Introduction

The Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994, was enacted and brought into operation from 1st January, 1996, in order to check female foeticide.
" An Act to provide for the regulation of the use pre-natal diagnostic techniques for the purpose of detecting genetic abnormalities or certain congenital malformations or sex-linked disorders and for the prevention of the misuse of such techniques for the purpose of prenatal sex-determination leading to female foeticide, and for matters connected therewith or incidental thereto"

Before going ahead, Lets have a look at the past..

 1 out of every 3 girls does not live to see her 15th birthday. One third of these deaths take place at birth. Every 6th girl childs death is due to gender discrimination. Female mortality exceeds male mortality in 224 out of 402 districts in India

 The world population has a sex ratio of 990 females per 1000 males. Sex Ratio: Japan - 1041 U.S.A -1029 Indonesia - 1004 Bangladesh - 953 China - 944 India 933 India has one of the lowest sex ratio in the world

State with Highest Female Sex Ratio State with Lowest Female Sex Ratio UT with Highest Female Sex Ratio UT with Lowest Female Sex Ratio District with Highest Female Sex Ratio District with Lowest Female Sex Ratio

Kerala Haryana Pondicherry Daman & Diu Mahe (Pondicherry) Daman (Daman & Diu)

1,058 861 1,001 710

1,147

591

Source: Census of India

Sex selective abortion is a fairly recent phenomena but its root can be traced back to the age old practice of female infanticide

In the 18th century, infanticide was initially documented by British officials

The scope of the problem became clear in 1871, at the time of Indias first census. there was a significantly abnormal sex ratio of 940 women to 1000 men

The Infanticide Act in 1870 by the British, making it illegal. But the Act was difficult to enforce in a country where most birth took place at home and registration was not compulsory

This inhuman practice continues even today. Unfortunately gross misuse of technological advancement has aggravated this problem of female foeticide and ultrasound machines that were earlier used for other medical purposes are now being extensively used to determine the sex of the child

Female Foeticide
It is a practice that involves the detection of the sex of the unborn baby in the womb and the decision to abort it if the sex is detected as a female This detection of the sex of the baby is done through three methods: amniocentesis; chronic villus sampling ultrasonography

Sex Pre-selection
Parents frequently prefer their offspring to be of a particular sex for a variety of reasons. Social sex selection or human sex selection is the attempt to control the sex of the offspring to achieve a desired sex Three categories for methods of Sex Selection

Causes of Female Foeticide

whereas state-of-theart supply side (technical and political) factors essentially fuel or at least tolerate prevailing social request
economic

political

social

Demand side (socioeconomic) factors seem to be primary reasons for the wide spread of FF

technology

governance and policies

Economic Causes
Daughters do Dowry is a not stay with huge financial Sons provide the family. burden on the the workforce Hence parents families. This as they bring do not profit burden leads in a bride seen from any to the as an extra daughter investments pair of hands made in the being perceived as a daughter. liability Women are often paid Labour lesser than market their male discrimination counterparts. s are an Womens important earnings in form of India are only economic discrimination 38% of the male earnings (HDR 2004)

Social Causes
Parents are considered to be the trustees of their daughters, who belongs to another family and in reality, is only a guest till she is married off into her matrimonial home

Social causes emanate from religious beliefs, sanctions and practices

Practice of dowry further reduces the status of women and the desire to have a daughter

Technological Factors
Before diagnostic techniques for sex detection were available, one could not carry out sex-selected abortions at all
With technology, a new way to get rid of the unwanted girl child was discovered

According to UNICEF, the problem of female foeticide has been rising, as technology has been improving

Different technologies for sex determination are increasingly being available in rural areas also, and this is fuelling fears that sex-determined abortions will only increase in the future

Foeticide is a natural corollary of infanticide, a result of the introduction of technology

Causes due to Governance and Policies

India was one of the first nations to have a family planning policy (1952)

Two-child norm has been inculcated to the people through public awareness campaigns, rather than through coercion

With increased urbanization families have become increasingly nuclear, there is realization of the economic benefits of the small family, at the same time, the ingrained values such as son preference have remained intact

In urban India, large no of people adopt a small family female foeticide often is practiced to limit the size of the family

-- Reema Rajoli

 "Appropriate Authority" means the Appropriate Authority appointed under section 17.
"Genetic Counselling Centre" means an institute, hospital, nursing home or any place, by whatever name called, which provides for genetic counselling to patients. "Genetic Clinic" means a clinic, institute, hospital, nursing home or any place, by whatever name called, which is used for conducting pre-natal diagnostic procedures. "Genetic Laboratory" means a laboratory and includes a place where facilities are provided for conducting analysis or tests of samples received from Genetic Clinic for pre-natal diagnostic test. "Regulations" means regulations framed by the Board under this Act.

 "Gynaecologist means a person who possesses a post-graduate qualification in gynaecology and obstetrics Medical Geneticist" means a person who possesses a degree or diploma or certificate in medical genetics in the field of pre-natal diagnostic techniques or has experience of not less than two years in such field after obtaining (i) Any one of the medical qualifications recognised under the Indian Medical Council Act, 1956 (102 of 1956) or (ii) a post-graduate degree in biological sciences Pre-natal diagnostic procedures" means all gynaecological or obstetrical or medical procedures such as ultrasonography foetoscopy, taking or removing samples of amniotic fluid, chorionic villi, blood or any tissue of a pregnant woman for being sent to a Genetic Laboratory or Genetic Clinic for conducting pre-natal diagnostic test

 Pre-natal diagnostic techniques includes all pre-natal diagnostic procedures and pre-natal diagnostic tests.

Pre-natal diagnostic test means ultrasonography or any test or analysis of amniotic fluid, chorionic villi, blood or any tissue of a pregnant woman conducted to detect genetic or metabolic disorders or chromosomal abnormalities or congential anomalies or haemoglobinopathies or sex-linked diseases. Prescribed means prescribed by rules made under this Act.
Registered medical practitioner means a medical practitioner who possesses any recognized medical qualification as defined in clause.

Regulations
No Genetic Counseling Centre, Genetic Laboratory or Genetic Clinic unless registered under this Act, shall..

Conduct or associate with, or help in, conducting activities relating to pre-natal diagnostic techniques

Employ any person who does not possess the prescribed qualifications

Registration
No person shall open any Genetic Counseling Centre, Genetic Laboratory or Genetic Clinic after the commencement of this Act unless such Centre, Laboratory or Clinic is duly registered separately or jointly under this Act. Every application for registration shall be made to the Appropriate Authority and shall be accompanied by such fees as may be prescribed. No Genetic Counseling Centre, Lab or Clinic shall be registered under this Act unless the Appropriate Authority is satisfied that such Centre, Laboratory or Clinic is in a position to provide such facilities, maintain such equipment and standards as may be prescribed.

 Every Genetic Counseling Centre, Lab or Clinic engaged in counseling or conducting pre-natal diagnostic techniques, immediately before the commencement of this Act, shall apply for registration within sixty days from the date of such commencement. shall cease to conduct any such counseling or technique on the expiry of six months from the date of commencement of this Act unless such Centre, Laboratory or Clinic has applied for registration.

Steps After Applying

Scrutiny by Appropriate Authority Inspection of the premises Scrutiny by Advisory Committee Appropriate Authority grants certificate of registration

The certificate is given in duplicate

The certificate should be displayed in the centre, laboratory or clinic The certificate may specify one or more tests or procedures The certificate is non-transferable In the event of change of ownership or management, both copies of certificate to be surrendered to Appropriate Authority

 Each new owner or manager to apply a fresh All bodies registered under the Act shall give an affidavit affirming that they will not indulge in pre natal determination of sex as mandated by the Supreme Court. The Certificate must mention the number of ultrasound machines in the centre. The list of machines, including portable, should be displayed. Rejection: If rejected, the reasons shall be given in writing and as specified in Form C. The same shall be communicated to the applicant within 90 days from the date of receipt of the registration. Cancellation / suspension of registration: The Appropriate Authority can at any time, on its own or on a complaint issue a show cause notice as to why the registration should not be cancelled or suspended for breach of any of the provisions of the Act or the rules. The clinic, laboratory or centre must be given an opportunity to defend itself against the charges. In exceptional cases, the AA may act without issuing a show cause notice. Validity: 5 years. Renewal 30 days before the date of expiry.

Regulation No.1
No place including a registered Genetic Counseling Centre or Genetic Laboratory or Genetic Clinic shall be used by any person for conducting pre-natal diagnostic techniques except for the purposes specified in the act

Regulation No.2
No pre-natal diagnostic techniques shall be conducted except for the purposes of detection of any of the following abnormalities, namely :

Chromosomal abnormalities

Genetic metabolic diseases

Haemoglobin opathies;

Congenital anomalies;

Sex-linked genetic diseases;

Regulation No.3
No pre-natal diagnostic techniques shall be used or conducted unless the person qualified to do so is satisfied that any of the following conditions are fulfilled, namely:- age of the pregnant woman is above thirty-five years; the pregnant woman has undergone of two or more spontaneous abortions or foetal loss; the pregnant woman had been exposed to potentially teratogenic agents such as drugs, radiation, infection or chemicals; the pregnant woman has a family history of mental retardation or physical deformities such as spasticity or any other genetic disease; any other condition as may be specified by the Central Supervisory Board.

Regulation No.4
No person, being a relative or the husband of the pregnant woman shall seek or encourage the conduct of any pre-natal diagnostic techniques on her except for the purpose specified in clause (2).

Regulation No.5
Written consent of pregnant woman and prohibition of communicating the sex of foetus. 1. No person shall conduct the pre-natal diagnostic procedures unless (a) he has explained all known side and after effects of such procedures to the pregnant woman concerned (b) he has obtained in the prescribed form her written consent to undergo such procedures in the language which she understands; an (c) a copy of her written consent obtained is given to the pregnant woman. 2. No person conducting pre-natal diagnostic procedures shall communicate to the pregnant woman concerned or her relatives the sex of the foetus by words, signs or in any other manner.

Penalties For Violation

Person who seeks the aid of a genetic or ultrasound clinic for sex selection

Imprisonment for a three years and fine of Rs 50,000. Subsequent offence, the fine can go up to Rs 1,00,000 and imprisonment up to five years

Advertisement for prenatal & pre-conception sex determination

Gynaecologist, registered medical practitioner or any person who owns an genetic counseling center where the test is conducted

Imprisonment for up to 3 years and fined Rs. 10,000

Imprisonment for up to 3 years and fined Rs. 10,000. Subsequent offence, the fine can go up to Rs 50,000 and imprisonment to five years

 All records, charts, forms, reports, consent letters and all other documents required to be maintained under this Act shall be preserved for a period of two years. If any criminal or other proceedings are instituted against any Genetic Counseling Centre, Lab or Clinic, then the records shall be preserved till the final disposal of such proceedings. All such records shall, at all reasonable times, be made available for inspection to the Appropriate Authority or to any other person authorized by the Appropriate Authority in this behalf.

Medico-legal Implications
Foeticide or feticide is primarily a legal issue referring to illegal killing of a foetus Maybe a legitimately induced abortion Unfortunately fetal homicide are running rampant An issue closely related to violation of not just women rights but more importantly, of human rights

Medico-legal Implications
Against medical ethics to determine the sex of a foetus As per the PCPNDT act, any attempt to determine the gender of a foetus is a punishable act under legal jurisdiction New Delhi, July 13: India plans to create a registry of all pregnancies to help curb widespread female foeticide and reduce its high infant mortality rate, although activists say the scheme will be hard to implement

Medico-legal Implications
The Rajasthan government has filed police complaints against 21 doctors alleged to have been involved in the practice of female foeticide. (Case of 2006) No action yet One of the reasons why female foeticide is still quite prevalent in the state could be the low conviction rate in such cases Despite making strong cases against the accused, there have hardly been any convictions under the Pre Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act in the recent past

Safeguards
Ultrasound machines, including mobile ones, have to be registered and records of all pre-natal diagnostic tests conducted to be maintained [F ] form need to be filled by radiologists and patients Every month the records are submitted at BMC office

The centre's which default their ultrasound machines are confiscated by BMC

Safeguards
SILENT SCREENER coming soon Sonography centre's across the state will soon have to fall in line and install a special device called a silent observer in pregnancy test machines to help curb female foeticide The central and state supervisory board will have representatives of woman welfare organizations, social scientists as well as medical experts

How Can You HELP ?

-each one of us counts

We can contribute by:

Understanding the underlying factors that lead to sex selection Creating awareness about this issue in our homes, communities, neighbourhoods and organisations Encouraging a greater public debate and bringing the issue out in the open by raising it at every possible forum Reporting the matter to the authorities when the law is infringed Encouraging the media to undertake in-depth reporting of this issue Lobbying with the authorities for effective implementation of the law Networking with groups and bodies actively involved in mobilizing the community Encouraging setting up new groups and forums to work in this area, and Taking the first steps towards gender equality in our own workplaces and homes

Case Study
Channo Devi is a scheduled caste Sikh from mansa district which is the most backward area of Punjab She and her husband are illiterate and are landless labourers. She is from a very poor family and not very religious

She has three daughters 6,5 and 3 years old. She thinks a boy is must in the family
She has been pregnant 5 times and got female foeticide done twice. She thinks sex of the child depends on God and came to know about ultrasound through a neighbor.

 She thinks it is better to know the sex of the foetus as it is very essential to have a son as he looks after the parents in old age According to her first child should be male and she thinks had it been the case with her, she would not have given birth to so many daughters
She was physically abused by her in laws for not giving birth to a son

She got the abortion done on the advice of her husband and has no regrets

 She is 34 and still plans to give any number of chances to have a male child and does not want to have any more daughters, therefore, she plans to go for sex determination and abortion in case foetus is female
She feels it is sin to kill the foetus but this does not deter her from selective abortion IN SUCH CASES ,RELIGIOUS ADVOCACY IN THE PRESENT FORM IS NOT GOING TO WORK

References
http://www.medindia.net/indian_health_act/the_pre_n atal_diagnostic_techniques_pndt_act_rules/list-ofacts.htm http://pndt.gov.in/ http://www.indiafemalefoeticide.org/