The Madras High Court has allowed termination of pregnancy beyond 24 weeks, holding that a mother has the right to decide whether to bring into the world a child who will not lead a normal life.
Chennai: The Madras High Court has quashed a government women’s hospital’s refusal to approve the termination of a pregnancy that had crossed 24 weeks, and directed that the procedure be carried out forthwith by a registered medical practitioner, after scans showed substantial foetal abnormalities [P.K. v. The Secretary, Health and Family Welfare Department, Government of Tamil Nadu and Others].
Justice P.T. Asha allowed the writ petition under Article 226 of the Constitution on October 15, 2026, setting aside the Form D order of October 13 passed by the Chairman of the Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Egmore.
How the case reached the Court
The petitioner married in December 2022 and has a son born in February 2024. She conceived for the second time in early 2026. A scan on March 1 recorded a viable gestation of about 19 to 20 weeks, and she was asked to return for a follow-up scan at 28 weeks. That scan found mild foetal ventriculomegaly, and a second opinion confirmed it.
A detailed neurosonogram on October 5 went further. It noted agenesis of the corpus callosum with bilateral moderate ventriculomegaly, and advised a foetal brain MRI. The MRI of October 6 reported that the corpus callosum and cavum septum pellucidum were not visualised and that the lateral ventricles were dilated, at 16 mm on the right and 15 mm on the left. The scan report recorded that the condition carries an increased risk of developmental difficulties, including learning difficulties, epilepsy and intellectual disability, and that the degree of impairment cannot be reliably predicted before birth.
The petitioner and her husband consented to termination. The medical board, however, declined to approve it on the ground that the neurological abnormalities were not lethal, and asked for genetic testing. It stated that isolated corpus callosal agenesis carries a variable prognosis. The petitioner’s case was that a genetic test would only trace the genetic history of the foetus and would not serve the purpose, and she moved the High Court.
The legal position
The Court surveyed the framework of the Medical Termination of Pregnancy Act, 1971 and the 2003 Rules. Up to 20 weeks, one registered medical practitioner may terminate a pregnancy; between 20 and 24 weeks, the opinion of two practitioners is needed for prescribed categories of women. Under Section 3(2B), the gestational limit does not apply where termination is necessitated by substantial foetal abnormalities diagnosed by a Medical Board, whose powers are set out in Rule 3A. The Court noted that the pregnancy had crossed 24 weeks and that the Board had not granted approval.
It then turned to precedent. It cited the Supreme Court’s three-judge Bench ruling in Suchita Srivastava v. Chandigarh Administration (2009) 9 SCC 1, which held that reproductive choice is a facet of Article 21 and that the pregnant person’s consent is paramount. It also relied on the Supreme Court’s decision in A v. State of Maharashtra (2024) 6 SCC 327, which stressed that delays in Medical Board opinions or court procedure must not frustrate the fundamental rights of pregnant persons, and on a Delhi High Court ruling that examined the meaning of “substantial foetal abnormalities”.
What the Court said
“In the instant case, the scan reports clearly show substantial fetal abnormalities. The mother has the right to take a decision as to whether she would like to bring such a child into the world, particularly when the child is not going to lead a normal life. Therefore, this Court has to bow down to the decision of the petitioner / mother who has taken a painful and extreme step by taking note of the considerable risk involved in this child’s chance of leading a dignified and self-sustained life.”
The Court added that it is the parents who would have to watch, day in and day out, the suffering such a child would undergo, and that it must also consider the life of the child after the lifetime of the parents.
The directions
“…the impugned order of the 3rd respondent cannot be sustained and is accordingly quashed and the respondents are directed to terminate the medical pregnancy of the petitioner as per medical records and the termination shall be done by the registered medical practitioner, forthwith.”
Why the order matters
The ruling shows a constitutional court treating the mother’s decision as decisive where the scans point to serious, life-long impairment, even when a Medical Board has called the abnormality non-lethal. It reads the Board’s role under the MTP Act as a safeguard that cannot override reproductive autonomy under Article 21.
It also ties the outcome to time. By directing termination forthwith, the Court recognised that every week of delay narrows the petitioner’s options, a concern the Supreme Court has repeatedly voiced in cases on late-term pregnancies.
Case Title: P.K. v. The Secretary, Health and Family Welfare Department, Government of Tamil Nadu and Others [W.P. No. 42910 of 2026]
Bench: Justice P.T. Asha, Madras High Court
Date of Order: October 15, 2026
Appearances: Advocate N. Manokaran (for Mr. A. Kanakavelappan) for the petitioner; Government Advocate J.V. Sakthi Balakrishnan for respondents 1 and 3; Standing Counsel V. Bharanidharan for respondent 2