Sex determination: Answer thishttps://indianexpress.com/article/opinion/columns/sex-determination-answer-this/

Sex determination: Answer this

If the government does not have the will to regulate 55,000 pre-natal diagnostic clinics, how will it track 29 million pregnancies annually?

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Sex selection was introduced in India as a method to control population growth.

I was inspired by Maneka Gandhi’s struggle to get back her passport (impounded by the Janata Party government) as an IIT student in 1977. Her Supreme Court case led to a landmark judgment on personal liberty. Subsequently Gandhi filed petitions in courts to protect animal rights. Given this early commitment to the law, her recent statement against the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act was bizarre.

Over the past 25 years, more than 15 million girls have been eliminated because of determination of foetal sex before birth. This was the outcome of at least 45 million medical crimes of determination and elimination. Sex selection was introduced in India as a method to control population growth. The department of reproductive physiology was set up in 1970 in AIIMS by a doctor from the Population Council, New York and funded by the Rockefeller Foundation. The research published in the medical journal, Indian Pediatrics, in 1975 argued that the excess girls born, for a son, was unnecessary fecundity and that elimination of girls would lead to population control.

Following concerns of discrimination against women, sex determination was banned in Delhi government hospitals in 1978. But this practice spread into the private sector. Leading newspapers in Delhi carried advertisements for ultrasound sex determination in the late 1980s. Punjab clinics opened sister clinics in Delhi, asserting that they had 10 years of expertise in determining sex. The medical geneticist who taught genetics students in Guru Nanak University, Amritsar in the 1980s would announce at global genetics conferences that foetal sex determination would prevent women from dowry deaths and other forms of violence.

In the late 1980s, in Hisar, glass jars with preserved female foetuses were exhibited by doctors to encourage female foeticide. Thus, it was a steady growth from the early genetic clinics in Amritsar in 1979 to over 50,000 ultrasound clinics all over India today. The initial phase of denial about the demographic consequences of this medical malpractice by scholars in the early 1990s assisted in the popularisation of this extreme form of violence against women.

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The women’s movement recognised sex selection as violence as early as in the 1980s. By 1985, public campaigns against sex selection started in Bombay and elsewhere. Protests were made against advertisements of sex selection (“Save Rs 50,000 in dowry by doing sex determination for Rs 500”). Finally, in 1988, Maharashtra enacted the first law against foetal sex determination and Parliament did so in 1994.

However, this was not implemented. Therefore, I filed a PIL in the Supreme Court along with two organisations against the non-implementation of the law and for including pre-foetal sex selection in the ambit of the PCPNDT Act in 2000. And with the disastrous outcomes in the 2001 Census (child sex ratios in Punjab dropped to 798 girls per 1,000 boys; about one in five girls eliminated before birth), this created a national discourse. The Supreme Court orders ensured that registrations of pre-natal diagnostic clinics increased from 600 in the year 2000 to 55,000-plus today. Advertisements for sex selection had practically disappeared from print media, television and from walls around the country by 2003. Last year, Google Shopping had to remove product advertisements from the internet.

Barely 3,000 cases have been filed against violators of the act over the past 21 years though half a billion medical crimes have been committed. However, the real impact of the law is felt only in Maharashtra, thanks to the efforts of advocate Varsha Deshpande. Fifty doctors have been convicted and sex ratios at birth have improved in favour of girls over the past few years. Regrettably, in other states, registration has not been followed by actions to prevent sex determination.

Medical associations and their supporters have made continuous efforts to undermine the law. It is in this context that Gandhi’s statement needs to be examined. The impact of the PCPNDT Act in Maharashtra being publicly denied is a setback to the implementation of the law. In several districts of Punjab and Haryana, improvements in Census 2011 were only after child sex ratios fell to the low 800s or less. If the rest of the country has to follow this pattern, then India will lose hundreds of millions of girls in the coming decades. The most worrisome trend is the spread of sex selection in UP and Bihar over the past two decades. Unlike Haryana and Punjab, which are small states, more than one in three Indian girls is born in UP or Bihar. Thus Gandhi’s endorsement of anti-law efforts will result in serious setbacks to the “Beti Bachao, Beti Padhao” scheme.

The country will welcome incentives for girls. But the only immediate deterrence against continuous promotion of sex selection by unethical medical professionals and agents is the implementation of the law. The law was enacted because professionals did not follow medical ethics. And Gandhi’s endeavour to put the burden on women to stop sex selection is unforgivable — they are being punished for crimes that are being perpetrated by doctors. If the government does not have the will to regulate 55,000 clinics, how will it track 29 million pregnancies annually? In addition to the impossibility of this, it would undermine the abortion needs of women.