What does the law say on SRHR services and marriage?

In India, there is no specific law that mandates or restricts access to Pap smear tests based on marital status. However, there are several legal, ethical, and policy frameworks that support a woman’s right to access reproductive health services — including Pap smears — regardless of her marital status.

'Over the last decade, Indian courts have issued several notable decisions recognizing women’s reproductive rights as part of the “inalienable survival rights” implicitly protected under the fundamental right to life.' [1]

Reproductive rights are essential to the realization of all human rights. They encompass a spectrum of civil, political, economic, and social rights, from the rights to health and life, to the rights to equality and non-discrimination, privacy, information, and to be free from torture or ill-treatment. [1]

Here’s a breakdown of relevant legal and regulatory points:

Legal and Rights-Based Frameworks Supporting Access

1. Fundamental Rights that the government has an obligation to uphold, including the right to equality and non-discrimination (Articles 14 and 15) and the right to life (Article 21) which is understood through jurisprudence to include the rights to health, dignity, freedom from torture and ill treatment, and privacy.
2. Article 21 of the Indian Constitution – Right to Life and Personal Liberty. Includes the right to health, bodily autonomy, and informed consent. Denying a Pap smear based on marital status can violate this right. 
3. The Medical Termination of Pregnancy (MTP) Act, 1971 (Amended 2021). Recognizes the reproductive autonomy of all women, including unmarried women, strengthening the principle that medical decisions are not dependent on marital status. 
4. National Health Policy 2017. Emphasizes equitable access to healthcare and explicitly promotes preventive healthcare, including cancer screening for women. 
5. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). Recommends cervical cancer screening (Pap smear) for women aged 30 and above as part of public health efforts. Has no mention of marital status.

International Obligations [1]

India is also a signatory to numerous international conventions, all of which recognize reproductive rights, such as 

1. The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW); 
2. The International Covenant on Civil and Political Rights (ICCPR); 
3. The International Covenant on Economic, Social and Cultural Rights (ICESCR); and 
4. The Convention on the Rights of the Child (CRC).

Article 51(c) of the Indian Constitution and the judiciary have established that the government has a constitutional obligation to respect international law and treaty obligations.

Therefore, spousal consent requirements to access reproductive health services are a discriminatory practice that undermines women's reproductive autonomy, and is a violation of women's fundamental rights.

What Is Not in Law

There is no legal requirement for a woman to be married to undergo a Pap smear or transvaginal ultrasound.

Medical providers denying access based on marital status are doing so based on unwritten, discriminatory, and medically unfounded assumptions, not law.

Ethical Guidelines (FOGSI, MCI/NMC)

Informed Consent is the only ethical and legal requirement for conducting diagnostic or gynecological procedures — not marital status.

Refusal to provide medically indicated tests could amount to medical negligence or violation of patient rights under NMC guidelines.

Landmark Supreme Court Ruling

In a landmark judgment on September 29, 2022, the Supreme Court of India expanded abortion rights to include unmarried women, affirming their autonomy and access to reproductive healthcare. The Court ruled that the distinction between married and unmarried women in accessing abortion services was discriminatory and violated Article 14 of the Constitution, which guarantees equality before the law. It emphasized that every pregnant woman has the intrinsic right to choose to undergo or not to undergo an abortion without any consent or authorization from a third party, making the woman the ultimate decision-maker in such matters. The judgment also addressed the issue of medical practitioners imposing extra-legal conditions, such as requiring consent from the woman's family or judicial authorization, and deemed such practices unacceptable

References:

1. Center for Reproductive Rights. (2016). Reproductive Rights in Indian Courts. [online] Available at: https://reproductiverights.org/sites/default/files/documents/Reproductive-Rights-In-Indian-Courts.pdf [Accessed 8 May 2025].

Author credits: ChatGPT and Spurthi