The scene outside a private nursing home in Guwahati. Picture by Biju Boro

An offending episode of the popular TV serial, Kyunki saas bhi kabhi bahu thi, aired on Star Plus last year, showed a young couple checking the sex of their unborn baby. This created a furore as it violated the Pre-Natal Diagnostic Techniques (PNDT) Regulation and Prevention of Misuse Act, 1994 which prohibits advertisements relating to sex determination tests.

The Maharashtra State Commission for Women forced the producer, Balaji Telefilms, to take out a public interest advertisement on the illegality of conducting foetal sex determination tests. The commission now plans to seek an amendment to the Act, making fictitious portrayal of sex determination tests an offence.

The “advancement” of technology has made it easier for people to determine the gender of a foetus and do away with the female foetus in preference for a son. This despite the fact that pre-natal sex determination is illegal under the PNDT Act.

“We will try to ensure that the Act is implemented and awareness is generated among the people regarding the illegality of such tests,” says Anima Guha, academician and social activist.

There is a legitimate reason to be alarmed as the myth of a “dowry-free Assam” is fast being shattered. A survey conducted by the All-India Democratic Women’s Association in five districts of Assam revealed that girls from economically weak families often remained unmarried because the parents could not meet dowry demands.

The sex ratio is also an indicator that female foeticide exists. In 1991, the census revealed that there were 975 females for every 1,000 males. It was reduced to 964 in 2001. Assam’s all-India position is 21. The 2001 census states that India has only 933 females for every 1,000 males, as opposed to the world average of 986.

An estimated 20 million female foetuses in this country have been eliminated following sex-determination tests, in spite of the fact that pre-natal sex determination is illegal under the Act.

“In Assam, there is a dearth of statistics but it does not mean that it is not prevalent here,” says Anima Guha, president of Nirjatan Birodhi Akya Mancha, a leading women’s rights organisation.

The pre-natal diagnostics techniques like ultrasonography, amniotic fluid analysis, amniocyte culture, enzyme assays, genetic study and chromosomal analysis are basically used to detect any kind of genetic abnormalities at an early stage of pregnancy.

“Early detection can offer the parents the choice of a termination or to get an anomaly corrected by choosing the mode, time or place of delivery. In certain conditions like in case of haemophilia, where the females are carriers, it becomes imperative to ascertain the sex of the child,” says Ephia Yasmin, a gynaecologist.

“However, routine anomaly scan in 18 to 22 weeks of pregnancy is advisable for all expectant mothers in order to ensure safe motherhood,” she adds.

Alaka Goswami, former head of department of gynaecology and obstetrics, Gauhati Medical College, says, “There have been stray foeticide cases in Assam, often done in a clandestine manner. There is a lot of risk involved as septic abortion or infections due to abortion is one of the major causes of almost 30-40 per cent of maternal death.”

The National Family Health Survey, India, 1998-99 revealed that the preference for a son has a pronounced influence on contraceptive use in Assam. “Women who have one or more sons are consistently more likely to use contraception than women who have the same number of children but do not have any sons,” says Goswami.

The survey revealed that in Assam, almost all women want to have two children, at least one son and one daughter (95 per cent of women want at least one son and 91 per cent want at least one daughter). However, a strong preference for sons among some women is indicated by the fact that 38 per cent want more sons than daughters but only three per cent want more daughters than sons.

“One reason that a substantial proportion of women want to have at least one daughter is to fulfil the Hindu obligation of kanyadaan, which is one of the acts that enable the parents to acquire the highest level of merit (punya). But people tend to be more practical and materialistic these days,” says Guha.

An estimated 193 diagnostic clinics were registered in Assam last year. However, in spite of directives, most of these clinics are yet to put up the mandatory sign stating that “determination of the sex of the foetus is not practised here”. But an official of a leading diagnostic centre of the city says, “We are not aware of this directive.”

Ananda Narzary, director health services (family welfare) says, “We have made it mandatory for all diagnostic centres with ultrasound facilities to register with the additional chief medical and health officer at the district level.”

“We are planning to send our team of doctors and health officials for training on the various implications of this Act at the Institute of Family Welfare in Patna in Bihar,” he adds.

The Act remained in the backdrop till 2002. Eight years after it was passed, the Medical Council of India (MCI) recognised undertaking sex-determination tests “with the intent to terminate the life of a female foetus” as professional misconduct which can lead to de-registration and criminal prosecution. However, till date, no medical personnel has been booked under the Act in Assam.

Sanjib Handique, secretary of the Indian Radiological and Imaging Association, Assam branch, says: “All ultrasound clinics have been directed to keep records of all pregnancy-related tests. Patients and the doctors have to declare that they are not conducting any tests to determine the sex of the child. All ultrasound clinics are deemed genetic clinics by this Act as it can detect the sex of the child.

“The law in India is not very specific as to who can conduct an ultrasound which is a non-invasive test. Any qualified or trained personnel can do it.”

Gautam Goswami, a radiologist, says, “Some of the radiologists are unduly being harassed for doing certain routine gynaecological tests. There are many other invasive tests which are being conducted by the gynaecologists themselves.”

The state government has set up a supervisory board at the district level which is headed by the joint director, health services. The member secretary is the superintendent of the civil hospital or deputy superintendent, Community Health Centre. There are three medical experts, a legal expert, director information and public relations (DIPR) and eminent social workers.

Arati Barkotoki, additional chief medical and health officer, Kamrup says, “We had conducted a survey in all the nursing homes and asked them to register all their diagnostic equipment and put up notices outside their clinics in both Assamese and English. In rural areas, we disseminate information through workshops and meetings with Mahila Swastha Sanstha, street plays in the PHCs and health melas.”

Violation of the PNDT Act is a cognisable and non-bailable offence. Gobind Lal Kashyap, a lawyer, says, “Doctors violating the PNDT Act can be fined Rs 10,000 for the first charge. This can increase to a fine of Rs 50,000 and five years in jail for the second conviction. A woman seeking such a test is also guilty and can be fined and jailed. The family members pressuring her can also be jailed and fined.”

“The law alone cannot get rid of female foeticide and infanticide. People should realise that it is futile to go for this step as there is no guarantee that the next child would be male. If the menace is not nipped in the bud, stray incidents might become the norm someday,” says Malati Barua, member of the District Level Advisory Board.