Reproductive Choice Includes Right To Procreate And Not To Procreate: Karnataka High Court Allows Termination Of Foetus With Brain Abnormalities

The Court observed that reproductive choice includes both the right to procreate and the right not to procreate, and held that denial of permission in the facts of the case would undermine the petitioner's constitutionally protected autonomy, dignity and bodily integrity.

The Court was hearing a writ petition filed by a pregnant woman seeking permission to medically terminate her pregnancy after diagnostic scans revealed partial agenesis of the corpus callosum and bilateral ventriculomegaly in the fetus.

The petitioner contended that medical experts had informed her and her husband that the abnormalities carried a substantial risk of profound neurological impairment, developmental delay, cognitive disability, recurrent seizures and lifelong dependence on specialised medical care.

A Bench of Justice Suraj Govindaraj observed: “Having regard to the constitutional principles recognised by the Hon'ble Apex Court, the wishes unequivocally expressed by the petitioner, the support extended by her husband, the medical evidence on record, the opinion of the Medical Board and the overall facts and circumstances of the case, this Court is satisfied that the balance overwhelmingly favours permitting the petitioner to undergo medical termination of pregnancy.”

The Court further observed: “Denial of permission in the peculiar facts of the present case would not only undermine the petitioner's constitutionally protected autonomy but would also disregard the considered medical opinion placed before this Court. Grant of permission, on the other hand, would uphold the petitioner's dignity, bodily integrity and decisional freedom while ensuring that any procedure undertaken is performed safely, lawfully and under expert medical supervision.”

Advocate Ravishankar G.S. appeared for the petitioner, while Additional Solicitor General Aravind Kamath appeared for the Union of India, and Additional Advocate General V.G. Bhanuprakash appeared for the State of Karnataka.

Background

The petitioner, a 36-year-old married woman and mother of a 10-year-old daughter, was undergoing regular antenatal care during her pregnancy. While an earlier scan conducted in April 2026 revealed no abnormalities, subsequent ultrasound examinations conducted on 06.05.2026 and 07.05.2026 detected serious structural abnormalities in the fetal brain.

The diagnostic reports indicated partial agenesis of the corpus callosum and bilateral ventriculomegaly, conditions associated with significant neurological impairment and developmental disability.

According to the petitioner, medical specialists informed her and her husband that if the child were born alive, there existed a substantial likelihood of severe neurological deficits, developmental delay, cognitive impairment, motor dysfunction, recurrent seizures and lifelong dependence on specialised medical and rehabilitative care. Consequently, they sought permission from the High Court to medically terminate the pregnancy.

Pursuant to directions issued by the Court, a Medical Board examined the petitioner. While noting that the condition was not invariably incompatible with life, the Board acknowledged the significant risk of neurological and developmental disabilities and ultimately concluded that termination of pregnancy may be considered.

Court's Observations

The Court observed that issues relating to medical termination of pregnancy extend beyond statutory interpretation and involve constitutional values of bodily autonomy, privacy, dignity and decisional freedom.

The Bench noted that the Supreme Court has repeatedly recognised reproductive autonomy as an inseparable component of the right to life and personal liberty guaranteed under Article 21 of the Constitution.

The Court observed: “The Hon'ble Apex Court has repeatedly held that reproductive choice includes both the right to procreate and the right not to procreate. The freedom to decide whether to bear a child, when to bear a child and under what circumstances to bear a child is a constitutionally protected choice.”

Relying on the Supreme Court's recent decision in S v. Union of India, the Court observed that Constitutional Courts must not approach requests for termination of pregnancy with a restrictive or prohibitory mindset.

The Court noted that refusal of permission may push women towards unsafe and unregulated procedures, thereby endangering their life and health.

The Bench observed: “The very fact that a woman approaches a Constitutional Court seeking permission demonstrates that she is attempting to act within the framework of law and under medical supervision. Constitutional Courts must therefore approach such requests with sensitivity, constitutional compassion and an awareness of the realities faced by women confronted with difficult reproductive choices.”

The Court noted that although the Medical Board had observed that the diagnosed condition was not invariably incompatible with life, the inquiry could not be confined to whether the fetus was capable of surviving birth.

The Bench held: “Survival alone cannot constitute the sole measure of constitutional adjudication in matters of reproductive choice. The quality of life that may reasonably be expected, the extent of disability likely to be suffered, the burden of medical intervention required and the prognosis indicated by medical experts are all relevant considerations.”

The Court observed that the evidence on record indicated a substantial possibility of severe developmental delay, cognitive impairment, motor dysfunction, recurrent seizures and lifelong dependence on specialised medical care.

The Court found that the Medical Board had independently assessed the petitioner and confirmed the presence of partial corpus callosum agenesis and bilateral ventriculomegaly.

The Bench observed that although medical science could not predict outcomes with absolute certainty, the law does not require certainty and only requires a reasoned assessment based on credible medical evidence. The Court noted that the Board acknowledged the significant risk of neurological impairment and developmental disability and ultimately supported termination of pregnancy.

The Court also took note of the statement made by the petitioner's husband, who informed the Court that the decision had been taken only after repeated consultations with specialists and consideration of the medical prognosis.

The Court observed: “Far from seeking to avoid parental responsibilities, the petitioner and her husband have demonstrated a willingness to undertake every possible measure for the welfare of the child. It is only after being informed of the serious abnormalities detected and the prognosis associated therewith that they have chosen to seek medical termination of pregnancy.”

The Bench further held that compelling the petitioner to continue the pregnancy despite a considered decision to the contrary would amount to a substantial intrusion into her bodily autonomy and decisional freedom.

Conclusion

Allowing the writ petition, the Karnataka High Court held that the petitioner had established a clear and compelling case warranting the exercise of the Court's extraordinary jurisdiction for medical termination of pregnancy.

The Court permitted doctors at Anupama Hospital, Bengaluru, to carry out the procedure at the earliest while ensuring that no harm is caused to the petitioner's life and liberty.

The Court also directed that the procedure be undertaken strictly in accordance with the Medical Termination of Pregnancy Act, applicable medical protocols and the recommendations of the Medical Board.

Detailed safeguards were prescribed regarding informed consent, emergency medical facilities, confidentiality of the petitioner's identity and medical records, post-procedure counselling and protection of the petitioner's life, health, dignity and bodily integrity.

Cause Title: XXX v. State of Karnataka & Anr. (Neutral Citation: 2026:KHC:25550)

Appearances

Petitioner: Ravishankar G.S., Advocate.

Respondents: Aravind Kamath, Additional Solicitor General of India, for the Union of India; V.G. Bhanuprakash, Additional Advocate General, for the State of Karnataka; Mohammad Jaffar Shah, AGA; Sadhna S Desaoi, CGC

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