The Union Minister for Women and Child Development, Maneka Gandhi, recently suggested turning the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act (PNDT) enacted from January 01, 1996 on its head. She suggested that it should be mandatory for women to know the sex of their babies and for pregnancies to be monitored. This offers a good time to review how effective the Act has been vis-a-vis deterring sex selective abortions and to maintain a healthy sex ratio. Nirupama Sekhri travels back and forth trying to make an assessment
Ms Maneka Gandhi’s comment took me back to my second pregnancy when I was appalled at the form I had to sign stating that I did not want to know the sex of my child. Because I did. It had helped me tremendously to know the sex of my baby during my first pregnancy - I had found a name for my daughter, ‘she’ was a little person growing inside me who I used to talk and sing to.
However, during the second time around, in Delhi, the doctor and I looked furtively at each other and guiltily at the form. I wanted to say, “Doc, I hardly fit your profile of a foetus killer, could I know the sex of my baby please, it really helps me.” But he already looked distressed and I didn’t want to indulge in ‘illegal’ practices, so my second child against my wishes was a ‘surprise’.
This desire to know the sex of my child seems totally trivial in comparison to the desire to stop female foeticide, infanticide and gross female neglect in India. So if the good doctor and I were going to be treated as potential criminals it was only a small price to pay for the greater good of saving girl children in the country.
But the question is that is that really so? Does this Act really contribute to bringing down female foeticide. Logic and statistics don’t seem to support that.
A social not a medical problem
It is pertinent to note that under British colonial rule, Richard Bourke, Governor-General of India had passed the Female Infanticide Prevention Act 1870. The murder of female infants was found to be common practice in certain parts of British India, like Oudh, North-Western Provinces and Punjab. The Act included a fine and imprisonment for disobeying the law, as well as a monthly charge from the family of the female infant for her upkeep and for avoiding her neglect.
The point being that violence against female infants has a long, deeply entrenched history in India, which Dr Marthanda Pillai, former president of the Indian Medical Association (IMA) in Thiruvananthapuram, Kerala, says “cannot be combated with medical solutions and interventions.” He feels that the PNDT Act has many superficial provisions and it has not taken the views of the medical community into consideration.
An interesting study published in January 2012, The Indian Ultrasound Paradox, by Mevlude Akbulut-Yuksel and Daniel Rosenblum Institute for the Study of Labour (IZA) in Bonn, Germany challenges the link between the technology and reduction in female foeticide. On the contrary, the study found that sex-selective abortion of female foetuses is rising in states with a slow expansion of ultrasound relative to those states with a rapid expansion of ultrasound. Thus, suggesting that the recent rapid spread of ultrasound is not causing higher rates of sex-selection in India.
This is challenged by activists like Kavita Krishnan of the All India Progressive Women's Association, who feels, “the idea to allow sex determination of an unborn child is outrageous, it echoes the corporate medical lobby's stand which just wants to ensure profits, they just want that those who go for sex selection to be let off the hook. Amending PNDT won't stop sex selective abortions, in fact it will increase the pressure on women from their family and society from the moment they know that she's going to have a girl.”
This is, however, countered by the fact put forward by Dr Pillai, “Girl children go missing not just in the foetal stage but in alarming numbers from 0-5 years. This is because they are neglected, not treated or vaccinated and allowed to languish from basic problems like nutritional deficiency, anaemia, diarrhoea, etc.”
Studies support this point. Girls have a biological advantage in infancy then have higher mortality than boys thereafter throughout the childhood. However, due to lower Neonatal Mortality Rate (NNMR), Infant Mortality Rates (IMR) in girls has been lower than among boys during all five year periods since 1981. It is the presence of social causes that adversely affect the mortality rate of girls, and this is what needs to be tackled.
In a study conducted by UNICEF that worked closely with a cohort of women to understand the reasons they undertook foeticide, 76.19 percent stated fear of safety for the girl as a reason for female infanticide and 83.33 percent accepted son preference because it is the male who carries the family lineage. Overwhelming majority (83.33 percent) of the respondents believed that they would have committed female infanticide if the voluntary organisation would not have intervened and provided economic assistance/incentives and awareness generation. Only 4.76 percent of the respondents said that they were afraid of the laws enacted by the Government.
So this patronising attitude of a handful who feel empowered to levy bans to ‘protect’ the rest seems misplaced. Bans need to be substituted with robust, rigorous work on the ground on education, health, property rights, etc.
Education and empowerment of Both sexes
I have the privilege of working with an overwhelming number of male colleagues who have daughters and ‘trying’ for a boy has never occurred to them. They all have had the advantage of being educated, exposed to progressive attitudes, and being strong enough to change attitudes of their own parents and families. This analysis based on a small, random sample is backed by adoption studies in India that show a distinct preference for girl children over the past three years.
Again the UNICEF study shows that among the rich and middle-classes in India it is conservative families that still lean towards female foeticide. This indicates that the need of the hour is to break this conservative male-biased mind-set by undertaking universal education on a war footing so that more women and men are able to reclaim love and empathy for their own progeny!
Another major and very negative fallout of an Act like the PNDT is of demonising technology. The Government needs to tread very carefully around scientific advances. Firstly, because it is ubiquitous, galloping at an unimaginable rate, and it cannot be stemmed by selective bans. It is better to prepare ourselves for its onslaught.
Secondly, the lack of robust data maintenance by the Ministries of Health or Women and Child establishing a clear link between the Act and reduction in female foeticide also reflects a greater want for scientific, objective attitudes. This is not unrelated to Nobel laureate Venkatraman Ramakrishnan panning the latest Indian National Science Congress “a circus”.
Making a scapegoat of technology to cover-up the Government’s inadequacies or using it as a populist tool for ‘action’ is detrimental to a healthy adoption of science and technology.
The role of medical community
No doubt that medical ethics also need to be questioned. But this needs to be done through a process of engagement. Dr SS Agarwal, National President IMA in Jaipur says that they understand this as well. In their most recent national level meeting, they have decided “that all our members will adopt a girl. We will empower her with education, health and social support. We will hold a big programme to formally launch this on March 1st this year.”
Biased or criminal
All of us harbour biases to lesser or greater degrees but all of us are not criminal. That line is crossed when you actively harm someone. Dr Mitu Khurana’s case is a classic one. In 2005 when she became pregnant with twin daughters she faced great pressure from her husband and in-laws to abort. She claims to have been assaulted by them, being pushed down a stairway and then locked in a room to prevent her getting medical help!
She blames the fact that they got to know she was carrying girls. Seriously! Such psychopathic people sound like they need long sessions of serious counselling to understand basic humanity. Like the dowry law, women should have a law supporting them to report male bias which should be made a non-bailable criminal offence.
The Way Forward
It is an established fact that protecting the foetus is a natural biological impulse and the killing of it is deviant. So if there are swathes of people indulging in such a barbaric practice we need to understand and address the factors that go into maintaining such a mindset and practices.
Professor Girishwar Misra, a social psychologist in Delhi University says that more visibility of women in professional spheres is an important way forward. A notion upheld by the Supreme Court in its recent ruling in favour of the lady sub-inspector of Chhatisgarh, Richa Mishra, to the post of deputy superintendant of police despite having crossed the upper age limit of 24 years. The SC said that “economic empowerment of women is the need of the hour” and, therefore, Ms Mishra should be promoted.
Another valuable input came from Dr Bina Agarwal who has just published a three-volume compendium ‘Gender Challenges’. She talks about a small study she co-conducted in Trivandrum district of Kerala.
Five hundred women were randomly selected from the urban and rural milieu. The study found a staggering difference between the domestic violence faced by women who owned property and who didn’t. It was only 7 percent from the former group and 49 percent from the latter. She points out that being economically independent or having a job is not sufficient because your partner knows you have nowhere to go. So implementing laws like the Hindu Succession (Amendment) Act, 2005 is one of the most powerful ways to empower women.
The International Land Coalition (ILC) and the UN Women India prepared a report on the formal and informal hurdles women, urban and rural, face in realizing this law.
The unique study shows that besides the ignorance of the law by women, it is arduous for even women aware of the law to overcome the male bias that continues in the law itself, where she is still put under pressure to give her property to her husband’s family rather than her natal one.
In traditional patriarchal societies, like Haryana, “local authorities brazenly deprive girls of their legal right to ancestral property.” Girls’ parents still largely feel that dowry is the trade-off to property ownership, which again is usually taken by the girls’ marital family.
These along with laws that ensure women minimum wages equal to those of men, safety at workplaces, are areas that Ms Gandhi needs to look into if she is genuinely serious about women empowerment and not just of brandishing power through legislating blanket compulsories over blanket bans.