Ensuring Timely Medical Termination of Pregnancy for Minor Rape Victims Beyond 24 Weeks

Introduction

This commentary examines the Delhi High Court’s judgment in “Minor S (Thru Mother M) v. The State, NCT of Delhi & Anr.” (2025 DHC 4803), delivered by Justice Swarana Kanta Sharma on May 29, 2025. A 17-year-old rape survivor became pregnant and faced multiple procedural hurdles—lack of identity proof, delay in ultrasound, confusion over the need for a court order, and conflicting gestational age reports—that postponed her Medical Termination of Pregnancy (MTP) beyond 24 weeks. The petitioner approached this Court by way of a writ petition under Article 226 of the Constitution of India, through her mother, seeking immediate directions to perform MTP at AIIMS, Delhi.

Key issues raised:

Mandatory production of identity documents before conducting ultrasound.
Constitution and functioning of Medical Boards for cases beyond 24 weeks.
Conflicting gestational age assessments—25 weeks vs. 23 weeks—and their legal consequences.
Procedural confusion over the need for a court order under the MTP Act.
Systemic delays in the medical and legal process in victim-sensitive cases.

Parties:

Petitioner: Minor S (through her mother M), represented by advocates from DHCLSC.
Respondent No. 1: The State, NCT of Delhi, represented by the Additional Standing Counsel.
Respondent No. 2: All India Institute of Medical Sciences (AIIMS), Delhi, represented by its Panel Counsel.

Summary of the Judgment

The Court granted immediate permission for MTP to be carried out on May 30, 2025, and signaled that a reasoned judgment with detailed guidelines would follow. The Court’s interim orders directed:

Constitution of a Medical Board at AIIMS, Delhi without further delay.
Provision of an expert medical opinion on the safety of MTP for the minor.
Clear recording of gestational age and the minor’s physical and mental fitness for MTP.
Preservation of fetal tissue for forensic purposes.
State to bear all hospital expenses for the victim.
Child Welfare Committee (CWC) involvement in post-MTP care if a live birth occurs.

The final reasoned judgment then addressed systemic lapses, clarified legal protocols under the Medical Termination of Pregnancy Act, 1971 (as amended in 2021) and the PC & PNDT Act, and consolidated all prior High Court directions into a single set of comprehensive guidelines to prevent future delays in similar cases.

Analysis

Precedents Cited

The judgment builds upon and reiterates three earlier decisions of the same Bench that sought to streamline MTP procedures for rape victims beyond 24 weeks:

Minor R Through Mother H v. State (NCT of Delhi), 2023 SCC OnLine Del 383: The Court observed that critical time was being lost in obtaining court orders and constituting ad-hoc Medical Boards when gestational age exceeded 24 weeks. It directed mandatory same-day constitution of permanent Medical Boards in designated hospitals and immediate assessment of the victim by the Board.
Minor L Through Guardian J v. State & Anr., 2023 SCC OnLine Del 7159: Despite the 2023 directions, another victim was turned away for lack of a court order. The Court expressed strong displeasure, emphasized the need for timely medical assessment, and mandated that Boards and Investigating Officers explain the implications of MTP in a language understood by the victim/guardian.
Minor S Through Father B v. State & Anr., 2025 SCC OnLine Del 2506: Reiterating the obligation of CWCs to immediately inform the Delhi High Court Legal Services Committee (DHCLSC) when a minor rape victim beyond 24 weeks seeks MTP. DHCLSC must facilitate prompt court petitions so that no further delay occurs.

Legal Reasoning

1. Statutory Framework: The MTP Act, 1971 (as amended in 2021) allows termination up to 20 weeks on the opinion of one RMP, and 20–24 weeks on the opinion of two RMPs for prescribed categories (including rape victims and minors). Beyond 24 weeks, only substantial fetal abnormalities (Section 3(2B)) or immediate threat to the mother’s life (Section 5) permit MTP.

2. Constitutional Jurisdiction: Constitutional Courts possess extraordinary jurisdiction to authorize MTP beyond 24 weeks in exceptional circumstances—particularly where forced continuation of a pregnancy resulting from sexual assault would violate the victim’s fundamental right to life with dignity.

3. Procedural Lapses and Confusion:

The insistence on identity proof for ultrasound, despite the presence of the Investigating Officer and official records.
Delay in constituting the permanent Board at AIIMS, contrary to the April 3, 2023 notification constituting Boards in 13 Delhi hospitals.
Conflicting ultrasound reports (25 weeks vs. 23 weeks) without explanation.
Original Board report failed to address the victim’s physical and mental fitness for MTP or risk to life.
Oscillation in hospital’s stance on whether a court order was required.

4. Remedial Directions: To address these systemic issues, the Court consolidated and updated its prior orders into a single set of mandatory protocols covering:

Immediate ultrasound and medical examination once the victim is produced by the IO or CWC, without insisting on identity cards.
Instant constitution of the Medical Board in cases beyond 24 weeks.
Standardised reporting format specifying gestational age, and physical and mental fitness, and risk to life.
Clear language-appropriate consent procedures.
Designation of nodal officers in hospitals and quarterly sensitisation training for medical and police personnel.
Preservation of fetal tissue for forensic needs.

Impact

The judgment will have far-reaching consequences:

Victim Protection: Ensures that minor rape victims are not thwarted by administrative technicalities in accessing constitutionally protected rights.
Uniform Protocols: Harmonises disparate practices across hospitals and police stations, reducing confusion and delay.
Judicial Oversight: Strengthens the role of High Courts in safeguarding victims of sexual assault through clear, actionable directions.
Training and Accountability: Mandates regular training for medical staff and police, and imposes nodal responsibility within hospitals.
Legal Precedent: Consolidates the principle that no court order should stand in the way of timely medical care once the victim is produced by official machinery.

Complex Concepts Simplified

• MTP Act (1971, as amended 2021): Governs lawful termination of pregnancy by registered practitioners. Gestational limits:

Up to 20 weeks: one RMP’s opinion.
20–24 weeks (victims of rape/minors): two RMPs’ opinion.
Beyond 24 weeks: only for serious fetal abnormalities or threat to mother’s life.

• PC & PNDT Act: Regulates ultrasound clinics to prevent sex-selection. Requires Form F for each ultrasound with patient particulars. In rape cases brought by the IO, formal ID proof need not delay an urgent diagnostic scan.

• Child Welfare Committee (CWC): Statutory body under POCSO Act to protect children. Can direct hospitals to conduct MTP and coordinate care of minor victims.

• Ossification Test: X-ray method to estimate age by bone maturity; margin of error ±2 years. Not reliable for a one-year difference and contraindicated during pregnancy.

Conclusion

The Court’s reasoned judgment in Minor S (Thru Mother M) v. The State, NCT of Delhi & Anr. addresses long-standing procedural gaps in handling MTP requests from minor rape victims. By reiterating and consolidating prior directions—immediate ultrasound, no undue insistence on identity proof, prompt constitution of Medical Boards, standardised reporting, language-appropriate consent, and regular training—the Court seeks to eradicate the delays and uncertainties that can exacerbate a victim’s trauma. This ruling fortifies the right to life with dignity, underscores the protective ambit of the MTP Act, and lays down a clear blueprint for medical and law-enforcement agencies to follow. The directives, once implemented in letter and spirit, will ensure that no minor rape survivor is ever again left waiting in limbo when seeking the constitutionally backed relief of medical termination of pregnancy.