Kerala High Court
Priskilla K Baby vs Union Of India on 13 February, 2026
2026:KER:13280
IN THE HIGH COURT OF KERALA AT ERNAKULAM
PRESENT
THE HONOURABLE MRS. JUSTICE SHOBA ANNAMMA EAPEN
FRIDAY, THE 13TH DAY OF FEBRUARY 2026 / 24TH MAGHA, 1947
WP(C) NO. 4996 OF 2026
PETITIONERS:
1 PRISKILLA K BABY
AGED 31 YEARS
W/O VIPIN A.G, AYYANDI HOUSE, ENGANDIYUR,
THRISSUR DISTRICT,, PIN - 680615
2 VIPIN A.G
AGED 30 YEARS
S/O GOPI, AYYANDI HOUSE, ENGANDIYUR,
THRISSUR DISTRICT,, PIN - 680615
BY ADVS.
SRI.JOSEPH GEORGE
SHRI.P.A.REJIMON
SMT.NIKITA NAIR C.S.
SHRI.VIVEKJOS PUTHUKULANGARA
SMT.MAHIMA MERINE REJI
SMT.TREASA ANN JOHN
RESPONDENTS:
1 UNION OF INDIA
REPRESENTED BY ITS SECRETARY,
MINISTRY OF WOMEN AND CHILD DEVELOPMENT SHASTRI
BHAVAN NEW DELHI, PIN - 110001
2 STATE OF KERALA
REPRESENTED BY ITS SECRETARY TO GOVERNMENT
DEPARTMENT OF CHILD WELFARE ,GOVERNMENT
SECRETARIATE, THIRUVANANTHAPURAM, PIN - 695001
2026:KER:13280
WP(C) NO. 4996 OF 2026
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3 DIRECTOR OF HEALTH SERVICES
OFFICE OF DHS, GENERAL HOSPITAL
JUNCTION,THIRUVANANTHAPURAM, PIN - 695035
4 THE DISTRICT MEDICAL OFFICER KOTTAYAM
OFFICE OF THE DMO, GENMERAL HOSPITAL KOTTAYAM,,
PIN - 686002
5 SUPERINTENDENT
MEDICAL COLLEGE HOSPITAL, GANDHI NAGAR P.O,
KOTTAYAM, PIN - 686008
6 PRINCIPAL
MEDICAL COLLEGE HOSPITAL, GANDHI NAGAR P.O,
KOTTAYAM, PIN - 686008
BY ADV SHRI.P.M.UNNI NAMBOODIRI, CGC
THIS WRIT PETITION (CIVIL) HAVING BEEN FINALLY HEARD ON
13.02.2026, THE COURT ON THE SAME DAY DELIVERED THE FOLLOWING:
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WP(C) NO. 4996 OF 2026
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JUDGMENT
The petitioners, who are the wife and husband, have been seeking medical termination of 27 weeks plus 2 days old pregnancy, after having found that the foetus suffers congenital abnormalities of the brain and head, including features suggestive of microcephaly, carrying a high likelihood of serious and lifelong physical and neurological disability. According to the petitioners, Exts.P4 Chromosomal Microarray Cytoscan Optima test report revealed that a gain of 33091 kbp on chromosome consistent with Trisomy 21 or Down's Syndrome, - the common genetic cause of mental retardation and is associated with several clinical traits including congenital heart disease, Duodenal stenosis or Atresia, Imperforate anus, Hirschsprung disease, Muscle Hypotonia, Immune system deficiencies, Increased risk of childhood Leukaemia and early onset Alzheimer's disease and Genomic Amauplory. The petitioners, therefore, seek for a direction to the respondents to permit the first petitioner to undergo medical termination of pregnancy.
2. Heard the learned counsel for the petitioners, the learned CGC and the learned Government Pleader.
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3. When the writ petition came up for consideration on 09.02.2026, this Court directed the fifth respondent to constitute a Medical Board for the purpose of assessing the following:-
(i) whether continuance of the petitioner's pregnancy will involve risk to her life or grave injury to her physical or mental health?
(ii) whether there is a substantial risk that if the child is born, it will suffer from such physical or mental abnormalities as to be seriously handicapped and if so, the nature of abnormalities; and
(iii) whether, having regard to the advanced stage of pregnancy, there is any danger (other than usual danger which arises even in spontaneous delivery at the end of full term) if the pregnant mother is permitted to terminate her pregnancy?
Today, the learned Government Pleader made available this Court the report of the Medical Board dated 11.02.2026 comprising of Professor (CAP) of OBG department, Associate Professors of Department of Neuro Medicine, and Assistant Professors of Department Radio Diagnosis and Cardiology, Paediatrics, Psychiatry Department, of the Government Medical College Hospital, Kottayam. The conclusion and final opinion of the Medical 2026:KER:13280 WP(C) NO. 4996 OF 2026 5 Board are as follows:-
FORM D (See sub-clause (ii) of clause (b) of rule 3A) Report of the Medical Board for Pregnancy Termination Beyond 24 weeks.
Details of the woman seeking termination of Pregnancy:
1 Name of woman : PRISKILLA K. BABY
2. Age 33 Years
3. Registration /Case Number : W.P.(C) No.4996 OF 2026 (Y)
4. Available report and investigations:
SL. No. Report Opinion on the finding
01. a. Continuation of pregnancy is not Priskilla .K.Baby, 33yrs was referred Department likely to produce increased risk to of OBG: from DH Kozhencherry with anomally her life or grave injury to her scan showing Echogenic intracardiac physical health foci in left ventricle. She was seen in b. Since she is remote from terms she Fetal Medicine Department, GMC will require induction of labour.
Kottayam. Amniocentesis done- Induction of labour causes more Chromosomal Microarray -Trisomy 21 risk than normal spontaneous labour. There is chance of failure of Duplication position.
induction which may require G2 A1, LMP: 01/08/2025, Caesarean section EDC:8/5/2026 POG: 27W 5 days.O/E:
Pulse RATE:96/minute, BP 125/70mmHG, Ht: 153 cm, Wt.72.1 kg, USG on-11/02/2026:SLIUF of 26w 5D, with EFW 8.4 percentile Abnormal Doppler indices Micrognathia, Reduced swallowing reflux, Clenched fist, Bilateral dilated renal Pelvis, Short femur, Echogenic intracardiac foci, Polyhydramnios, Moderate right Pleural effusion
02. Dept. Down Syndrome is a genetic condition Priskilla .K.Baby, 33yrs G2 A1-
OBG Fetal caused by extra chromosome on Medicine Reported at 22 weeks with abnormal chromosome 21 causing physical and ultrasound reports which pointed intellectual disability and affecting towards a genetic problem. Hence cognitive development. The probability invasive procedure done send for CMA of short life span, low IQ, development on 12/01/2026 (22 w 5 days). delay, leukemia, heart defects all were Advanced period of gestation and the discussed. Repeat ultrasound is showing fetus with decreased reports taking a minimum of 3 weeks swallowing reflux, pleural effusion, by the lab was explained. So by this clenched fist and micrognathia time the patient crossing 24 weeks was reinforcing findings of a genetic explained to the couple. Report came disorder. on 26/01/2026 as Down Syndrome.
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03. Dept of SLIUF of 26w 5D, with EFW 8.4 SLIUF of 26w 5D, Abnormal Doppler Radio percentile Abnormal Doppler indices indices, Micrognathia, Reduced Diagnosis (CPR 99 percentile Uterine artery4 swallowing reflux,, Clenched fist, percentile, Micrognathia, Reduced Bilateral dilated renal Pelvis, Short swallowing reflux, Clenched fist, femur, , Echogenic intra cardiac foci, Bilateral dilated renal Pelvis, Short Polyhydramnios, Moderate right Pleural femur, Echogenic intra cardiac foci, effusion Polyhydramnios, Moderate right Compared to the previous scan dated Pleural effusion 08.01.2026 Polyhydramnios, Moderate right Pleural effusion are new findings.
04.Dept. of Gestational age of 27 weeks. To go along with general amniocentesis s/o aneuploidy and consensus among other experts Cardiology trisomy. although fetal echo doesn't suggest definite intracardiac defects, of medical board there is increased incidence of general mental and physical retardation of growth and higher incidence of congenital anomalies and disorders A. 05 Priksilla, 33 year, female, G2 Al with Physical risk to mother: to ovulation induction history;
Dept. of be assessed by
Gestational age of 27 weeks 5 days by
Pediatrics,. LMP, wih trisomy 21 detected gynecologist; mental risk:
onamniocentesis. Last scan showing
moderate right pleural effusion in by psychiatrist
baby, clenched fist, micrognathia, If the child is delivered now or at
B.
polyhydramnios, short femur/ term the baby will suffer mental
disabilities in form of low I0, the
severity of which cannot be
estimated at present.
C. Risk to mother of
premature termination to
be determined by
gynecologist.
06. Gestational age of 27 weeks, To go along with general
amniocentesis showing trisomy consensus among other experts
Dept. of
21.Child can develop significant
Neuro neurological abnormalities like of medical board
intellectual disability, hypotonia which Medicine can cause gait instability, developmental delay, seizures, early onset dementia -alzheimer's.
7.Department Evaluated the mental status of Priskilla As per the mental status of Psychiatry .K.Baby, 33yrs. She is conscious, alert examination of and oriented to time place and person, She is cooperative and answers Priskilla.K.Baby, 2026:KER:13280 WP(C) NO. 4996 OF 2026 7 questions relevantly and coherently. No disorder of stream, form or it is inferred that continuation possession is elicited, No delusions or hallucinations are elicited. Cognitive of pregnancy is likely to be functions are within normal limits, associated with risk to her mental Clinical assessment of intelligence health. indicate average intellectual functioning. She has adequate judgment and insight regarding her present health condition and is able to assess appropriately the medical information provided to her by doctors regarding the health of her fetus.
Mrs.Priskilla.K.Baby reports significant anxious cognitions regarding continuation of her pregnancy. She reports that she finds it not possible to continue the pregnancy as it causes very severe emotional distress to her whil eevaluating her current and future life. She does not report of any guilt ideations regarding her wish to terminate the pregnancy and says that it is the best course of action for her and her fetus.
6. Opinion by Medical Board for termination of pregnancy:
a) Allowed: Allowed
b) Denied.:
Justification for the decision:As the baby is having chromosomal anomaly Trisomy 21, which is likely to affect the physical and mental health seriously. Hon. High Court may please grant permission to induce iatrogenic foetal demise as per recommendations of the Royal College of Obstetricians and Gynecologists (RCOG) and the FOGSI- ICOG guidelines (2017).
7. Physical fitness of the woman for the termination of pregnancy:
a) Yes : Yes
b) No. 2026:KER:13280 WP(C) NO. 4996 OF 2026 8
4. The termination of pregnancy is governed by the Medical Termination of Pregnancy Act, 1971 ('Act', in short) and the rules framed thereunder. The Act is a progressive legislation that regulates how pregnancies can be terminated.
5. Section 3 of the Act spells out the conditions to be satisfied to terminate a pregnancy, which reads as follows:
"S.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 sub-section (4), a pregnancy may be terminated by a registered medical practitioner, ―
(a) where the length of the pregnancy does not exceed twenty weeks, if such medical practitioner, is or (b) where the length of the pregnancy exceeds twenty weeks but does not exceed twenty - four weeks in case of such category of woman as may be prescribed by rules made under this Act, if not less than two registered medical practitioners are, of the 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 any serious physical or mental abnormality.
Explanation 1.―For the purposes of clause (a), where any pregnancy occurs as a result of failure of any device or 2026:KER:13280 WP(C) NO. 4996 OF 2026 9 method used by any woman or her partner for the purpose of limiting the number of children or preventing pregnancy, the anguish caused by such pregnancy may be presumed to constitute a grave injury to the mental health of the pregnant woman.
Explanation 2. ― For the purposes of clauses (a) and (b), where any pregnancy is alleged by the pregnant woman to have been caused by rape, the anguish caused by the pregnancy shall be presumed to constitute a grave injury to the mental health of the pregnant woman. (2A) The norms for the registered medical practitioner whose opinion is required for termination of pregnancy at different gestational age shall be such as may be prescribed by rules made under this Act. (2B) The provisions of sub-section (2) relating to the length of the pregnancy shall not apply to the termination of pregnancy by the medical practitioner where such termination is necessitated by the diagnosis of any of the substantial foetal abnormalities diagnosed by a Medical Board.
(2C) Every State Government or Union territory, as the case may be, shall, by notification in the Official Gazette, constitute a Board to be called a Medical Board for the purposes of this Act to exercise such powers and functions as may be prescribed by rules made under this Act. (2D) The Medical Board shall consist of the following, namely: (a) a Gynaecologist; (b) a Paediatrician; ― (c) a Radiologist or Sonologist; and (d) such other number of members as may be notified in the Official Gazette by the State Government or Union territory, as the case may be. (3) In determining whether the continuance of a pregnancy would involve such risk of injury to the health as is mentioned in sub-section (2), account may be taken of the pregnant woman's actual or reasonably 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."
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6. It is also necessary to refer to the Medical Termination of Pregnancy Rules, 2003, which reads as follows:
"3A. Powers and functions of Medical Board.--For the purposes of section 3,-- (a) the powers of the Medical Board shall be the following, namely:- (i) to allow or deny termination of pregnancy beyond twenty-four weeks of gestation period under sub-section (2B) of the said section only after due consideration and ensuring that the procedure would be safe for the woman at that gestation age and whether the foetal malformation has substantial risk of it being incompatible with life or if the child is born it may suffer from such physical or mental abnormalities to be seriously handicapped";
7. The position of law can therefore be summarised thus:
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8. Besides the above statutory safeguards, the Ministry of Health and Family Welfare, Government of India, has issued a comprehensive 'Guidance Note for Medical Boards for Termination of Pregnancy beyond 20 weeks of Gestation', dated 14th August 2017. The Note stipulates that it is the responsibility of the Medical Board to ascertain whether the foetal abnormality is substantial enough to qualify as either incompatible with life or associated with significant morbidity or mortality of the child if born.
Determining substantial foetal abnormalities should be based on a thorough review of the patient's medical records. The Medical Board should conduct additional investigations as may be necessary. It should base its decision on concrete medical evidence and expert evaluations, including reviewing the available documents and performing additional diagnostic tests to confirm the presence and extent of congenital abnormalities. The objective of the Note is to ensure that the decision to terminate the pregnancy is made with the utmost care and consideration of the potential outcomes and quality of life of the child.
9. A three-judge Bench of the Hon'ble Supreme Court, in Suchita Srivastava v. Chandigarh Admn. [(2009) 9 SCC 1], has 2026:KER:13280 WP(C) NO. 4996 OF 2026 12 held that the right to make reproductive choices is a facet of Article 21 of the Constitution and that the consent of the pregnant person in matters of reproductive choices and abortion is paramount.
10. In XYZ v. State of Gujarat (2023 SCC Online SC 1573), the Hon'ble Supreme Court held that the Medical Board or the High Court cannot refuse termination of pregnancy merely on the ground that the gestational age is above the statutory prescription.
It is held as follows:
"19. The whole object of preferring a Writ Petition under Article 226 of the Constitution of India is to engage with the extraordinary discretionary jurisdiction of the High Court in exercise of its constitutional power. Such a power is vested with the constitutional courts and discretion has to be exercised judiciously and having regard to the facts of the case and by taking into consideration the relevant facts while leaving out irrelevant considerations and not vice versa."
11. The Hon'ble Supreme Court in A v. State of Maharashtra [(2024) 6 SCC 327] has held as under:
" 28. The powers vested under the Constitution in the High Court and this Court allow them to enforce fundamental rights guaranteed under Part III of the Constitution. When a person approaches the court for permission to terminate a pregnancy, the courts apply their mind to the case and make a decision to protect the physical and mental health of the pregnant person. In doing so the 2026:KER:13280 WP(C) NO. 4996 OF 2026 13 court relies on the opinion of the Medical Board constituted under the MTP Act for their medical expertise. The court would thereafter apply their judicial mind to the opinion of the Medical Board. Therefore, the Medical Board cannot merely state that the grounds under Section 3(2-B) of the MTP Act are not met. The exercise of the jurisdiction of the courts would be affected if they did not have the advantage of the medical opinion of the board as to the risk involved to the physical and mental health of the pregnant person. Therefore, a Medical Board must examine the pregnant person and opine on the aspect of the risk to their physical and mental health.
29. The MTP Act has removed the restriction on the length of the pregnancy for termination in only two instances. Section 5 of the MTP Act prescribes that a pregnancy may be terminated, regardless of the gestational age, if the medical practitioner is of the opinion formed in good faith that the termination is immediately necessary to save the life of the pregnant person. Section 3(2-B) of the Act stipulates that no limit shall apply on the length of the pregnancy for terminating a foetus with substantial abnormalities. The legislation has made a value judgment in Section 3(2-B) of the Act, that a substantially abnormal foetus would be more injurious to the mental and physical health of a woman than any other circumstance. In this case, the circumstance against which the provision is comparable is rape of a minor. To deny the same enabling provision of the law would appear prima facie unreasonable and arbitrary. The value judgment of the legislation does not appear to be based on scientific parameters but rather on a notion that a substantially abnormal foetus will inflict the most aggravated form of injury to the pregnant person........
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32. This highlights the need for giving primacy to the fundamental rights to reproductive autonomy, dignity and privacy of the pregnant person by the Medical Board and the 2026:KER:13280 WP(C) NO. 4996 OF 2026 14 courts. The delays caused by a change in the opinion of the Medical Board or the procedures of the court must not frustrate the fundamental rights of pregnant people. We therefore hold that the Medical Board evaluating a pregnant person with a gestational age above twenty-four weeks must opine on the physical and mental health of the person by furnishing full details to the court".
12. As far as the present case is concerned, Exts.P2 & P4 scan reports, it is clear that foetus suffers from a gain of 33091 kbp on chromosome consistent with Trisomy 21 or Down's Syndrome, -
the common genetic cause of mental retardation and is associated with several clinical traits including congenital heart disease, Duodenal stenosis or Atresia, Imperforate anus, Hirschsprung disease, Muscle Hypotonia, Immune system deficiencies, Increased risk of childhood Leukaemia and early onset Alzheimer's disease and Genomic Amauplory. Further the Medical Board has opined that if the pregnancy continues and a baby is born, it would suffer from serious physical abnormalities.
13. Consequently, there is a decisive basis to hold that the first petitioner is eligible to get her pregnancy terminated, irrespective of the gestation age, in view of Section 3 (2-B) of the Act, as the foetus presents with substantial abnormalities that the Medical Board has confirmed.
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14. After an elaborate consideration of the facts, the materials on record and the well-settled principles of law on the subject, especially considering the recommendations of the Medical Board, I am of the view that denying termination may only delay the inevitable and extend the suffering of the family. The writ petition is to be disposed of by directing the fifth respondent to terminate the first petitioner's pregnancy.
In the aforementioned circumstances, I dispose of the writ petition by passing the following directions:
1. The fifth respondent shall take immediate measures for constituting a Medical Team to conduct the termination of the first petitioner's pregnancy, on production of a copy of this judgment.
2. The Medical Team shall, in their discretion and best judgment, adopt the best procedure recommended in the medical science to terminate the pregnancy and save the life of the first petitioner.
3. The petitioners shall file an undertaking authorising the fifth respondent to terminate the pregnancy at their risk and costs.
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4. Before conducting the termination of the pregnancy, the Medical Board shall reconfirm the fetal abnormalities by performing a final scan.
5. The parties shall appear before the Superintendent of Medical College Hospital, Kottayam on 14.02.2026.
sd/-
SHOBA ANNAMMA EAPEN JUDGE RK/ 2026:KER:13280 WP(C) NO. 4996 OF 2026 17 APPENDIX OF WP(C) NO. 4996 OF 2026 PETITIONER EXHIBITS Exhibit P-1 THE TRUE PHOTOCOPY OF USG-EARLY PREGNANCY (TVS) DATED 24-09-2025 Exhibit P-2 TRUE PHOTOCOPY OF OBSTETRIC USG LEVEL 1 REPORT DATED 08-01-2026 Exhibit P-3 TRUE PHOTOCOPY OF OP CARD DATED 09.01.2026 ISSUED FROM THE MEDICAL COLLEGE HOSPITAL KOTTAYAM Exhibit P-4 THE TRUE PHOTOCOPY OF THE CHROMOSOMAL MICROARRAY CYTOSCAN OPTIMA TEST REPORT DATED 26.01.2026 Exhibit P-5 THE TRUE PHOTOCOPY OF OP CARD DATED 29.1.2026 ISSUED FROM THE MEDICAL COLLEGE HOSPITAL, KOTTAYAM Exhibit P-6 THE TRUE PHOTOCOPY OF THE JUDGMENT DATED 12-03-2025 IN WA NO.477/2025 OF THIS HON'BLE COURT