Pre-natal sex selection: conditions apply
Kirti Sharma is 40, has an M Phil degree in Political Science, and in addition to being a homemaker, works for a non-governmental organisation for better governance. She is a loving mother to two daughters aged 14 and 8. She has also knocked on the doors of the Bombay High Court, asking for legal permission to ensure that her third child is a boy.
Sharma is pleading against the provision under the Pre Conception and Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) (PNDT) Act, 1994 that puts a blanket ban on pre-conception sex selection.
She emphasises that she is against aborting a female foetus and that is why she wants to choose a male embryo.
Pre-implantation Genetic Diagnosis (PGD), a sex selection technique which involves in vitro segregation of a fertilised ovum (female egg) with the XY chromosomes that makes a boy, was in use before the ban in 2002.
The Bombay High Court will deliver its judgement after hearing the arguments of advocate Ratna Bhargavan representing Kirti and her husband Vijay Sharma and advocate Uday Warunjikar on behalf of Varsha Deshpande, member of the National Inspection and Monitoring Committee for the PNDT Act.
While the court deliberates the issue, the medical fraternity is divided in its opinion on pre-conception sex selection. Though everyone condemns sex determination — identifying the sex of a foetus — which often leads to the abortion of a female foetus, a substantial section of medical practitioners question the ban on PGD.
Most doctors desist from speaking on the issue fearing their views may be considered politically incorrect. But a few dare to stick their necks out.
“Why not?” asks Dr Indira Hinduja, the infertility expert who helped create India’s first test-tube baby. “Aborting a foetus after sex determination is wrong but I see no harm in helping a couple increase the chances of conceiving a baby of its preferred sex.” She adds, “If you can choose to stay single or childless, why should you not have the right to choose whether you want a boy or a girl?”
Dr Geeta Chadha, senior consultant, department of gynaecology and obstetrics at Delhi’s Indraprastha Apollo hospitals, argues, “The government can’t put a blanket ban on a personal human desire. If someone has two girls, they have a right to balance their family by using this method.”
Skewed sex ratio
Not all agree with this point of view, though. India’s sex ratio is loaded against the girl child: 933 women to 1,000 men is the national figure with the ratio dipping as low as 874:1000 and 861:1000 in the prosperous states of Punjab and Haryana, respectively. Going by the dwindling girl population in the country, the misuse of the sex selection technique in a country obsessed with male progeny is a very real danger.
At the Centre for Enquiry into Health and Allied Themes (CEHAT) senior research officer Kamayani Bali Mahabal says, “The basic spirit of the PNDT Act is to legislate against any discrimination based on sex using any diagnostic technique whether pre-, intra- or post-conception. And sex selection violates that spirit.”
Dr Anjali Kumar, senior consultant, gynaecology and obstetrics at Gurgaon’s Paras Hospital, agrees: “The sex ratio in our country is already skewed. Such techniques are bound to fall in the wrong hands. Our society is obsessed with the male child, and the connotations of sex selection will be entirely different.”
While pre-conception sex selection can be used to detect congenital X-linked diseases like haemophilia and colour blindness, Kumar says that in this case, the negatives outweigh the positives. “We have seen educated Indian couples adamant on a male child. No logic works on them,” she says.
Varsha Deshpande believes that in India, pre-natal sex selection cannot be a matter of personal choice but that of discrimination on the basis of sex.
Mumbai infertility expert Dr Aniruddh Malpani, points out, “A DNA test on a blood sample of a seven-weeks-pregnant woman can determine the gender of the foetus. Those desperate for a boy will repeatedly abort a female foetus, endangering the life of the mother. Is it not better to give them their choice and ensure the safety of the woman?” Malpani, who is a happy father of two daughters, believes lifting the ban will not result in people opting for only one male child.
“Nobody in their right mind will go for a treatment costing Rs 2.5 lakh when they can make a baby in their bedrooms,” he says. But those who prefer to have a boy as their second or third child should be allowed the option, he says. Instead of throwing the baby out with the bath water, the government can impose checks and balances to ensure that only those with one or two girls can opt for the procedure, he adds.
But, in a country of one billion, who will monitor that the provision is not misused, asks Dr Vipin Pandit, chairman, medico-legal cell of Obstetrics and Gynecologist Association. Besides, says Dr Sabhyata Vaid of Artemis Hospitals in Gurgaon, “You can’t go shopping for children to add variety. Such artificial balance within the family is going to create social unrest in the future. Let nature take its course when it comes to reproduction and creating a balance.”
But ask Malpani and Hinduja how many people opted for a girl in pre-natal sex selection procedures before the ban and the candid reply is: “About five per cent.” That figure perhaps says it all.