ORDER : 1. Application for non-disclosure of name and details of the petitioner is allowed. The petitioner's name and details will not be disclosed and she will be named as 'ABC'. 2. The petitioner, who is a 13 years old tribal girl and a victim of rape and sexual violence, has preferred this writ petition through her mother for termination of pregnancy which according to her is a result of commission of the offence of gang rape on her. The petition was filed on 23-1-2018 which came up for hearing before this Court on 31-1-2018. On that day, the Court constituted a Medical Board consisting of Dean, Late Baliram Kashyap Medical College, Jagdalpur; two senior gynecologists available in the hospital; and one Radiologist to examine the petitioner qua examination report of the patient with regard to her physical and mental stage; stage of pregnancy; over all condition of foetus; how far the termination of pregnancy will be detrimental to the petitioner; how far it will be detrimental, if the petitioner is allowed to complete full term of pregnancy; and investigation reports, and directed the Collector, Narayanpur to ensure the compliance of the order and submit medical report of the Medical Board on 2-2-2018 before this Court. In compliance of the order of this Court, the Collector, Narayanpur has done the needful and the Medical Board has examined and submitted its report through Mr. Arun Sao, Deputy Advocate General which is taken on record. The medical report will be considered a little later. 3. Mr. Rohit Sharma, learned counsel appearing for the petitioner, would submit that the petitioner, who is aged about 13 years, is a tribal girl from remote place of Chhattisgarh i.e. Narayanpur District and she has been gang raped by four accused persons pursuant to which FIR No.14/18 has been registered at Police Station Narayanpur on 11-1- 2018 and thereafter, the accused persons have been arrested and the Station House Officer, Police Station Narayanpur got the petitioner medically examined on 12-1-2018 and submitted medical report on 13-1-2018. The petitioner also underwent ultra sonography in which she was found to have carrying pregnancy of 20 weeks three days. The petitioner also underwent ultra sonography in which she was found to have carrying pregnancy of 20 weeks three days. Later on, the matter was reported to the Child Welfare Committee, Narayanpur and that Committee directed the Medical College, Jagdalpur to examine the petitioner again by two Associate Professors of the College examined and found that she was carrying pregnancy of 20 weeks three days. She has also given consent in Form Ga under the Medical Termination of Pregnancy Act, 1971, for termination of pregnancy and her mother Smt. Mangti Mandavi has also given her consent for terminating the pregnancy. Thereafter, the Medical College in its memo dated 18-1-2018 clearly held that termination of pregnancy is permissible up to 20 weeks as per their knowledge. Thereafter, by memo dated 19-1-2018, Nyayalay Bal Kalyan Samiti directed the District Child Protection Officer to take appropriate legal steps, as the petitioner is carrying pregnancy of 21 weeks two days and is likely to affect her psychologically and it endangers her life also. Thereafter, the petitioner has knocked the doors of this Court by filing this writ petition as stated herein-above to prevent herself from severe mental agony of carrying unwanted pregnancy. Buttressing his submission by relying upon a decision of the Supreme Court in the matter of Suchita Srivastava and another v. Chandigarh Administration, (2009) 9 SCC 1 a prayer has been made to direct termination of pregnancy applying the “best interests” theory to prevent the petitioner from further mental agony which is a grave injury to her. Mr. Sharma has prayed for issuance of an immediate direction in that regard. 4. Mr. Arun Sao, learned Deputy Advocate General appearing for the State/respondents, submits that as per the direction of this Court, the petitioner was examined on 1-2-2018 by the medical team duly constituted and report has been placed on record. 5. I have heard learned counsel for the parties and also considered the medical report with utmost circumspection. 6. Before proceeding with the medical report, it would be appropriate to notice the relevant provisions by which pregnancy can be directed to be terminated under the Medical Termination of Pregnancy Act, 1971 (for short, 'the Act of 1971'). Section 3 of the Act of 1971 provides for when pregnancies may be terminated by registered medical practitioners and states as under: - “3. Section 3 of the Act of 1971 provides for when pregnancies may be terminated by registered medical practitioners and states as under: - “3. When pregnancies may be terminated by registered medical practitioners.— (1) Notwithstanding anything contained in the Indian Penal Code (45 of 1860), a registered medical practitioner shall not be guilty of any offence under that Code or under any other law for the time being in force, if any pregnancy is terminated by him in accordance with the provisions of this Act. (2) Subject to the provisions of sub-section (4), a pregnancy may be terminated by a registered medical practitioner,— (a) where the length of the pregnancy does not exceed twelve weeks, if such medical practitioner is, or (b) where the length of the pregnancy exceeds twelve weeks but does not exceed twenty weeks, if not less than two registered medical practitioners are, of opinion, formed in good faith, that— (i) the continuance of the pregnancy would involve a risk to the life of the pregnant woman or of grave injury to her physical or mental health; or (ii) there is a substantial risk that if the child were born, it would suffer from such physical or mental abnormalities as to be seriously handicapped. Explanation 1.—Where any pregnancy is alleged by the pregnant woman to have been caused by rape, the anguish caused by such pregnancy shall be presumed to constitute a grave injury to the mental health of the pregnant woman. Explanation II.—Where any pregnancy occurs as a result of failure of any device or method used by any married woman or her husband for the purpose of limiting the number of children, the anguish caused by such unwanted pregnancy may be presumed to constitute a grave injury to the mental health of the pregnant woman. (3) In determining whether the continuance of pregnancy would involve such risk of injury to the health as is mentioned in sub-section (2), account may be taken of the pregnant woman's actual or reasonably foreseeable environment. (4) (a) No pregnancy of a woman, who has not attained the age of eighteen years, or, who, having attained the age of eighteen years, is a mentally ill person, shall be terminated except with the consent in writing of her guardian. (b) Save as otherwise provided in clause (a), no pregnancy shall be terminated except with the consent of the pregnant woman.” 7. (b) Save as otherwise provided in clause (a), no pregnancy shall be terminated except with the consent of the pregnant woman.” 7. The aforesaid provision permits termination of pregnancy by a registered medical practitioner with regard to the circumstances, formed in good faith, specified in sub-clauses (i) and (ii) of subsection (2) of Section 3 of the Act of 1971 as stated herein-above. Likewise, Explanation I to sub-section (2) of Section 3 also provides in no uncertain terms that where the pregnancy is alleged by the pregnant woman to have been caused by rape, the anguish caused by such pregnancy shall be presumed to constitute a grave injury to the mental health of the pregnant woman. 8. In this regard, the Supreme Court in Suchita Srivastava (supra) has laid down the guidelines based on the principle of “best interests” theory and held that the Court is required to ascertain the course of action which would serve the best interests of the person in question. Paragraphs 36 and 37 of the report are relevant and are extracted herein-below: - “36. Courts in other common law jurisdictions have developed two distinct standards while exercising “parens patriae” jurisdiction for the purpose of making reproductive decisions on behalf of mentally retarded persons. These two standards are the “best interests” test and the “substituted judgment” test. 37. As evident from its literal description, the “best interests” test requires the Court to ascertain the course of action which would serve the best interests of the person in question. In the present setting this means that the Court must undertake a careful inquiry of the medical opinion on the feasibility of the pregnancy as well as social circumstances faced by the victim. It is important to note that the Court's decision should be guided by the interests of the victim alone and not those of the other stakeholders such as guardians or the society in general. It is evident that the woman in question will need care and assistance which will in turn entail some costs. However, that cannot be a ground for denying the exercise of reproductive rights.” 9. It is evident that the woman in question will need care and assistance which will in turn entail some costs. However, that cannot be a ground for denying the exercise of reproductive rights.” 9. The Supreme Court in the matter of X v. Union of India and others, (2016) 14 SCC 382 has clearly held that termination of pregnancy after 20 weeks to save life of pregnant woman (an alleged rape victim) in case of grave danger to physical and mental health of the said woman, is permissible, and observed as under: - “13. Having perused the medical report (relevant extracts whereof have been reproduced hereinabove), we are satisfied that a clear finding has been recorded by the Medical Board, that the risk to the petitioner of continuation of her pregnancy can gravely endanger her physical and mental health. The Medical Board has also expressed an advice that the patient should not continue with the pregnancy. In view of the findings recorded in Para 6 of the report, coupled with the recommendation and advice tendered by the Medical Board, we are satisfied that it is permissible to allow the petitioner to terminate her pregnancy in terms of Section 5 of the Medical Termination of Pregnancy Act, 1971. In view of the above, we grant liberty to the petitioner, if she is so advised, to terminate her pregnancy.” 10. Similar proposition has been laid down recently by the Supreme Court in the matter of X and others v. Union of India and others, (2017) 3 SCC 458 and also in the matter of Meera Santosh Pal and others v. Union of India and others, (2017) 3 SCC 462 . 11. In a more recent decision, Their Lordships of the Supreme Court in the matter of Tapasya Umesh Pisal v. Union of India and others, AIR 2017 SC 3931 have permitted termination of pregnancy of a woman, aged 24 years, in her 24th week of pregnancy wherein the Medical Board opined that baby if delivered would have to undergo several surgeries associated with high morbidity and mortality, and thus, granted permission. 12. Similarly, in the matter of Mrs. 12. Similarly, in the matter of Mrs. A v. Union of India and others, AIR 2017 SC 4037 , the Supreme Court has granted permission for termination of pregnancy of a woman, aged 22 years, in her 25th to 26th weeks of pregnancy holding that continuation of pregnancy can pose severe mental injury to the petitioner and no additional risk to the petitioner's life is involved if she is allowed to undergo termination of her pregnancy. Their Lordships held as under: - “6. Upon evaluation of the petitioner, the aforesaid Medical Board has concluded that her current pregnancy is of 25 to 26 weeks. The condition of the fetus is not compatible with life. The medical evidence clearly suggests that there is no point in allowing the pregnancy to run its full course since the fetus would not be able to survive outside the uterus without a skull. 7. Importantly, it is reported that the continuation of pregnancy can pose severe mental injury to the petitioner and no additional risk to the petitioner's life is involved if she is allowed to undergo termination of her pregnancy.” 13. At this stage, it would be appropriate to notice the medical report submitted by the Medical Board. In the medical report submitted, the condition of fetus i.e. gestation age of fetus has been indicated to be 23 weeks 4 days and it has been stated as under: - “IMPRESSION – Single live intra uterine fetus with floating transverse presentation Avg. GA 23 weeks 4 days. EDD – 27/05/18.” 14. So far as the examination report of the patient i.e. the petitioner herein is concerned, the report dated 1-2-2018 states as under: - “1. Examination report of the patient with regard to her physical and mental stage is attached. 2. Stage of pregnancy on examination is 22 wks to 24 wks- second trimester. 3. Over all condition of the fetus is normal according to sonography report of 01-02-2018 as given by radiologist. 4. Termination of pregnancy will be detrimental to the petitioner due to her age, anemia, sickle cell trait and stage of pregnancy. 5. It will be more detrimental, if the petitioner is allowed to complete full term of pregnancy due to her age, anemia, sickle cell trait. 6. Investigation reports reveal anemia and sickle cell trait. Rest blood reports are normal.” 15. 5. It will be more detrimental, if the petitioner is allowed to complete full term of pregnancy due to her age, anemia, sickle cell trait. 6. Investigation reports reveal anemia and sickle cell trait. Rest blood reports are normal.” 15. From the aforesaid medical report, it is quite vivid that the stage of pregnancy on the date of examination is 22 to 24 weeks – second trimester and it has been held by the medical team that it will be detrimental, if the petitioner is allowed to complete full term of pregnancy due to her age, anemia, sickle cell trait. It is not in dispute that her age is 13 years. 16. The World Health Organization (WHO) in its report (updated January, 2018) considered Adolescent Pregnancy and held that complications during pregnancy and childbirth are the leading cause of death for 15 to 19 year-old girls globally. It has been held as under: - “Key facts xxx xxx xxx Adolescent mothers (ages 10 to 19 years) face higher risks of eclampsia, puerperal endometritis, and systemic infections than women aged 20 to 24 years, and babies born to adolescent mothers face higher risks of low birth weight, preterm delivery, and severe neonatal conditions than those born to women aged 20 to 24 years (5). Health consequences Adolescent pregnancy remains a major contributor to maternal and child mortality, and to intergenerational cycles of ill-health and poverty. Pregnancy and childbirth complications are the leading cause of death among 15 to 19 year-old girls globally, with low and middle-income countries accounting for 99% of global maternal deaths of women ages 15 to 49 years (4), (12). xxx xxx xxx” 17. The first risk to be suffered by the adolescent mothers is Eclampsia – onset of seizure – sudden uncontrolled change in brain activity. Eclampsia can be understood in following ways: - Specialty Obstetrics Symptoms Seizures, high blood pressure Complications Aspiration pneumonia, cerebral hemorrhage, kidney failure, cardiac arrest Usual onset After 20 weeks of pregnancy Risk factors Pre-eclampsia Prevention Aspirin, calcium supplementation, treatment of prior hypertension Treatment Magnesium sulfate, hydralazine, emergency delivery Prognosis 1% risk of death Frequency 1.4% of deliveries Deaths 46,900 hypertensive diseases of pregnancy (2015) 18. According to Julie S. Moldenhauer, MD, Associate Professor of Clinical Obstetrics and Gynecology in Surgery, The University of Pennsylvania Perelman School of Medicine; Puerperal endometritis is uterine infection, typically caused by bacteria ascending form the lower genital or GI tract. Symptoms are uterine tenderness, abdominal or pelvic pain, fever, malaise, and sometimes discharge. Endometritis may develop after chorioamnionitis during labor or postpartum. Predisposing conditions include Prolonged rupture of the membranes Internal fetal monitoring Prolonged labor Cesarean delivery Repeated digital examination Retention of placental fragments in the uterus Postpartum hemorrhage Colonization of the lower genital tract Anemia Bacterial vaginosis Young maternal age Low socioeconomic status 19. According to Medical Encyclopedia, Systemic infection means affecting the entire body, rather than a single organ or body part. Systemic disorders, such as high blood pressure, or systemic diseases, such as the flu, affect the entire body. An infection that is in the bloodstream is called a systemic infection. 20. Now, this will bring me to the fact that the victim in the present case i.e. the petitioner herein is suffering from anemia. According to the Medical Jurisprudence, anemia can leave a person feeling tired and weak. If it is severe but goes untreated, it can increase the risk of serious complications like preterm delivery in case of pregnancy. Following risk factors for anemia in pregnancy have been held in the Medical Jurisprudence: - “Risk Factors for Anemia in Pregnancy All pregnant women are at risk for becoming anemic. That is because they need more iron and folic acid than usual. But the risk is higher if you: Are pregnant with multiples (more than one child) Have had two pregnancies close together Vomit a lot because of morning sickness Are a pregnant teenager Don't eat enough foods that are rich in iron Had anemia before you became pregnant” 21. Now, the last one is, the petitioner is suffering from sickle cell trait. Texas Health and Human Services, Texas Department of State Health Services has considered the sickle cell trait, which is inherited from parents, as under: - “To have sickle cell trait means one carries a gene for sickle cell anemia which can be passed to his/her children. As a carrier of this gene your baby has red blood cells that contain some sickle hemoglobin, but far less than the person with sickle cell anemia. As a carrier of this gene your baby has red blood cells that contain some sickle hemoglobin, but far less than the person with sickle cell anemia. (Hemoglobin is in red blood cells and carries the oxygen to your baby. Sickle hemoglobin is an abnormal type of hemoglobin.)” 22. Reverting to the facts of the case in hand, it is quite vivid that pregnancy of the petitioner has crossed 23 weeks of gestational age and unless the judicial order directing termination is available, it may not be possible for the doctors even to proceed with termination of pregnancy. 23. Taking into consideration the entire facts including her age (13 years) and circumstances what has been stated by the victim, her gestational age, judicial precedents, taking into consideration her adolescent pregnancy and risk involved in childbirth, medical condition of the victim / petitioner, as she is suffering anemia and sickle cell (trait), considering the fact that the fetus if allowed to born, would have a limited life span with serious handicaps, and that as per Explanation I appended to sub-section (2) of Section 3 of the Act of 1971 mental agony of a rape victim (petitioner) has to be treated as a case of grave injury, particularly taking into consideration that it is in the best interests of the victim alone which has to be kept in view and considering the provisions of Sections 3 and 4 of the Act of 1971 and Explanation I that the termination of pregnancy is immediately necessary to save the life of a pregnant girl like the petitioner herein, in the interest of justice, it would be proper to direct that a team of five doctors shall consider the feasibility of termination of pregnancy at this gestational age. Accordingly, the writ petition is allowed with following directions: - 1. The petitioner to remain present at Dr. B.R. Ambedkar Government Medical College, Raipur on 4-2-2018 so that termination of pregnancy can be carried out on 5-2-2018 or on the next day by a team of doctors consisting of Dean, Medical College; two senior gynecologists available in the hospital; one Radiologist; one Clinical Psychiatrist and one Anesthetist. The Dean of Dr. B.R. Ambedkar Government Medical College, Raipur is directed to make all such arrangements if the petitioner and her mother give consent in the prescribed proforma under the Act of 1971 and the rules made thereunder. 2. The Dean of Dr. B.R. Ambedkar Government Medical College, Raipur is directed to make all such arrangements if the petitioner and her mother give consent in the prescribed proforma under the Act of 1971 and the rules made thereunder. 2. The termination of pregnancy of the petitioner will be supervised by the above-stated Medical Board who shall maintain complete record of the procedure which is to be performed on the petitioner for termination of her pregnancy. 3. The District Collector, Narayanpur shall ensure safe journey of the petitioner along with her parents from Narayanpur to Dr. B.R. Ambedkar Hospital, Raipur on 4-2-2018 and all necessary expenses will be borne by the State in this regard. 4. On being informed, the District Collector, Raipur shall make necessary arrangements for journey of the petitioner and her parents from Raipur to Narayanpur after her discharge. 5. The petitioner will be allowed all medical and requisite facilities till she is medically fit even after the termination of pregnancy. 24. A copy of this order be sent to the Dean, Medical College, Raipur and Collector, Narayanpur directly by fax and e-mail by today itself and through Mr. Arun Sao, Deputy Advocate General, today itself so that he or she can make arrangements for termination of pregnancy of the petitioner well in advance. 25. I place on record, the deep appreciation of assistance rendered by Mr. Rohit Sharma, learned counsel appearing for the petitioner, and Mr. Arun Sao, learned Deputy Advocate General, Government of Chhattisgarh. 26. No order as to costs. 27. Certified copy today to the parties.