Bombay High Court permits termination of fetus with severe abnormalities at the 25-week mark

Priti Mahendra Singh Rawal vs Union Of India And Ors Writ Petition no. 11940 OF 2017, November 6, 2017 Inadequate access to health care, poor quality services, and outdated abortion restrictions contribute to India’s high Maternal Mortality Rate (MMR) of 174 deaths per 100,000 live births. Improving maternal health and reducing the MMR is a United Nations Millennium Development Goal (MDG). India is expected to have an MMR of 139 deaths per 1 lakh live births in 2015 -- missing the MDG by 30 percentage points. This is a case of Priti Mahendra Singh Rawal, a 28-year-old Mumbai resident who was 25 weeks pregnant and barred from medical termination of her pregnancy in spite of the diagnosis of a fetal abnormality. The disorder was detected during an Ultrasonography in October 2017, and it was found that the fetus suffered from anomalies such as Neural tube defect which is seen at dorso-lumbar junction, a meningomyelocele [30 x 30 mm], secondary brain changes of hydrocephalus [16 mm] and Arnold Chiari malformation. Under the Medical Termination of Pregnancy (MTP) Act, pregnancies beyond 20 weeks cannot be terminated, which rendered Priti unable to seek an abortion even after discovering the fetal abnormality. In the absence of a safe, legal option for women to seek abortions, this provision of the Act forces women across the country to seek unsafe abortions from untrained medical personnel. Indeed, illegal abortions are the third leading cause of maternal death in India and account for 13% of maternal deaths worldwide. In the current case, a board of medical experts -- including pediatrics surgeon, professor and head of the department of pediatrics, professor and head of the department of cardiovascular surgery, associate professor and head of the department of psychiatry of the Sir JJ Group of Hospitals, Mumbai, was taken. They concluded that there were multiple serious neurological and skeletal abnormalities in the fetus. These abnormalities, according to them, increased greatly the high chances of morbidity and mortality in the newborn, and if the baby were to be born, it would require multiple surgeries. It would suffer from a high chance of meningitis, mental retardation, paralysis of lower limbs and loss of urine and bowel control. The court observed that “the condition of the fetus fulfills the criteria of ‘substantial risk of serious physical handicap’ in the fetus. It is also clear that the petitioner has voluntarily expressed her desire to terminate the pregnancy and is well informed about the nature of the fetus and its outcome.” It then directed that the petitioner’s pregnancy be terminated at the Sir JJ Group of Hospitals, Mumbai the next day, and disposed of the matter.