A pregnant woman was about to walk into a sting. Health officials in Maharashtra had received a tip that an agent was taking expectant mothers from Akola to Buldhana for illegal foetal sex determination tests and abortions. Instead of waiting for another complaint, they sent a pregnant woman as a decoy, hoping she would be offered the service banned under the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act.
On August 1, the operation ended with officials seizing a portable tablet-based sonography machine and medicines from an unregistered centre. Three people were booked. The decoy worked and exposed something Maharashtra’s health department says is becoming increasingly common: illegal sex determination and abortions are moving away from registered clinics into homes, temporary premises and portable machines that are far harder to detect.
This explains why Maharashtra recorded 899 girls for every 1,000 boys at birth during 2022-24, only a marginal improvement from 896 a decade earlier. The real story lies within those numbers. Rural Maharashtra improved from 888 girls to 910 girls per 1,000 boys, while the urban ratio fell from 908 to 885, leaving urban Maharashtra at the same level as Haryana’s overall sex ratio at birth and below the national average of 918.
The question is no longer whether authorities are detecting violations. It is whether detection is translating into convictions, and whether enforcement can keep pace with an underground network driven by son preference.
From registered centres to homes
The PCPNDT Act prohibits sex selection, bans communicating the sex of a foetus to the family and regulates the use of pre-natal diagnostic technology.
Maharashtra has significantly intensified enforcement under the law. “Between March 2024 and March 2026, the state registered 627 court cases under the Act, of which 127 resulted in convictions,” Dr Vijay Khandewad, Director of Public Health, told The Indian Express. During this period, nearly all of the state’s 11,837 registered sonography centres were inspected. Since June 2012, altogether 219 doctors were referred to medical councils for disciplinary action while registrations of 62 doctors were cancelled by the Maharashtra Medical Council, 10 by the Maharashtra Council of Homoeopathy and four by the Medical Council of India.
The state has also increased its use of decoy or sting operations. According to Khandewad, 118 decoy operations were conducted in 2025-26, of which 13 were successful, compared with 82 operations and 11 successful operations in 2024-25.
The increased reliance on decoys reflects the difficulty of detecting sex determination through routine inspections. A registered centre can be inspected, its records checked and its ultrasound machine monitored. An unregistered operator working from a house with a portable machine presents a very different challenge.
What happens after a raid?
Authorities can issue notices, seal ultrasound machines, register FIRs and initiate prosecution under the PCPNDT Act. But every case must still survive investigation and trial.
On May 23, officials sent a decoy pregnant woman after receiving information about alleged sex determination at a hospital at Malegaon in Washim district. The doctor allegedly conducting the scan was not registered with the centre and fled before the team arrived. An FIR was later filed against those associated with the hospital. These cases demonstrate how evidence must be collected, accused identified and prosecutions pursued long after the raid ends.
“Of 625 cases disposed of by February 2025, 127 ended in convictions, while 332 resulted in acquittals or dismissals. Another 163 cases were pending. The numbers do not by themselves establish why individual cases ended in acquittal or dismissal. But they show the considerable gap between cases reaching court and cases ending in conviction,” explains an official from the State Family Welfare Bureau.
When the demand for a son turns deadly
In 2013, a team working with the state PCPNDT machinery received a call from a reputed hospital in Kolhapur about a woman who had been admitted to the intensive care unit in critical condition, with doctors suspecting that she had suffered serious injuries during an illegal abortion.
Her uterus had ruptured and part of her large intestine had been pulled through the rupture. When the team questioned her husband, he disclosed that the couple already had a one-and-a-half-year-old daughter and that the woman was pregnant for the second time. The couple had allegedly gone to a nearby village for sex determination. After learning that the foetus was female, they went to another clinic and terminated the pregnancy.
The abortion was allegedly carried out in unhygienic conditions, without proper medical facilities and without anaesthesia. The woman survived after being shifted to a better-equipped hospital, but her reproductive injuries were severe.
In another case, around 2015-16, a 23-year-old woman who already had a two-year-old daughter became pregnant again. Her sister-in-law, with the help of an agent, allegedly took her to a doctor in Vijayapur for sex determination. The family was allegedly told that the foetus was female.
After returning to their village, they approached a person practising medicine without being a qualified or registered medical practitioner. He had previously worked as a hospital compounder. He allegedly attempted to terminate the pregnancy when the woman was around five months pregnant. She developed uncontrolled bleeding. Attempts were made to treat her at home, but her condition deteriorated. She died while being taken to a larger hospital. The practitioner was arrested.
“All of this demonstrates the devastating consequences of the preference for a male child: the sex of the unborn child has become more important than the life and health of the woman carrying it,” says an advocate handling a case.
“This is not just an issue of education; it is about how people think about gender,” says Khandewad.
What the Supreme Court says
On June 11, 2026, while dismissing a Maharashtra doctor’s appeal challenging criminal proceedings under the PCPNDT Act, a Supreme Court bench of Justices Sanjay Karol and P K Mishra referred to the continuing “deep-seated patriarchal preferences towards a male child” and the “behind the curtains” prevalence of sex-selection practices. It said strict enforcement of the PCPNDT Act remained essential until there was a widespread change in attitudes towards the girl child.
Meanwhile, Maharashtra officials are increasingly trying to identify agents, unregistered operators and portable machines while taking cases through the criminal justice system. But it is still an uphill task to change the social preference that creates demand for unfair practices.
Seized scanners and equipment from a raid (Express Photo by Purnima Sah) 
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