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Women and Child Development, Maneka Gandhi proposed pre-natal sex determination test to be made compulsory. Will it really help female birth rate go higher?
The Union minister for Women and Child Development, Maneka Gandhi, started a fresh round of debate on one of India’s oldest social malice–the dipping sex ratio, when she proposed pre-natal sex determination test to be made compulsory in order to track women pregnant with a girl child, as a measure to check female foeticide. Suggesting this measure as a new perspective on the problem (of female foeticide), which could help solve it permanently, Mrs. Gandhi said at a public conference in Jaipur, ‘’ so, till when will we keep the onus on the ultrasound owner….till when will we keep arresting people (doing illegal ultrasound to determine sex of the foetus)? In this country, if a person goes to an ultrasound owner and asks for the gender of his (unborn) kid, who will dare say no?’’ Thus, she suggests that the policy be changed and the pregnant woman be told about the gender of her foetus; and if it is a girl the pregnancy be monitored till birth to check possible foeticide.
Mrs. Gandhi’s suggestion has drawn a huge round of public uproar against the proposal. Activists and experts working on the issue of female foeticide has criticised the ill-thought out proposal, pointing out that this will only make female foeticide more rampant. Critics also point out that the new system will shift the culpability of sex selection from the medical professionals to women and violating women’s right to their bodies.
Howsoever well–intentioned it might be, Mrs. Gandhi’s suggestion looses ground to the criticisms raised against it. Her suggestion brings out, yet again, one of the classic maladies of Indian policy making- the propensity for reactionary legislation to cover up the state’s failure to address chronic social problems in the country. Mrs. Gandhi’s proposal has several practical feasibility issues- how does one hope the government to monitor 29 million pregnancies annually, when it has failed grossly to check 50,000 illegal ultrasound clinics? Majority of pregnant women in India still deliver outside the institutional health care system. ‘At home’ deliveries using local mid-wives are rampant in rural areas till date. How does the minister hope to monitor such deliveries?
But perhaps the most frustrating part of the suggestion lies beyond these viability questions. Mrs. Gandhi’s suggestion reflects, once again, the insensitivity of the state and policy makers to the real life situations of India’s women populace. And coming from a minister who holds a portfolio that one would hope, understands better the challenges women face, and the patriarchal mindset of the society that they fight, makes the suggestion even more unacceptable.
Sadly however, the Indian Medical Association (IMA) has come out in support of the Minister’s suggestion. Voicing Mrs. Gandhi’s words, this national body of doctor’s said that the existing laws against sex determination, the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 2003, commonly called PC-PNDT Act, have clearly failed to check the dropping sex ratios as has been revealed in the latest data from Census 2011. India’s dipping sex ratio, currently stands at 914, reaching the lowest levels since 1961! Thus, they suggest the law be revoked and the alternative suggested by Mrs. Gandhi be implemented
Perhaps our esteemed medical fraternity and the Minister for Women and Child Development have forgotten (or worse still, are not aware of) the basis and reasons why the sex determination tests were banned in India or maybe aren’t aware of the misogyny that pervades around the birth of a female child in our country. It is imperative we remind them of these basic facts.
The movement against using medical technologies to determine and select the sex of the foetus was launched almost 30 years back in Mumbai by a group of activists, which culminated in the first law against sex-selective abortions being passed by the Maharashtra government on January 1, 1987. In those days, the popular method of sex detection was amniocentesis. It was an invasive procedure involving amniotic fluid being extracted from the womb for testing. The technology had been devised to detect foetal abnormality. Instead, in India it began to be used to detect the sex of the foetus. Women risked an abortion if the test confirmed a female foetus even if they got to know at a later stage of pregnancy. In the absence of any law or restriction against such sex determination and selection tests, the clinics which conducted such tests, publicly advertised them as well. Common advertisements like, ‘’Better 500 now, than 50,000 later’’ encouraged people to pay Rs. 500 to confirm the sex of the foetus, in order to save a larger amount for dowry later!
The impact of the sex selection technologies started showing skewed sex ratio amongst children in the 1981 census and concerns were further raised following the census of 1991. But it was difficult to bring the issue under the ambit of legislation, since it was virtually impossible to prove the crime, as neither the mothers, nor the doctors would admit that the test had been used for such a purpose. The Maharashtra law also came about after much push from below by the activists. The activists tried to gather as much evidence and data that they could about something that was just below the surface. Through a variety of techniques, including sending in decoys to doctors suspected of conducting such tests, the activists assembled some proof. They were lucky to find at least one sympathetic senior bureaucrat, the Maharashtra Health Secretary. Thanks to the sympathetic bureaucrat, the government and activists spoke to each other, argued over the provisions in the Bill and ensured that it was finally passed. That law was the precursor to the central law banning sex-determination tests passed in 1994 and amended in 2003 to include sex pre-selection – the Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex-selection) Act 2003.
The PC-PNDT Act 2003 makes it illegal to determine the sex of the unborn child or even use sex-selection technologies. The law first came into force in 1994, prohibiting ultrasound clinics, genetic counselling centres and genetic laboratories from revealing the sex of the unborn foetus, except in the case of gender related diseases. The law was amended in 2003 to bring the technique of preconception sex selection within the ambit of the Act – essentially, banning practices where medical practitioners try to influence the sex of the child before conception by using techniques such as sperm sorting (where a sperm cell is specifically chosen because of its sex chromosome). The law as it stands today, not only prohibits determination and disclosure of the sex of the foetus but also bans advertisements related to preconception and prenatal determination of sex, regulation of sale of ultrasound machines, and more stringent punishments for breaking the law (PCPNDT).
Despite the stringent laws in place, the death of the girl child in the womb using methods of sex determination continues unabated. A recent study published on the data available of 2011 census by a British medical journal estimated that 12 million girls were aborted in India in the last three decades. In 2006, the United Nations said that 7,000 female foetuses are aborted every day in India. Decades of sex determination tests and female foeticide that has acquired genocide proportions are catching up with the states in India. Like a virus, the declining child sex ratio is spreading to districts that till now had not been affected.
In spite of the increase in numbers of our disappearing daughters, the rate of conviction under the law has been poor. From 2003 to December 2014, only 206 doctors had been convicted by courts, of which Maharashtra had the highest number at 96, followed by Rajasthan, Punjab and Haryana. At least 15 states and four union territories had zero convictions all these years. According to experts, the problem isn’t with the Act but with its implementation. State advisory committees that help in implementing the Act do not meet regularly. Besides, there is poor monitoring of ultrasound clinics. Such clinics are required to maintain records of the scans they conduct but the violators are often let off with a fine.
Mrs. Gandhi needs to understand that merely replacing old laws with new ones will not solve the problem. What is the guarantee that new laws will achieve what stringent laws could not? Despite strict laws in place we have not been able to deter the medical practitioners from conducting pre-natal sex determination and selection tests, and aborting the female foetus. The change suggested by Mrs. Gandhi completely absolves them of any responsibility in the occasion of death of a female foetus (no wonder the IMA rejoices the suggestion coming from the minister!). Mrs. Gandhi’s proposal makes the mother of the foetus culpable to the acts of sex selection and aborting a female foetus. Well we need to consider, how much choice a woman really can exercise over her pregnancy, foetus and health in a patriarchal set up? Most times the choice of aborting the female child is not the woman’s decision. She is led to it because of the biases that exist in her family and society. If we follow Mrs. Gandhi’s suggestions there will be greater pressure on the pregnant woman to abort the foetus from her family and society if they find out early on that her child is a girl, especially in cases of second or third pregnancy. We need policies and programmes that would address the biases that exist in our minds against the girl child and attempt to change them, instead of making the position of the already victimised mother more vulnerable.
Mrs. Gandhi suggests monitoring of pregnancies when the foetus is female. This effectively means monitoring millions of deliveries that happen in the country every year. Do we have the public infrastructure to execute such a humongous task effectively? Who will be responsible for the task of monitoring pregnancies? According to Mrs. Gandhi, this can be achieved by making deliveries institutionalised. Rather she is of the opinion that the move will encourage institutional deliveries and discourage women from giving birth at home. If we were living in an ideal world with zero challenges this would have sounded plausible, but does our minister realise that there is a huge mismatch in the ratio of beds in hospitals and the number of deliveries every year? Not many pregnant women can afford private hospitals. Most are left to the mercy of government health institutions. These government institutions not only do not have enough beds, but the medical supervision and hygiene conditions are so bad that that women often lose their babies because of medical negligence such as blood loss. In the new policy suggested by Mrs. Gandhi, how would a woman account for loss of her female foetus due to substandard medical conditions during institutionalised deliveries?
A related process that has contributed to the skewed sex ratio along with female foeticide is female infanticide. Female infanticide is still practiced in rural areas by families who either have no access to or cannot afford the prenatal tests. In many of India’s least-developed states – Uttar Pradesh, Bihar, Rajasthan, Madhya Pradesh, Odisha, Jharkhand, Chhattisgarh, Uttarakhand and Assam – girls are disappearing not so much from foeticide as from infanticide. A change in law to prevent losing the girl child also needs to take into account the rising cases of female infanticide. We need to think how to monitor and prevent the death and discrimination of a girl child even if she is lucky enough to be born? Maneka Gandhi’s proposals also violate the democratic right of a woman to her body and reproductive health. The proposal is an encroachment on a woman’s reproductive rights and shifts the burden on the woman by criminalising her.
Maneka Gandhi’s proposal suffers from the presumption that the mother carrying the foetus is the criminal and she alone decides the fate of it. Instead of asking why a woman is opting for termination of the foetus, it is already making her the offender. What we need is to change is the mindset of our society at large. The onus of protecting the girl child lies as much with the state, the medical fraternity, the family, and the community, as with the mother carrying the female foetus. We need policies which would aim to change the existing mindset. We need effective implementation of existing government policies and laws, not ill thought proposals for new ones. That, Dear Minister, will bring about change!
Cover image via Shutterstock
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