Maha PAC’s ‘Revolutionary’ Sex Determination Idea May Backfire

A group made of 24 men and one woman has come up with yet another recommendation on women’s maternal health and reproductive rights, and they’re calling it “revolutionary”.

The Maharashtra’ Public Accounts Committee (PAC), while studying the falling sex-ratio in the state, put forth a recommendation in front of the Assembly on 9 April which would make sex-determination tests not only legal, but also compulsory for expecting women.

PAC’s RecommendationWhen parents come for sonography, compulsory sex determination must be allowed and follow-ups must be done at the local level to ensure the couples come for further check-ups. It is necessary to visit these couples at home if they stop check-ups.

Social activists and feminist NGOs in the state, however, are alarmed at the suggestion which in their view would, in fact, facilitate female foeticide and shift the blame from doctors to parents. “It is ironical that such a recommendation is being made in Maharashtra, which pioneered the law to curb sex selection after a long campaign by women and health activists...” said a statement signed by over 100 women and NGOs in response. The Quint finds out more.

The PAC’s Recommendation

The committee’s recommendation comes after the discovery of a sex-selective abortion racket in Sangli, Maharashtra, where the police found 19 aborted female foetuses dumped near a hospital. According to the panel, the Pre-Conception and Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) or the PCPNDT Act 1994 has decidedly failed in decreasing the number of sex-selective abortions.

Leader of PAC, Congress MLA Gopaldas Agrawal said: “We have penalised doctors under the Act, but the sex-ratio is not improving. We need to make sure that families who do not want girls to be born are scared of the law. Right now the doctor is a criminal for revealing the gender of the foetus. If we keep on accusing doctors, they will stop doing sonography. ”

According to PAC’s recommendation, when expecting parents come for a sonography, doctors should determine the sex of the foetus, disclose it to the parents and register it officially. The PAC suggests that healthcare professionals follow these tests up by tracking parents who are known to be expecting a girl child, to ensure they follow through with the pregnancies and not opt for a termination.

Women, Activists, NGOs Respond

Resistance to the recommendation is being termed a “breach of right to privacy” by a group of 100 women, NGOs and social collectives who signed a statement slamming the PAC’s idea. “This new proposal will only result in a 24-hour surveillance of pregnant women both within the family and by the state authorities. It will unnecessarily target every woman bearing a female foetus, and will link any abortion that such a woman has (for any reason) to sex selection. This will adversely impact women's already poor access to legal and safe abortion”, says the statement.

In India, abortion is currently legal up to 20 weeks of gestation when performed in accordance with the terms of the Medical Termination of Pregnancy Act. Already this is challenging, with doctors fearing that legitimate abortions will be misconstrued as sex-selective ones by the authorities. If this recommendation was to be accepted, it would not only be violative of the PCPNDT Act, but will also impinge on the MTP Act by linking it to the other.

A foetus at 20 weeks of gestation, the outer limit when abortion is allowed. (Photo: iStock) 

Additionally, the PAC’s attempt to bring parents under the purview of the Act goes against the founding thought process behind it, which recognised that women often don’t have autonomy in deciding to get an abortion, and are forced by their husbands and families. Under the Act, it is “presumed unless the contrary is proved that the pregnant woman was compelled by her husband or any other relative, as the case may be, to undergo pre-natal diagnostic technique.”

The PAC’s recommendation sets to change that, and bring women under the Act. This move has been accepted by the Indian Medical Association (IMA), whose President, Dr KK Agarwal said: “The government’s focus should be on families who abort girls and not doctors. If women don’t go and abort the foetus, there will be no gender imbalance in the first place.” Dr Gayatri Rao, a senior doctor at the Women’s Hospital in Khar agrees.

Dr Gayatri RaoThe recommendation is great because it shifts the responsibility to protect a baby intrauterine from the radiologist when all they did is take a scan, while the parents who make the decision to abort go scott-free.

It is this viewpoint that activists against the recommendation are worried about. If accepted, the recommendation will have grave consequences and easy loopholes to manipulate. Parents could enter wrong addresses or contact information, doctors could fudge papers and then take bribes for terminations, families could get abortions once they know the gender and blame it on medical complications and genetic defects under the MTP – all the loopholes recognised and covered under the PCPNDT Act.

Rizwan Parez, Coordinator of Girls Count, a national coalition of over 400 civil society organisations working towards improving the declining sex-ratio in the country, feels this recommendation stems from the Indian mentality which still sees abortions as a sin and not as a part of maternal healthcare.

Rizwan Parez, Coordinator, Girls CountLegalising sex determination will certainly lead to an increase in domestic violence to miscarry the pregnancy, in cases where the family of the woman does not want a girl child. Health professionals will conduct these medical terminations; what they were first doing illegally will be done earlier and legally.

A protest demanding safe and basic healthcare for women during a march in the US. (Photo: iStock)

In addition, there is a chance of harassment of the women by her family, the NGOs and police in charge of tracking her pregnancy and law enforcement officials in case she gets a legal abortion under the MTP. This Act will also push women, especially in the villages of Maharashtra, away from a regulated healthcare system and seek out uncertified or corrupt doctors for dangerous terminations of their pregnancies.

Show Me the Money?

Varsha Deshpande, social activist and member of the national inspection and monitoring committee for the PCPNDT Act, has single-handedly carried out scores of sting operations across Maharashtra, bringing to rampant corruption by medical practitioners.

“If doctors don’t provide sex-determination services, no one will of avail it. The recommendation is impractical because the government wants to spend its limited resources on tracking lakhs of pregnant women instead of tracking a few thousand doctors in the state,” Deshpande said, speaking to Scroll.

Tracking lakhs of women across a vast state like Maharashtra will be logistical monstrosity, requiring new machines and trained manpower. Editors at the Forum for Medical Ethics, too, believe that instead, “the government should spend what they have on providing basic healthcare to pregnant women.”

Is It the Law or Its Implementation?

“I am wondering why suddenly such a recommendation has been floated when there is ample evidence that the PCPNDT Act, when properly implemented, has led to an increase in the sex ratio at birth in Haryana and Rajasthan,” said Rizwan Parwez.

In December 2015, the sex ratio of Haryana crossed the 900-mark for the first time in ten years at 903 girls for every 1,000 boys. Data collected by the civil registration system of the state government shows that in March 2017, 950 girls were born for every 1,000 boys in the state.

An image of a clinic with a notice made mandatory by the PCPNDT Act. (Photo credit: Twitter)

The coalition of women and NGOs has also asked for the PCPNDT act to be implemented stringently, “which has clearly acted as a deterrent wherever it has been used effectively” if one looks at other sources of data besides the 2011 census data. On the other hand, between 1994 and 2014, there have been only 206 convictions of medical practitioners with 2,021 pending cases of illegal sex determination in Maharashtra.

For this recommendation to pass, the PCPNDT Act will need to be amended in the Parliament, to which end the State can only suggest a change. The State is also not obliged to accept the PAC’s recommendations. But activists fear that following Union Minister for Women and Child Development Maneka Gandhi’s similar recommendation in February 2016, the “revolutionary” idea may actually be taken seriously by politicians keen to regulate women’s wombs.