Context:

• In a significant judgment, the Supreme Court of India overturned a Bombay High Court ruling and permitted a teenager to terminate her 30-week pregnancy.
• The decision assumes importance in the backdrop of the Medical Termination of Pregnancy Act, 2021.
• The act allows abortion up to 24 weeks under specified conditions but remains silent on late-term terminations beyond this limit, leaving courts to intervene on a case-by-case basis.
• This judgment marks a notable reaffirmation of women’s reproductive autonomy and expands the constitutional conversation on mental health, bodily integrity, and dignity.

Legal Framework - The MTP Act and Judicial Discretion:

• Expanded but limited statutory framework:
  • The MTP (Amendment) Act, 2021 extended the gestational limit for abortion from 20 to 24 weeks for certain categories of women (including survivors of rape, minors, and other vulnerable groups).
  • Beyond 24 weeks, termination is permissible only in cases of substantial foetal abnormalities, as diagnosed by Medical Boards.
  • There is no explicit fundamental “right to abortion” under Indian law.
• Judicial role in late-term abortions: Due to statutory limits, courts frequently adjudicate petitions for termination beyond 24 weeks. However, outcomes have been inconsistent, revealing judicial subjectivity and moral complexities.

Key Observations by the Supreme Court:

• Reproductive autonomy cannot be compelled:
  • The Court emphatically stated that it “cannot compel” a woman to continue a pregnancy if she is unwilling.
  • This marks a clear shift toward prioritising bodily autonomy and individual choice, consistent with Article 21 (Right to Life and Personal Liberty).
• Restrictive laws increase unsafe abortions:
  • The Court acknowledged an important public health reality - restrictive access does not prevent abortions.
  • It increases the risk of unsafe procedures by “quacks and unauthorised doctors”.
  • Thus, access to safe Medical Termination of Pregnancy (MTP) services becomes central to reproductive justice and public health policy.
• Mental health equals physical health:
  • A landmark aspect of the judgment is the recognition of mental trauma as equally significant as physical health, placing mental health on par with physical health.
  • It adopted a broader, health-based approach rather than a moralistic “pro-life vs pro-choice” framework.
  • This aligns with a rights-based and health-centred interpretation of reproductive autonomy.

Health as a Determinant: Whose Health Matters?

• Abortion jurisprudence globally wrestles with the foetus’s potential “right to life”, and the pregnant woman’s right to choice.
• The Bombay HC had denied termination citing that the foetus was “healthy and viable”.
• The SC set this aside and prioritised the pregnant individual’s unwillingness, thus clearly foregrounding maternal autonomy over foetal viability in this case.

The Minor and the Question of ‘Illegitimacy’:

• Special consideration for minors:
  • The Court referred to the petitioner as a “child” (she had conceived as a minor though she turned 18 later). It held that minors cannot be compelled to continue pregnancy.
  • This is significant in light of rising cases of sexual abuse against minors, concerns under the POCSO Act, and the constitutional emphasis on dignity and best interests of the child.
• Role of marital status:
  • The pregnancy was described as “illegitimate” (outside marriage), which arguably influenced the Court’s empathetic stance.
  • However, this raises critical questions: Would the outcome have differed if the women were married?; Does marital status shape judicial perception of reproductive rights?

Inconsistency in Judicial Approach (The 2023 Case):

• In 2023, the SC rejected a 26-week termination plea of a married 27-year-old woman, despite her citing mental health concerns and an unwanted pregnancy.
• This contrast highlights judicial inconsistency, the continued influence of marital norms, and the entanglement of motherhood with marriage in legal reasoning.

Broader Constitutional and Social Questions:

• Marriage, motherhood and autonomy: Indian women’s sexual and reproductive autonomy often remains overshadowed by marital status.
• This ties into: The ongoing debate on the marital rape exception, societal notions of “legitimacy”, and patriarchal assumptions about motherhood.
• The Court’s observation: That “the mother’s reproductive autonomy must be given emphasis” should ideally transcend marital and social categories.

Challenges:

• Absence of absolute right to abortion: Decisions hinge on judicial discretion.
• Inconsistent jurisprudence: Similar cases yield divergent outcomes.
• Foetal viability debate: Ethical and legal tensions persist.
• Marital status bias: Marriage continues to shape legal outcomes.
• Limited mental health integration: Despite recognition, practical implementation remains weak.
• Access barriers: Medical Boards, procedural delays, and stigma hinder timely access.

Way Forward:

• Codify: Reproductive autonomy as a fundamental right. Explicit recognition under Article 21 through judicial clarification or legislative reform.
• Uniform: Guidelines for late-term abortions. Clear medical and psychological parameters to reduce judicial arbitrariness.
• Strengthen: Public health infrastructure. Ensure safe, affordable, stigma-free access to abortion services. Expand trained providers and Medical Boards.
• Mainstreaming: Mental health. Integrate psychiatric evaluation and trauma-informed care in reproductive health policy.
• De-link: Autonomy from marital status. Ensure rights are not mediated by notions of legitimacy or marriage. Align abortion jurisprudence with gender justice principles.
• Rights-based framework: Move from morality-based reasoning to dignity, autonomy, and health-based reasoning.

Conclusion:

• The Supreme Court’s ruling marks a progressive reaffirmation of women’s reproductive autonomy and a crucial shift toward a health-centred, dignity-based framework.
• By recognising mental health as central and rejecting coercive continuation of pregnancy, the Court strengthens the constitutional promise of personal liberty.
• However, inconsistencies across cases reveal that reproductive autonomy in India remains conditional and context-dependent.
• For reproductive rights to become truly inalienable, the guiding principle going forward must be unequivocal: a woman’s reproductive autonomy is integral to her dignity, bodily integrity, and constitutional freedom.