India’s top medical authority, the Indian Medical Association (IMA), has sparked a fresh debate on the country’s ban on prenatal sex determination tests. Dr. RV Asokan, the president of the IMA, has called for a re-evaluation of the law, arguing that the current ban has not led to a significant improvement in India’s skewed sex ratio.
Prenatal gender determination and sex-selective abortions have been illegal in India under the Pre-Conception and Pre-Natal Diagnostic Techniques (PC-PNDT) Act since 2003. The law, originally enforced in 1996, aims to prevent gender-based abortions and includes strict provisions penalising doctors involved in illegal sex determination.
The Law in India:
The PC-PNDT Act explicitly states that “no person shall, by whatever means, cause or allow to be caused selection of sex before or after conception.” It bars ultrasound clinics, genetic counselling centres, and genetic laboratories from determining the sex of a foetus, except when identifying abnormalities or genetic disorders. Those found violating the Act face severe penalties, including jail time and fines.
What the IMA President Has Proposed:
Dr. Asokan believes that legalising prenatal gender tests could protect unborn girls and improve India’s sex ratio. He mentioned that the IMA’s central committee supports this idea, suggesting that if a child’s gender is known, authorities could monitor and ensure the child’s safe delivery, holding individuals accountable if anything goes wrong.
He also criticized the current law for unfairly targeting doctors, claiming it hasn’t been effective and instead harasses medical professionals. The PC-PNDT Act requires strict record-keeping by ultrasound centres and clinics. Dr. Asokan highlighted that failure to fill out Form F, a document detailing the medical history of a pregnant woman leads to harsh penalties similar to those for illegal sex determination, which he feels is unjust.
“It is a massive failure and has not shown results. Instead, it has harassed obstetricians, radiologists and even cardiologists,” Dr Asokan told The Indian Express. According to Dr.
The Debate on Effectiveness:
The PC-PNDT Act was introduced to combat India’s declining sex ratio, which has improved over the years, though progress remains limited. In 2022-23, India’s sex ratio at birth stood at 933 girls per 1,000 boys, up from 918 in 2014-15. However, this still falls short of the ideal ratio of 960-970 girls per 1,000 boys.
Many experts and activists oppose the legalisation of sex determination, warning that it could lead to an increase in female foeticide. Dr. Sabu George, a long-time advocate for the effective implementation of the PC-PNDT Act, has argued that mandatory gender determination could push families towards unsafe abortions if they learn early in the pregnancy that the child is female.
Others, like Dr. Harsh Mahajan, former president of the Indian Radiological & Imaging Association, have called for more innovative approaches. He suggested that an ultrasound before an abortion could help determine whether it was medically necessary or gender-selective.
“Falling sex ratio is a concern, but prosecuting radiologists is not the solution. More out-of-the-box solutions are needed,” Dr Harsh Mahajan told Hindustan Times.
The Way Forward:
Critics of the current law believe the problem lies in its implementation. They argue that many ultrasound clinics are not properly monitored, and offenders are often let off with fines. Activists like Varsha Deshpande, a member of the National Inspection and Monitoring Committee, argue that the IMA should expose wrongdoers within the medical community instead of pushing for a change in the law.
“If the IMA is worried about the Act, then let it expose the wrongdoers in the medical fraternity,” Varsha Deshpande said.
Globally, the legality of prenatal gender determination varies. Countries like South Korea, China, Australia, Canada, and Vietnam have banned the practice, while the United States allows it for medical reasons. In India, the ongoing debate reflects a clash between cultural traditions and medical ethics, highlighting the complexities of addressing gender-based social biases.
The PC-PNDT Act has some success in improving India’s sex ratio, but there are strong differences of opinion about its impact and fairness. Whether legalisation of prenatal sex determination could help or harm remains a contentious question that demands careful consideration.