found that she is carrying two months’ pregnancy.   Thereafter, the accused and his relatives threatened the complainant for dire   consequences,   if   he   does   not   take   case   back. Therefore,   applications   were   submitted   in   the   police station.

6. According   to   the   petitioner,   minor   victim   who was under constant mental and physical pressure of the accused, initially did not attribute any overtact against the accused.   Only when she was in Child Rehabilitation Home,   she   has   gathered   courage   and   she   narrated   the incident.     As   such,   firstly   the   victim   was   sexually assaulted and then she was pressurized for not giving any statement against the accused.   Thus, the victim became pregnant   due   to   heinous   act   committed   by   the   accused person.     Therefore,   considering   her   age,   her   marital status, physical and mental condition and her education, it is desirable to terminate unwanted pregnancy in the light of provisions under sub­section 2(b)(i) of section 3 of the MTP Act.   It is contended that after getting knowledge of pregnancy of the victim, the petitioner and his   entire   family   was   disturbed   and   was   in   shock   and therefore some time was consumed.

7. Considering   aforesaid   contentions   in   the petition and prayer of the petitioner to send the victim for medical examination and opinion of two experts, by order dated 23.01.2018, we had directed to produce the victim   before   the   Medical   Board   constituted   for   the purpose under the MTP Act, with directions to the Medical Board to forthwith examine the victim and tender report to this Court.  The petitioner was medically examined at Government Medical College and Hospital, Aurangabad, by expert   committee   consisting   of   the   following   five members:­
i)  Dr. Shrinivas Gadappa (Chairman) Prof.  HOD, OBGY
ii) Dr.Prashant Titare (Member) Asso. Prof. Radiology
iii)Dr.P.S. Patil (Member) Prof.  HOD Paediatrics
iv) Dr. Ghuge (Member) Prof  HOD, Psychiatry
v)  Dr.Rashmi Bengali (Member) Asso. Prof. Anaesthesia

8. Said Committee tendered to this Court a report dated   25.01.2018.     Said   report   is   taken   on   record   and marked   “X”   for   the   purpose   of   identification.     In   the said report, the following findings are recorded :­
1)   From   general   medical   examination   she   has   no   active medical complaints.
2) Obstetric examination her vital parameters are within normal limits with 16.2 weeks of pregnancy.
3)   Ultrasonographic   examination   suggestive   of   single live   intrauterine   foetus   of   approximately   16   weeks   2 days.  No gross lethal foetal anomaly (Report attached)
4)   On   Psychiatric   examination,   clinically   she   is   of average intelligence. No active current psychopathology. Her concept and judgment are intact. She is aware about the incident and the consequences about the continuation of pregnancy.

9. The   conclusions   of   the   said   Committee   are   as follows :­
1) Current   pregnancy,   on   clinical   and ultrasonographical   examination   is   around   16.2   weeks   of gestation.   No gross lethal congenital anomalies in the foetus.
2) Her   physical   and   mental   health   is   within   normal limits.
3) Under   the   Medical   Termination   of   Pregnancy   Act, 1971 (34 of 1971) under clause 3 of 2 on humanitarian grounds such as when pregnancy arises from a sex crime like   rape   or   intercourse   with   a   “mentally   ill   person” etc.;   when   the   length   of   pregnancy   is   less   than   20 weeks.
4) Risk of termination of pregnancy is within normal acceptable limits.

10. The provisions of sections 3,4 and 5 of the MTP Act, which provide for termination of certain pregnancy by   the   registered   medical   practitioner   and   which   are relevant are as under :­
3. When   pregnancies   may   be   terminated   by registered medical practitioners ­
(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   sub­section (4),   a   pregnancy   may   be   terminated   by   a registered medical practitioner, (a) where the length of the pregnancy does not

exceed twelve weeks, if such medical practitioner is, or
(b) where   the   length   of   the   pregnancy   exceeds twelve weeks but does not exceed twenty weeks, if not   less   than   two   registered   medical practitioners   are,   of   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   such physical   or   mental   abnormalities   as   to   be seriously handicapped.

Explanation 1 – Where any pregnancy is alleged by the pregnant woman to have been caused by rape, the   anguish   caused   by   such   pregnancy   shall   be presumed   to   constitute   a   grave   injury   to   the mental health of the pregnant woman.
Explanation 2 – Where any pregnancy occurs as a result of failure of any device or method used by any married woman or her husband for the purpose of   limiting   the   number   of   children,   the   anguish caused by such unwanted pregnancy may be presumed to   constitute   a   grave   injury   to   the   mental health of the pregnancy woman.

(3) in determining whether the continuance of a pregnancy   would   involve   such   risk   of   injury   to the   health   as   is   mentioned   in   sub­section   (2), account   may   be   taken   of   the   pregnant   woman’s actual or reasonable 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.

4. Place   where   pregnancy   may   be   terminated   ­ No   termination   of   pregnancy   shall   be   made   in accordance with this Act at any place other than
(a) a   hospital   established   or   maintained   by Government , or
(b) a place for the time being approved for the purpose of this Act by Government or a District Level   Committee   constituted   by   that   Government with the Chief Medical Officer or District Health Officer as a Chairperson of the said Committee. Provided   that   the   District   Level   Committee shall consist of not less than three and not more than   five   members   including   the   Chairperson,   as the Government may specify from time to time.

5. Sections 3 and 4 when not to apply ­
(1) The provisions of section 4, and so much of of the provisions of sub­section (2) of section 3 as relate to the length of the pregnancy and the opinion   of   not   less   than   two   registered   medical practitioners, shall not apply to the termination of   a   pregnancy   by   a   registered   medical practitioner   in   a   case   where   he   is   of   opinion, formed   in   good   faith,   that   the   termination   of such   pregnancy   is   immediately   necessary   to   save the life of the pregnant woman.
(2) Notwithstanding   anything   contained   in   the Indian   Penal   Code   (45   of   1860),   the   termination of pregnancy by   person who is not a registered medical   practitioner   shall   be   an   offence punishable with rigorous imprisonment for a term which shall not be less than two years but which may extend to seven years under that Code, that Code shall, to this extent, stand modified.
(3) Whoever terminates any pregnancy in a place other than that mentioned in section 4, shall be punishable with rigorous imprisonment for a term which shall not be less than two years but which may extend to seven years.

Explanation 1 ­ For the purposes of this section, the   expression   “owner”   in   relation   to   a   place means   any   person   who   is   the   administrative   head or   otherwise   responsible   for   the   working   or maintenance   of   a  hospital   or   place,   by   whatever name   called,   where   the   pregnancy   may   be terminated under this Act.
Explanation   2   ­   For   the   purposes   of   this section,so   much   of   the   provisions   of   clause   (d) of   section   2   relate   to   the   possession,   by registered medical practitioner, of experience or training in gynaecology and obstetrics shall not apply.

11. Referring   the   above   provisions,   this   Court   in Writ Petition No.14173   of 2017  “X (since minor through her   mother)   Vs.   The   Union   of   India     Ors.,   (Coram   : R.M.Borde  Smt.Vibha Kankanwadi,JJ) in para 10 of the judgment dated 12.12.2017 observed as under :­ “10. Although section 3 of the Act provides the limit of

12   weeks   for   medically   terminating   pregnancy   by   a medical practitioner and, where the length of pregnancy exceeds 12 weeks but does not exceed 20 weeks and if, not less than two medical practitioners are of opinion, formed in good faith, the continuance of pregnancy would involve   a   risk   to   the   life   of   the   pregnant   woman   or grave  injury   to   her   physical   or   mental   health  or   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, it  would be permissible to terminate the pregnancy.   It must be noted that section 5 of the Act is not controlled by the limitation in respect of duration of pregnancy contained in sections 3 and 4 of the Act.   If in the opinion of medical   experts,   arrived   at   in   good   faith,   the termination   of   pregnancy   is   immediately   necessary   to save   the   life  of   the   pregnant  woman,   such  a   pregnancy can   be   terminated.     It   also   must   be   noted   that Explanation   1   to   section   3   records   that   where   the pregnancy is alleged by the pregnant woman to have been caused by rape, the anguish caused by such pregnancy can be presumed to constitute a grave injury to the mental health of the pregnant woman.   Sub­section (1)(b)(i) of section   3  refers   to   the   risk   involved  to   the   pregnant woman   which   includes   even   injury   in   respect   of   mental health.   There shall not be reason to doubt that since pregnancy   in   the   instant   matter   is   as   a   result   of offence of rape, it causes a huge mental trauma and such inference is in consonance with explanation 1 to section 3(1) of the Act of 1971.“

12. Moreover, in the above decision, the decision of the   Hon’ble   Supreme   Court   in   the   case   of  Suchita Srivastava Vs. Chandigarh Administration, 2009(9) SCC 1, was referred wherein it has been observed that there is no   doubt   that   a   woman’s   right   to   make   reproductive choices   is   also   a   dimension   of   “personal   liberty”   as understood under Article 21 of the Constitution of India. It is important to recognize that productive choice can be   exercised   to   procreate   as   well   as   to   abstain   from procreating.     Moreover,   in   para   19   of   the   aforesaid judgment, the Apex Court has observed as under :­ “19. As evident from its literal description, the “Best interests”   test   requires   the   Court   to   ascertain   the course of action which would serve the best interests of the   person   in   question.     In   the   present   setting   this means that the Court must undertake a careful inquiry of the medical opinion on the feasibility of the pregnancy as   well   as   social   circumstances   forced   by   the   victim. It is important to note that the Court’s decision should be guided by the interests of the victim alone and not those of other stakeholders such as guardians or society in general.   It is evident that the woman in question will need care and assistance which will in turn entail some   costs.     However,   that   cannot   be   a   ground   for denying the exercise of reproductive rights.”

13. This Court in the case of “X” Vs. Union of India   Ors.   in   W.P.9915   of   2017  (Coram   :   R.M.Borde     S.M. Gavhane,   JJ)   decided   on   10.08.2017   observed   that Explanation 1 to section 3 records that where the pregnancy is alleged by the pregnant woman to have been caused by rape, the   anguish   caused   by   such   pregnancy   can   be   presumed   to constitute   a   grave   injury   to   the   mental   health   of   the pregnant woman.  Sub­section (1)(b)(i) of section 3 refers to the risk involved to the pregnant woman which includes even injury   in   respect   of   mental   health.     There   shall   not   be reason to doubt that since pregnancy in the instant matter is as   a   result   of   offence   of   rape,   it   causes   a   huge   mental trauma   and   such   inference   is   in   consonance   with explanation 1 to section 3(1) of the MTP Act.   It was further observed that it must be noted that the pregnancy carried by petitioner is as a result of physical abuse thrust against her and that she has a choice whether to continue with such pregnancy which is result of offence against her person.   The freedom of making choice by a woman which is integral part of personal liberty cannot be taken away.  It shall also be taken into consideration that besides physical injury, the legislature has widened the scope of term injury by including injury to mental health of a pregnant woman.  If continuation of pregnancy is harmful to mental health of a pregnant woman, then it shall be construed as a good legal ground for permitting her   to   terminate   pregnancy   and,   since   in   the   instant matter,   pregnancy   is   alleged   to   be   as   a   result   of physical abuse, in view of section 5 of the MTP Act, the choice   of   the   victim   of   rape   of   terminating   unwanted pregnancy needs to be respected.   Observations made by Division Bench of this Court in Suo Motu Public Interest Litigation no. 1/2016 in the matter of High Court on its own   motion   Vs.   The   State   of   Maharashtra    reported   in LEX(BOM)   2016   9   page   114,   in   paragraph   no.   13   of   the judgment are relevant for consideration which read thus :

13. A woman irrespective of her marital status can be pregnant either by choice or it can be an   unwanted   pregnancy.     To   be   pregnant   is     a natural phenomenon for which woman and man both are   responsible.     Wanted   pregnancy   is   shared equally,   however,   when   it   is   an   accident   or unwanted,   then   the   man   may   not   be   there   to share the burden but it may only be the woman on   whom   the   burden   falls.   Under   such circumstances,   a   question   arises   why   only   a woman   should   suffer.     There   are   social, financial   and   other   aspects   immediately attached to the pregnancy of the   woman and if pregnancy   is   unwanted,   it   can   have   serious repercussions.     it   undoubtedly   affects   her mental health.   The law makers have taken care of helpless plight of a woman and have enacted Section   3(2)(b)(i)   by   incorporating   the   words “grave   injury   to   her   mental   health”.     It   is mandatory   on   the   registered   medical practitioner while forming opinion of necessity of   termination   of   pregnancy   to   take   into account whether it is injurious to her physical or mental health.   While doing so, the woman’s actual   or   reasonable   foreseeable   environment may be taken into account.

14. In the case of  “X” Vs. Union of India (Supra), this Court has also observed that apart from danger to the life of the petitioner, this Court has to take note of the psychological trauma the petitioner is undergoing as a result of carrying unwanted pregnancy.  As has been stated above, the freedom of petitioner to make choice to terminate unwanted pregnancy which is result of physical abuse needs to be respected and such freedom of choice shall   have   to   be   construed   as   integral   part   of   her personal liberty.

15. In the present case, the date of birth of the petitioner   is   05.01.2001.     On   the   date   of   filing   of petition   on   15.01.2018,   she   completed   17   years   of   her age.  Thus, there is no dispute that she is a minor being below   18   years   of   age   and   therefore   she   filed   this petition through her father – the guardian.  On complaint of   her   father,   crime   was   registered   in   Kingaon   Police Station,   Dist.   Latur,   initially   for   the   offence punishable under section 363 read with section 34 of the IPC against Vikas and his father and then after recording statement of the victim, offence under sections 376 of the   IPC   was   added.   Thus,   it   is   clear   that   the   minor victim who claims termination of pregnancy by filing this petition  through her  father is a victim of  rape.   The report of the expert committee under the MTP Act, 1971 shows that current pregnancy of the victim is of around 16.2   weeks.     Thus,   it   is   clear   that   length   of   the pregnancy   of   the   victim   exceeds   12   weeks   but   does   not exceed   20   weeks   and   hence   said   pregnancy   can   be terminated   by   registered   medical   practitioners,   if   not less   than   two   registered   medical   practitioners   are   of opinion   formed   in   good   faith   that   continuation   of pregnancy   would   involve   a   risk   to   the   life   of   the pregnant   woman   or   of   grave   injury   to   her   physical   or mental health; or 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, in the light of provisions under section 3 (2)(b) (i) and (ii) of the MTP Act.

16. In   the   present   case,   from   the   conclusions recorded by the expert committee under the MTP Act, in its   report   (Exh.”X”),   it   is   not   stated   that   there   is substantial risk if the child is born, in the light of sub­clause   (ii)   of   clause   (b)   of   sub­section(2)   of section   3   of   the   MTP   Act.       However,   considering   the contentions in the petition that the pregnancy is caused by   rape,   the   case   of   the   petitioner   falls   under   subclause (i) of clause (b) of sub­section(2) of section 3 of the MTP Act.

17. Keeping   this   in   view,   now   it   is   to   be   seen whether the victim in the present case can be allowed to terminate the pregnancy in the light of aforesaid said provision.  The expert committee in its report gave four conclusions   referred   in   detail   in   para   No.   9   (supra). Amongst said conclusions, conclusion No.3 is that under the   Medical   Termination   of   Pregnancy   Act,   1971   (34   of 1971) under clause 3 of 2 on humanitarian grounds such as when   pregnancy   arises   from   a   sex   crime   like   rape   or intercourse with a “mentally ill person” etc.; when the length of pregnancy is less than 20 weeks.

18. It   appears   from   the   above   conclusion   that   in case   pregnancy   arises   from   sex   crime   like   rape   or intercourse with mentally ill person and when the length of   the   pregnancy   is   less   than   20   weeks,   there   can   be termination under the MTP Act.  This conclusion does not state   that   in   case   pregnancy   of   the   present   victim   is allowed to continue, the same would involve risk to the life  of the victim  or grave injury to her physical  or mental health.  However, from the above referred admitted facts   that   the   victim   is   pregnant   because   of   rape   and crime is registered against the accused for the offence punishable under section 376 of the IPC, it can be said that said pregnancy has been foist on the victim against her   wish   and   said   pregnancy   is   unwanted   pregnancy. Therefore,   anguish   caused   by   such   pregnancy   shall   be presumed   to   constitute   a   grave   injury   to   the   mental health of the pregnant woman, as per Explanation 1 under section 3 referred to above.  Another reason to hold so is that admittedly the victim is taking education in 10th standard and she is residing in the village.  Therefore, she will have to face to the blame of the society, if she continues   with   the   pregnancy   and   even   it   would   be difficult   for   her   to   continue   with   her   education. Naturally,   therefore   said   pregnancy   would   cause   huge trauma to victim.  As the petitioner victim is minor, the petition  is filed by her  father – guardian. As she  is minor, as per sub­section (4) of section 3 of the MTP Act ,   consent   in   writing   of   her   guardian   is   required   to terminate pregnancy.   However, considering her age i.e. 17 years, on her request through her Counsel, in order to know   her   wish   when   heard   in   the   Chamber,   she   also disclosed that it is difficult for her to show her face to   the   people   in   the   village   and   school   due   to   the pregnancy   with   which   does   not   wish   to   continue.     The expert   committee   conclusion   also   shows   that   risk   of termination   of   pregnancy   is   within   normal   acceptable limits. In these circumstances, for the reasons discussed above, we hold that there is no impediment in allowing the petitioner – victim to terminate her pregnancy.

19. Learned   counsel   for   petitioner,   states   on instructions, that the petitioner would like to complete the procedure of termination of pregnancy at Government Medical College, Latur, which is approved as per section 4 of the MTP Act as informed by the Government Pleader. The   Dean   of   Government   Medical   College,   Latur   is   thus directed   to   forthwith   complete   the   procedure   of termination   of   pregnancy   of   minor   petitioner   under supervision   of   the   team   of   medical   experts   after obtaining consent in writing of guardian as per law.  Two members of the team shall be experts in Obstetrics and Gynecology.

20. Since   according   to   petitioner,   the   pregnancy carried   by   her   is   as   a   result   of   offence   of   rape, complaint has already been lodged and the matter is under investigation,   the   Dean,   Government   Medical   College, Latur   is   directed   to   preserve   tissue   sample   and   blood sample of the foetus for carrying out necessary medical tests   including   DNA,   finger   printing/mapping.     The Investigating   Officer   conducting   investigation   in   the matter shall ensure that the samples of tissues and blood etc.   shall   be   forwarded   to   the   Regional   Forensic Laboratory, Aurangabad, for DNA, Finger printing/mapping and   for   carrying   necessary   tests   and   the   samples   and report shall be preserved for the purpose of trial of the offence.

21. It is made clear that the Doctor who have put their opinions on record shall have the immunity in the event of occurrence of any litigation arising out of the instant petition.

22. Rule is accordingly made absolute.  There shall be no order as to costs.

23. Parties   and   all   concerned   to   act   upon authenticated copy of this judgment
.

[S.M.GAVHANE,J.] [S.S.SHINDE,J.]
snk/2018/FEB18/wp956.18

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