Madhya Pradesh High Court: In a suo motu writ petition registered in response to conflicting judicial directions issued by two Single Benches of the Madhya Pradesh High Court regarding the termination of pregnancy under the Medical Termination of Pregnancy Act, 1971 (MTP Act), a Division Bench of Suresh Kumar Kait, CJ., and Vivek Jain, J., laid down Standard Operating Procedures (SOPs) for termination of pregnancy up to and beyond 24 weeks for the survivor of sexual assault or rape or incest with additional directives.
Factual Matrix
In the instant matter the issue arose due to procedural delays in terminating pregnancies of rape survivors, particularly in Crime No. 532/2024 at Police Station Mehidpur, District Ujjain. Recognizing the time-sensitive nature of such cases, the Indore Bench formulated a procedure to expedite legal and medical intervention, while the Jabalpur Bench emphasised that statutory provisions already allow termination up to 24 weeks without court orders.
The present suo motu writ petition is registered due to conflicting judicial directions issued by different Benches of this Court regarding the procedure for termination of pregnancy under the MTP Act. The Indore Bench of this Court in Seema Bai v. State of M.P., 2024 SCC OnLine MP 8433, issued guidelines mandating a judicial process for all cases of pregnancy termination, including those within the 24-week limit. However, the Jabalpur Bench of this Court in X6 v. State of M.P., 2025 SCC OnLine MP 580, held that termination of pregnancy up to 24 weeks does not require court intervention, while judicial permission is necessary only when pregnancy exceeds 24 weeks.
Conflicting Judicial Views
Indore Bench’s Guidelines
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SHO of the concerned police station must refer the victim to the District Court upon confirmation of pregnancy.
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District Court shall refer the rape survivor for a medical opinion on the feasibility of termination.
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Upon receiving the medical report, the District Court must refer the case to the High Court Registry.
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The High Court shall then register the matter as a suo motu writ petition and issue appropriate orders.
Jabalpur Bench’s Ruling
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Under Section 3(2)(A) and 3(2)(B) of the MTP Act, pregnancies up to 24 weeks can be terminated by Registered Medical Practitioners (RMPs) without judicial intervention.
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Only pregnancies exceeding 24 weeks require High Court approval under Article 226 of the Constitution.
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Rule 3B of the MTP Rules, 2003, permits rape survivors to terminate pregnancies up to 24 weeks without court involvement.
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Judicial proceedings should not be mandated unless statutorily required.
Moot Point
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What is the permissible procedure for the purpose of termination of pregnancy by the registered medical practitioner under the provisions of Medical Termination of Pregnancy Act, 1971 and rules framed thereunder?
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Whether resort to judicial proceedings under Article 226 of the Constitution of India is necessitated for the termination of pregnancy in each and every case?
Legal Provisions
MTP Act, 1971:
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Section 3(2)(A): Pregnancy can be terminated up to 20 weeks by one registered medical practitioner.
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Section 3(2)(B): Pregnancy can be terminated up to 24 weeks by two registered medical practitioners if it poses a risk to the woman’s physical or mental health, including rape survivors.
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Section 5(1): Termination beyond 24 weeks is permissible only if necessary to save the woman’s life.
MTP Rules, 2003 (Amended 2021):
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Rule 3B: Specifies categories of women, including rape survivors, eligible for termination up to 24 weeks.
Protection of Children from Sexual Offences (POCSO) Rules, 2020:
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Rule 6(3): Medical practitioners must provide emergency care without requiring legal documentation.
Court’s Resolution
The Court opined that in case of survivors of sexual assault or rape or incest, the pregnancy upto 20 weeks may be terminated by a registered medical practitioner and where the pregnancy exceeds 20 weeks but does not exceed 24 weeks, by two registered medical practitioners in accordance with the provisions of Section 3 of the MTP Act, and Rules without taking resort to judicial proceedings before the High Court under Article 226 of the Constitution of India. However, judicial approval is required only in case of survivors of sexual assault or rape or incest, for pregnancies exceeding 24 weeks, as termination beyond this period is not expressly permitted by the MTP Act.
The Court noted that Indore Bench’s procedure required judicial approval for all pregnancy terminations, whereas the Jabalpur Bench limited this requirement to cases exceeding 24 weeks. To resolve the inconsistency, the Court laid down following Standard Operating Procedures (SOPs) for the survivor of sexual assault or rape or incest —
SOP for Pregnancies up to 24 Weeks
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When a rape case is registered, the Station House Officer (SHO) must act based on the Medical Legal Certificate (MLC) indicating pregnancy within 24 weeks and immediately refer rape survivors to the concerned District Court, preferably a Special Judge/POCSO.
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District Court must direct an immediate medical examination to determine eligibility for termination under the MTP Act. If conditions under Section 3(2)(A) or 3(2)(B) are met, termination should be carried out within three days.
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The medical board must examine the case urgently and, if permissible, terminate the pregnancy within three days of referral. The rape survivor’s or guardian’s consent is mandatory under Section 3(4) of the MTP Act.
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Every care and caution will be taken by the doctors while terminating the pregnancy. All medical attention, medical facilities and other specialist doctors, if required, will be made available to the rape survivor.
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The post operative care, upto the extent required, will be extended to the rape survivor.
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The doctors will ensure that a sample from the fetus is protected for DNA examination and will be handed over to the prosecution for use in the criminal case.
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Medical officers/boards must not demand any legal or magisterial requisition before rendering emergency care, as mandated by Rule 6(3) of Protection of Children from Sexual Offences Rules, 2020 (POCSO Rules).
SOP for Pregnancies Exceeding 24 Weeks
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Upon confirmation of pregnancy exceeding 24 weeks through Medical Legal Certificate (MLC), the SHO must forward the rape survivor to the concerned District Court (Special Judge, POCSO).
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The Special Judge must refer the victim to a medical board for assessment. If termination is possible, the case must be referred to the High Court through the Registry.
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Upon receiving the medical report, the District Judge shall refer the case to the High Court Registry. The High Court Registry shall register the matter as a writ petition under Article 226 of the Constitution of India and place it before the appropriate High Court Bench for urgent orders.
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The High Court will decide whether to permit the termination based on the medical report. The High Court shall act without undue delay.
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If termination is approved, a team of expert doctors shall conduct the procedure. The risks and consequences must be explained to the rape survivor and her family before proceeding.
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Every care and caution will be taken by the doctors while terminating the pregnancy. All medical attention and other medical facilities including that of a presence of a pediatrician as well as a Radiologist and other required doctors will be made available to the rape survivor.
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The post operative care, upto the extent required, will be extended to the rape survivor.
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The doctors will ensure that a sample from the fetus is protected for DNA examination and will be handed over to the prosecution for using in the criminal case
In addition to SOPs, the Court issued additional directives such as —
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The SOPs do not limit the power of the medical board to terminate pregnancies under Section 3(2B) and Section 5(1) of the MTP Act, 1971, in cases where the termination is necessary.
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All forensic evidence, including the fetus sample, must be preserved as per Rule 6(6) of the POCSO Rules, 2020.
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The identity of the rape survivor must be strictly protected, in compliance with Section 5A of the MTP Act, 1971.
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Failure to comply with the above-mentioned guidelines shall amount to contempt of court, and strict contempt proceedings will be initiated against the erring officers under the Contempt of Courts Act, 1971.
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Copies of this order shall be circulated to Registrar General of the High Court (Principal Seat Jabalpur & Indore Bench), District Courts of Madhya Pradesh, Office of the Advocate General and Principal Secretary of Medical & Health Centre.
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Director General of Police, Bhopal, shall further circulate it to all police stations for compliance.
[In Reference (Suo Motu) v. State of M.P., Writ Petition No. 5184 of 2025, Decided on 20-01-2025]
*Judgment by Chief Justice Suresh Kumar Kait
Advocates who appeared in this case :
Shri Abhijeet Awasthi, Deputy Advocate General with Shi Anubhav Jain, Government Advocate, Counsel for the Respondents/State
