The Indian Medical Association (IMA) has urged the Haryana government to reconsider its directive requiring pregnant women to register with local auxiliary nurse midwives (ANMs) before accessing free ultrasound services.
In a letter to the director-general of health services, the IMA supported the government’s aim of monitoring pregnancies and combating female foeticide but cautioned against the “rapid implementation” of the January 14 order, according to The Times of India.
The association warned that mandatory registration could have social drawbacks, particularly for women with unwanted or unplanned pregnancies, as they might feel uneasy disclosing personal information to ANMs in their communities. This, the IMA argued, could prevent them from seeking essential healthcare.
“Such individuals may resist sharing details with local ANMs and avoid reporting their pregnancies to the formal healthcare system,” said Mahaveer P. Jain, IMA Haryana president. The association warned that privacy concerns could push some women toward unqualified practitioners, endangering their health and undermining progress in safe motherhood initiatives.
The IMA highlighted that the issue was particularly concerning in urban areas, where locating an ANM could be challenging, and residents might hesitate to invest time in registration before receiving medical care. Additionally, ANMs are not available 24/7, potentially delaying urgent medical attention.
On ethical grounds, the association pointed out that women experiencing first-trimester complications, such as ectopic pregnancies or threatened abortions, require immediate medical attention, often including ultrasounds. “Denying them services due to mandatory registration poses a serious risk to their lives,” the IMA emphasized. The association also questioned the ethics of requiring patients with symptoms like vaginal bleeding to obtain a reproductive child health (RCH) ID before receiving care.
The IMA also raised concerns for patients traveling from distant districts for ultrasound services, only to be turned away due to the registration requirement. It argued that forcing these women to return for an RCH ID would cause “unnecessary harassment.” Additionally, the association warned that enforcing local ANM registration might conflict with confidentiality provisions under the Medical Termination of Pregnancy (MTP) Act, necessitating legal amendments to avoid contradictions.
As a solution, the IMA proposed mandatory registration only for pregnancies beyond 10 weeks, as sex determination typically occurs between 14 and 16 weeks. “This approach would also help prevent unwanted pregnancies from being terminated in the informal sector,” the letter stated. Addressing concerns over female foeticide, the IMA asserted that a well-structured registration policy could enhance the sex ratio and reduce maternal mortality.
Ajay Mahajan of the IMA reiterated the association’s commitment to the government’s objectives but urged authorities to pause the directive until comprehensive guidelines were established. “We fully support this initiative, but the current order should be kept in abeyance until proper regulations are formulated,” he said.
Health department officials confirmed receipt of the IMA’s letter. “Civic surgeons have already discussed the directive with IMA representatives in their respective districts. It has been agreed that the plan will be implemented soon,” a senior official stated.
