The reasons for the decline are all too familiar: the low status of women and “son preference” leading to selective abortion of the female foetus. From the mid-1980s onwards, women’s rights activists have been fighting to prevent the misuse of ultrasound or sonography to determine the sex of the foetus. Medical practitioners who use technology for female foeticide have used every “innovative” trick in the book to remain ahead of the legal restrictions. From devising sign language to overcome the prohibition of indicating the sex of the foetus to using mobile clinics (vehicles) fitted with portable imaging machines, these strategies have ensured that the number of India’s missing girls has multiplied. The government’s measures to halt the fall in the CSR have come up against the usual roadblock of faint-hearted implementation.
If any further evidence of the phenomenon of a falling sex ratio is needed, the result of a new study provides unambiguous information (“Trends in Selective Abortions of Girls in India: Analysis of Nationally Representative Birth Histories from 1990 to 2005 and Census Data from 1991 to 2011”, The Lancet, 4 June). The study which analysed population census data and tracked the birth history of about 2,50,000 children born between 1990 and 2005 found that when the first child was a male, there was no fall in the sex ratio of the second child. But when the first born was a female, the sex ratio of the second births declined. The study confirms yet another familiar and disturbing trend: selective abortion of the female foetus is the highest in the most educated and in the richest 20% of the households. Despite the sociological fallout of the declining sex ratio such as the non-availability of brides for young men in many of the worst-affected districts of northern and western India, medical technology continues to be used to target the female foetus. Anyone with just six months training or one year’s experience in image scanning can use the ultrasound machines, thus making sex determination easily accessible.
The government’s half-hearted actions give the lie to its impassioned slogans and announcements on saving the girl child. For example, the Central Supervisory Board was supposed to meet every six months to monitor the implementation of the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994. The board last met in December 2007. Incidentally, until now only around 6% of cases filed against doctors involved in sex-selection practices have resulted in convictions. This means that of the 805 cases filed since the Act came into effect, only 55 have reached a legal conclusion. Now the union health ministry has reconstituted the board and will place further amendments to the PCPNDT Act before it. Mobile genetic clinics where prenatal diagnostic tests are done will have to be registered, including vehicles carrying portable ultrasound machines. There is also a proposal to ensure that only gynaecologists and obstetricians and practitioners who have Diplomates of the National Board (DNB) will be allowed to use ultrasound machines. The Bombay High Court recently ruled that ultrasound machines being illegally used for sex determination can be seized by the government.
Yet, the government’s attention lies elsewhere. A new proposal that has been reported to be on the table is to make abortion rules stricter. This has given rise to apprehensions that it will make life difficult for women who seek abortion for reasons other than female foeticide. In Maharashtra, women’s organisations are protesting that the state supervisory board on the PCPNDT Act has been more interested in making statements about regulating the sale of the “morning after” pill than in targeting the problem of sex determination. Any move to make abortion rules more stringent will only affect poor women and the unmarried who will thus be pushed to risk the services of quacks and illegal clinics.
In the battle to save the girl child, one of the strategies that has shown positive results has been the involvement of community leaders in changing the attitudes of parents. For example, one of the worst-affected districts, Fatehgarh Sahib in Punjab, has shown a turnaround due to the involvement of Sikh religious and community leaders in the campaign against sex determination tests. For years now women’s rights activists have been demanding that the unholy alliance between local medical and paramedical practitioners on the one hand and government health officials and sonography clinics on the other must be destroyed, public health programmes must be delinked from family planning ones, the value of women’s work must be recognised and women’s right to inheritance and property must be ensured. Some of these are long-term goals which obviously require sustained and committed action, but work on short-term goals like stringent implementation of the PCPNDT Act must start immediately.
Punishing the illegal use of ultrasound machines for sex determination may have some effect but deep-rooted prejudices against the girl child calls for different measures. Strict enforcement of the Hindu Succession Act of 2005 (which allows daughters to inherit ancestral or joint family property), the anti-dowry law and implementation of measures that enforce gender justice and care for senior citizens will go a long way in weakening “son preference”.