Dr. Vinod Chandrashekhar Dixit
Sex determination tests on pregnant women have been illegal in India for several decades. Yet, the persistent preference for sons continues to drive the selective termination of pregnancies, resulting in a disturbing rise in cases of female foeticide. The widespread use of illegal sex determination tests remains a key factor behind India’s skewed gender ratio.
India banned sex determination tests in 1994 as the gender balance became increasingly distorted. Under Indian law, sex determination tests are not permitted under any circumstances when the intent is to terminate the life of a fetus developing in the mother’s womb, except where termination is allowed on specific medical grounds under the Medical Termination of Pregnancy (MTP) Act, 1971.
The MTP Act was enacted primarily to regulate abortion and to help control population growth. However, in certain cases, the desire for a small family has been overshadowed by a preference for a child of a particular gender. This has led to abortions when the sex of the fetus does not match the family’s expectations. In India, where the large-scale abortion of female fetuses has contributed to a national gender imbalance, it is illegal for doctors to disclose the sex of an unborn child. Despite this, a lucrative underground industry continues to thrive, driven by the social and cultural devaluation of daughters.
Although sex determination through techniques such as ultrasonography and amniocentesis is prohibited, female fetuses are still routinely aborted in regions where son preference remains deeply entrenched. Under the Indian Penal Code, causing an abortion—whether by the pregnant woman herself or by others—is a criminal offense unless it is performed to save the life of the woman. Such an offense is punishable with imprisonment of up to three years, a fine, or both.
The Pre-Natal Diagnostic Techniques (PNDT) Act mandates that all ultrasound facilities be registered and that medical practitioners maintain detailed records of every scan conducted on pregnant women. The Act clearly states that pre-natal diagnostic techniques may be used only to detect genetic abnormalities, metabolic disorders, chromosomal abnormalities, congenital malformations, or sex-linked disorders. Due to growing concerns that ultrasound technology was being misused to identify the sex of the fetus and facilitate female foeticide, the 1994 law explicitly prohibited medical professionals from revealing the sex of an unborn child.
Despite these legal safeguards, sex determination and female foeticide persist, largely due to inadequate monitoring and weak enforcement. In many families, the birth of a son is celebrated as a matter of pride, while the birth of a daughter is often met with disappointment or even mourning. For poor families in particular, daughters are seen as financial burdens because of the social pressure to provide dowries at the time of marriage.
Over time, the issue of foeticide has been conveniently sidelined. Little is done to curb illegal sex determination and foeticide, allowing those involved to operate with impunity. Experts argue that the problem lies not in the law itself but in its poor implementation. Monitoring of ultrasound clinics remains weak, and although clinics are required to maintain detailed records, violations often result in nothing more than minor fines.
Encouragingly, India’s sex ratio at birth has shown signs of improvement. The national average rose to 917 females per 1,000 males during 2021–23, compared to 899 in 2016–18. Twelve states have surpassed the national average, indicating progress in reducing sex-based discrimination. The Beti Bachao Beti Padhao scheme, launched in 2015, has contributed to this improvement, with the sex ratio at birth increasing from 918 in 2014–15 to 930 in 2023–24.
To further minimize the risk of foeticide and infanticide, it is now essential to consider reforms to the PNDT Act. One proposed measure is to make it compulsory for all pregnant women to undergo scans exclusively at government hospitals, ensuring stricter oversight and accountability in monitoring prenatal diagnostic procedures.
