An ultrasound test costs Rs 200-300 in a government hospital, but the charges at a private clinic could run up to Rs 30,000 and more for parents who want to know the sex of their unborn baby.
And there are many who pay up, making unscrupulous doctors involved in illegal sex determination rich beyond belief. India is missing more than 25 million girls since 1991 — which is like losing the population of Australia in two decades — and unscrupulous doctors choosing money over lives are to blame.
Illegal abortion of unborn baby girls has brought down India’s child sex ratio — ratio of girls per 1,000 boys at age six — to 919 girls per 1,000 boys, down from 983 in 1951. Though the Pre-Conception & Pre-Natal Diagnostic Techniques Act (PC-PNDT Act) banned sex determination and pre-conception sex-selection in 1994, the high demand for services from parents desperate for a son has led to sex-determination services reaching villages where there are no toilets or safe drinking water.
India recorded its sharpest 18-point fall in child sex ratio between 2001, and 17 points in 1991, when prenatal diagnostic techniques such as ultrasounds and amniocentesis became widely available, marking the beginning of their misuse for sex determination. Apart from pre-conception procedures that help parents choose the gender of the baby, tests are now available that can determine the sex of the foetus in the seventh week of pregnancy. A blood test that analyses foetal DNA found in the would-be mother can determine a baby’s gender before eight weeks into pregnancy. The test, available in India, measures DNA fragments from the placenta circulating in the mother’s blood to detect Down syndrome and two other chromosomal abnormalities in the foetus, but it is also being used to determine the gender of the unborn baby for sex-selective abortions.
“I’m not so worried about these tests because they are highly specialised and not available everywhere, unlike the around 55,000 registered ultrasound clinics registered in India, which are being misused by unscrupulous profiteers to bring down child sex ratio in almost every district of India,” says Sabu George, who is on India’s national inspection and monitoring committee PC&PNDT.
“I’m just back from Rajasthan, where ultrasound clinics are now found in every block in every district, unlike a decade ago when you just found them around urban hubs,” adds George, who has been tracking India’s falling sex ratio for more than three decades.
Some people blame the lack of a central supervisory mechanism. The PC-PNDT Act is under the ministry of health, schemes for the girl child are under the ministry of women and child development, while birth registration is under the ministry of home affairs. It should be under one nodal agency for effective implementation, recommends the Asian Centre for Human Rights’s report on The State of the PC&PNDT Act: India’s losing battle against female foeticide.
George disagrees: “The PC-PNDT act is very clearly under the ministry of health and family welfare and if states choose to act against those who break the law, foeticide can be stopped.”
Over the past two decades, the implementation of the PC-PNDT has been poor with some states showing spurts of activity. Haryana is on the right track, where the child sex ratio crossed 900 in two decades and even found mention by Prime Minister Narendra Modi at Haryana’s recent Swarna Jayanti Utsav.
“For the Beti Bachao, Beti Padhao (scheme), I begged people of Haryana to protect the lives of daughters... Today, in the entire country, if anyone is bringing improvement in the gender ratio at a fast pace, it is Haryana,” said Modi last week.
Not quite. The state that’s out-performed Haryana is Rajasthan, which is among nine states with a sex ratio of less than 900. The state conducted 17 raids over the past four months, with seven raids carried inter-state — three in Gujarat, three in Uttar Pradesh, and one in Haryana. All the cases are under trial, with the respective high courts rejecting bails in four cases.
Rajasthan made it possible by setting up a PC-PNDT Bureau of Investigation, which works under the state appropriate authority empowered by the PC-PNDT Act to implement the law. Set up in September 2012 by an Act, the bureau has jurisdiction over the PC-PNDT Acct, the Drugs and Magic Remedies (Objectionable Advertisements) Act, and the Medical Termination of Pregnancy Act, which bans abortions after 20 weeks of gestation.
The bureau works closely with the chief medical and health officers’ team. “The police have too many things to do, the idea is to have policemen dedicated to stopping the killing of the unborn girl child,” says Raghubir Singh, project director, PC-PNDT and an additional superintendent of police. The bureau has 120 posts for Rajasthan’s 33 districts, including a police officer in every district to set up decoy operations and conduct raids, NGO representatives and health officials.
“Section 178 in code of criminal procedure has a provision for action against continuing offences in different local areas, which makes it possible for us to raid offenders in other states who have patients from Rajasthan,” says Singh.
George says that no other state has taken the law as seriously and pushed convictions through like Rajasthan, Maharashtra and Haryana.
“Sporadic convictions will not give results, you have to seal clinics and stop doctors from breaking the law. In Uttar Pradesh, for example, 30 clinics doing illegal ultrasounds were closed in Kushinagar district in March 2013, but that momentum was lost when the district collector was transferred,” he says.
The pressure to not implement the law is immense. “Doctors who make money, parents who don’t want a girl, people who see it as a social and cultural issue, not a crime, all want the law to fail but that cannot be allowed to happen. India needs its daughters as much as it sons,” Singh adds.