MP High Court Addresses Late-Term Abortion Hurdles for Sexual Assault Victims

Given the existing gaps in the law and the challenges faced by victims, there is a strong argument for more comprehensive legislation in India. Such legislation could include specific rules that proactively address the needs of vulnerable groups like sexual assault survivors, provide essential guidelines, and ensure timely access to termination of pregnancy services beyond 24 weeks.

While the Medical Termination of Pregnancy Act, 1971 (amended 2021) generally limits termination to 24 weeks in India, there’s no uniform law permitting it beyond this for all reasons. Consequently, in the absence of clear, readily available legal precedents or specific state laws, especially concerning late-term abortions for survivors of sexual assault, victims in India, may find themselves reliant on court intervention to address their mental trauma.

Addressing conflicting legal views on the Medical Termination of Pregnancy Act, 1971, within its own ranks, the Madhya Pradesh High Court initiated a suo motu writ petition. In response, a Division Bench under Chief Justice Suresh Kumar Kait and Justice Vivek Jain established Standard Operating Procedures (SOPs) for pregnancy termination in cases of sexual assault, extending to pregnancies over 24 weeks. These guidelines prioritize victim-centric care, judicial oversight, and swift medical assessments.

SOP Issued by MP High Court

1. SOP for Termination of Pregnancy in Sexual Assault Cases:

The Madhya Pradesh High Court laid down SOPs in February 2025 regarding the termination of pregnancy for survivors of sexual assault, rape, or incest.
These SOPs address pregnancies up to and exceeding 24 weeks.
The court aimed to resolve inconsistencies in previous judicial views on the matter.
Key aspects of the SOPs include:
- For pregnancies up to 24 weeks:
  - The Station House Officer (SHO) must refer the victim to the District Court upon confirmation of pregnancy within 24 weeks.
  - The District Court should direct an immediate medical examination.
  - If conditions under the Medical Termination of Pregnancy (MTP) Act are met, termination should be carried out within three days.
  - Consent of the survivor or guardian is mandatory.
- For pregnancies exceeding 24 weeks:
  - The SHO must forward the survivor to the District Court (Special Judge, POCSO).
  - The Special Judge refers the victim to a medical board.
  - If termination is possible, the case is referred to the High Court.
  - The High Court decides on permission for termination.
  - Expert doctors conduct the procedure with due care and explanation of risks.

Indian law regarding the termination of pregnancy up to 24 weeks is primarily governed by the Medical Termination of Pregnancy Act, 1971 (MTP Act), as amended by the Medical Termination of Pregnancy (Amendment) Act, 2021.

General Provisions:

Gestation Period: The law allows for the termination of pregnancy up to 24 weeks under specific conditions.
Consent: The consent of the pregnant woman is required for the termination. In the case of a minor or a woman with a mental illness, the consent of the guardian is also necessary.
Registered Medical Practitioner (RMP): Termination of pregnancy can only be performed by a registered medical practitioner.

Requirements based on Gestation Period:

Up to 20 Weeks:
- Requires the opinion of one registered medical practitioner.
- Termination is permitted if the continuation of the pregnancy would involve a risk to the life of the pregnant woman or cause grave injury to her physical or mental health.
- It is also allowed if there is a substantial risk that if the child were born, it would suffer from any serious physical or mental abnormality.
- In cases where the pregnancy is a result of contraceptive failure by a married woman or her husband, the anguish caused is presumed to constitute grave injury to her mental health.
Between 20 and 24 Weeks:
- Requires the opinion of two registered medical practitioners.
- This is allowed for specific categories of women, including:
  - Survivors of sexual assault or rape or incest.
  - Minors.
  - Women with a change in marital status during pregnancy (widowhood and divorce).
  - Women with physical disabilities.
  - Mentally ill women.
  - Women with foetal anomalies that have a substantial risk of being incompatible with life or if the child is born, it may suffer from serious physical or mental abnormalities.
  - Women in humanitarian settings or disaster or emergency situations.
Beyond 24 Weeks:
- - Termination of pregnancy beyond 24 weeks is permissible if a Medical Board (constituted by the State Government) diagnoses substantial foetal abnormalities.

Important Points:

The law presumes that pregnancy resulting from rape causes grave injury to the mental health of the woman, allowing termination up to 24 weeks.
The Supreme Court has clarified that all women, irrespective of marital status, have equal access to abortion up to 24 week.
The Medical Termination of Pregnancy (Amendment) Rules, 2021, further elaborate on the procedures and conditions.

It’s important to note that this is a general overview, and specific details and interpretations can be found in the MTP Act and related rules and judgments. For precise legal advice, it is recommended to consult with a legal professional.

Other Courts

1. Delhi High Court

In January 2023, the Delhi High Court permitted the termination of a 25-week pregnancy of a minor rape survivor. The court issued guidelines for the medical examination of pregnant rape victims exceeding 24 weeks, emphasizing the need for a Medical Board to assess the feasibility and safety of the procedure.

2. Gujarat High Court

In February 2025, the Gujarat High Court approved the termination of a pregnancy exceeding 24 weeks for a minor rape survivor. The court provided guidelines for Medical Boards to consider while forming opinions on such abortions, ensuring that the rights and health of the survivor are prioritized.

3. Supreme Court of India

The Supreme Court has also addressed cases involving the termination of pregnancies beyond 24 weeks:

August 2023: The Court allowed a sexual assault survivor to terminate a 27-week pregnancy, recognizing the trauma and stress associated with such circumstances.
September 2022: The Supreme Court ruled that all women, irrespective of marital status, have equal access to abortion up to 24 weeks. The Court also observed that for purposes of abortion, the terms “sexual assault” and “rape” include marital rape, expanding the scope of protections under the Medical Termination of Pregnancy (MTP) Act.

These judgments highlight a judicial trend toward recognizing and safeguarding the reproductive rights of women, particularly survivors of sexual assault, even when pregnancies extend beyond the typical 24-week limit set by the MTP Act.

The judgment also draw the attention towards-

Lack of Uniform Law After 24 Weeks: There isn’t a uniform law in India that broadly permits termination of pregnancy beyond 24 weeks for all reasons.
Dependence on Court Intervention: In the absence of clear legal precedents or specific laws for late-term abortions, especially for sexual assault survivors, victims might need to seek court orders for relief.
Hospitals’ Compliance: Hospitals in are expected to comply with the MTP Act, general best practices for handling sexual assault cases, and potentially relevant guidance from the government or health authorities. Who is to check that the hospitals or doctors have protocols to follow for such victims seeking remedy is duly complied?
Medical Board’s Decision Time: While the MTP Act doesn’t specify a strict timeframe, the expectation is that the Medical Board should make a prompt and efficient decision regarding termination beyond 24 weeks, considering the woman’s well-being and medical urgency.
No Explicit Consequences for Delays/Denials: The MTP Act does not explicitly outline specific legal consequences for delays in the Medical Board’s decision, denial of services, or refusal by a provider to act.

Is the Legislation Complete?

No, it is likely not entirely complete or perfect. Law is a dynamic field that evolves with societal changes, medical advancements, and emerging issues. The Medical Termination of Pregnancy Act, 1971 (amended in 2021) is a significant step forward, but it may still have gaps and areas needing further clarity or expansion. These judgments press upon the issues to look at steps to better protect the citizens
Ambiguities and Gaps: As highlighted, there are areas where the law is silent or where interpretations can vary, leading to situations where victims face challenges in accessing timely and appropriate care. For example, the lack of explicit consequences for delays or denials in late-term abortion cases.
Evolving Medical and Social Context: Medical science and societal understanding of issues the reproductive rights continue to evolve. Legislation needs to adapt to these changes to remain relevant and effective.
Legislature’s Crucial Role: The primary responsibility for creating such a robust legal framework lies with the legislature.

1. Ritu (Feb 2025), SCC Online, MP High Court lays down SoPs for termination of pregnancy up to & exceeding 24 weeks in sexual assault cases Website