When Can You Get An Abortion In India, And Who Decides?

In July 2025, a 16-year-old rape survivor was blocked from terminating her 27-week pregnancy, even after a court had initially approved it. The case exposed the uneasy balance between reproductive rights, medical authority, and legal caution in India. 

On July 3, a division bench of the Delhi High Court stayed an earlier order that had allowed the abortion. The All India Institute of Medical Sciences (AIIMS) had raised strong objections, arguing that terminating the pregnancy at that stage would involve foeticide. Under Indian law, this is not permitted unless there is a serious threat to the mother’s life or major fetal abnormalities. 

The AIIMS medical board also alerted that a cesarean delivery at this phase could affect the minor’s reproductive health in the future. Because the fetus was viable, the court noted that any termination would require steps to prevent a live birth, which raised legal and ethical concerns. 

The council, representing the case, after consulting with the survivor and her mother, informed the bench that they have agreed to continue the pregnancy until 34 weeks to allow for a safer delivery. The Delhi High Court then directed AIIMS to provide free medical care, psychological support, and nutritional assistance to the girl and the child for five years. The Delhi Government’s Women & Child Development Department was asked to present a support plan within two weeks for the survivor and the baby to be born. The plan should also include education, vocational training, and adoption counselling. This case brings attention to how reproductive rights in India are influenced by both legal and medical factors, especially when it comes to late-term pregnancies and minors. 

Between 2021 and 2025, India made several legal and constitutional changes related to abortion. The law aims to balance a woman’s right to bodily autonomy with the state’s interest in protecting fetal life. However, how this balance is applied often depends on the facts of each case. 

The main law is the Medical Termination of Pregnancy (MTP) Act, of 1971. Initially, it permitted abortion up to 12 weeks with the opinion of one doctor, and up to 20 weeks with the opinion of two doctors. Abortion was permitted if the pregnancy threatened the woman’s health or was the result of rape or contraceptive failure—though this last ground applied only to married women. 

The MTP (Amendment) Act, 2021, updated the law. It extended the limit to 24 weeks for certain categories, including rape survivors, minors, and women with disabilities. It also removed the restriction based on marital status for contraceptive failure. Section 3(2B) of the amendment allows abortion beyond 24 weeks in cases of serious fetal abnormalities, if approved by a state-level medical board. Section 5A was added to protect the privacy of the person seeking an abortion. 

While these changes have expanded access in theory, court decisions have shaped how the law works in practice. Many important rulings since 2021 have involved survivors of sexual violence, minors, or requests for abortion after the 24-week limit. 

In November 2021, the Karnataka High Court allowed a 16-year-old rape survivor to terminate her pregnancy at over 25 weeks. The court accepted the medical board’s opinion that continuing the pregnancy would cause serious mental distress and held that forcing her to carry it to term would violate her right to dignity under Article 21 of the Constitution. 

In September 2022, the Supreme Court ruled that the 2021 amendment applies equally to all women, whether married or unmarried. This overturned a Delhi High Court decision that had denied an unmarried woman an abortion at 22 weeks. The Supreme Court stated that reproductive autonomy falls under the right to privacy and personal liberty, protected by Articles 14 and 21. The judgment also noted that the law covers any person capable of becoming pregnant, including transgender and gender-diverse individuals. 

In October 2023, the Supreme Court allowed a rape survivor to terminate her pregnancy at 27 weeks, even though the fetus was viable. The court found that the woman’s mental trauma outweighed other concerns. It also clarified that medical board opinions are advisory, not binding. 

In May 2024, however, the Supreme Court denied abortion to an unmarried woman at 27 weeks who was not a survivor of sexual violence and did not report fetal abnormalities. The court said that the fetus had an independent right to life and found no strong reason to allow termination. This decision was criticised by legal experts and activists, who said it created inconsistencies in how the law was applied. The Delhi case from July 2025 also followed a cautious approach, where fetal viability and potential health risks were given more weight than the minor’s original request for termination. 

In another 2025 ruling, the Madhya Pradesh High Court allowed a 16-year-old rape survivor to terminate a 28-week pregnancy. The court accepted the medical board’s view that carrying the pregnancy could lead to serious psychological harm. It recognised the need to protect the survivor’s mental health and supported her right to make the decision. 

These cases show a pattern, courts are more likely to allow abortions beyond 24 weeks when the person is a minor or a survivor of sexual violence. But for adult, unmarried women who do not fall into these categories, access remains limited, especially for late-term abortions. This raises concerns regarding how consistently the right to bodily autonomy is applied across such cases. 

Senior Advocate Anjana Prakash of the Supreme Court highlights this inconsistency, “The courts have never made out any hard and fast rule. It’s always a knee-jerk reaction for them. The tragedy is that there’s no standardisation; whatever is routine is given, and when anything is beyond, then, by looking at certain circumstances, the courts make the decision.”

She says that the challenge lies in balancing competing rights, “When there are medical issues involved when emotional issues are also involved, then the court asks to give up the child. 

Prakash further adds how the law looks into everything while drafting a decision, and how such a law/act is made after considering medical science. Referring to a case where the court allowed abortion at 27 weeks, she says, “For them, the right to life is also important, and only in extraordinary cases do they make such decisions.” 

Her comments reflect the broader issue that legal interpretations are still reactive rather than guided by uniform principles, especially in emotionally complex or medically uncertain situations. 

Medical boards set up under Section 3(2B) of the MTP Act play an important role in complex abortion cases. However, in time-sensitive situations, their involvement can lead to delays. These delays can happen because sometimes forming the board takes time, doctors may not agree on how serious the medical risks are, and boards often take a very cautious approach, especially in sensitive cases.

In the 2025 Delhi case, for example, the AIIMS medical board raised legal and medical concerns about a late-term abortion. As a result, the court did not allow the abortion and instead ordered the pregnancy to continue with medical and social support for the girl. 

Outside the courtroom, access to safe abortion is still unequal. Urban areas have more doctors and legal aid, while rural and marginalised communities often face serious barriers. 

Recent data from India indicates that unsafe abortions remain a significant concern, particularly in rural areas. A 2022 study examining NFHS-5 (2019–21) data shows that 30.3 per cent of abortions in rural regions were unsafe, compared to 23.1 per cent in urban settings, revealing a rural-urban gap of over seven percentage points. 

Nationwide, this means roughly one in four abortions is unsafe, with self-managed, out-of-facility abortions accounting for nearly 27 per cent of procedures, many of which may be unsafe in the absence of proper medical oversight. 

These figures highlight that despite recent legal reforms, improvements in public health infrastructure and trained provider availability remain vital, especially in underserved rural areas.

In 2017, the Supreme Court’s decision in the Puttaswamy case said that privacy is a fundamental right. Since then, courts in India have started seeing reproductive rights, like the right to have an abortion, as part of a person’s right to control their own body and make personal choices. This has changed how the Medical Termination of Pregnancy (MTP) Act is used.

But in cases like the 3rd July Delhi High Court judgement for the 16-year-old survivor, judges still focus a lot on health risks. These include physical risks (reproductive health) and mental health issues (like emotional trauma). These concerns sometimes affect whether or not someone is allowed to get an abortion, even if they have the right. 

India’s abortion laws have become more supportive in some cases, especially for minors and survivors of sexual violence. But for many others, the rules can still be unclear and unevenly applied. To make access fair for everyone, clearer laws and better healthcare support are needed.