Female foeticide is being widely practised in many Indian States, with modern technological tools being used to determine the sex of the foetus. The sociological costs of such selective abortions, which are illegal, are alarming.MADHU GURUNG
SEATED on a charpoy in a hut in Bhalli Anandpur village near Rohtak in Haryana, Kishan Devi, 65, chews on a meal of bajra roti and raw onions and muses on her life. She is the mother of 14 children, all daughters, the eldest of whom looks after Kishan De vi and her husband Dayanand, 70, a landless labourer. Each child was borne with the hope that it would be a boy, but that wish was never fulfilled. "If he could get another wife, he would still want a son," a weary Kishan Devi says of Dayanand, who looks away. "I had a tough time getting my daughters married off," she recalls. "No one wanted to marry a brotherless girl. They thought the girl would, like me, be unable to bear a son."
Over in the gynaecology ward of the Christian Medical College (CMC) Hospital in Ludhiana, Sheela, 32, from Sirsa in Haryana, lies on a bed. Seven months into her pregnancy, she has developed a gynaecological complication. There is a hint of worry in her brown eyes, and her arms lie protectively on her stomach. "I don't want to lose my baby," she says. "It's a son - the ultrasound test says so." Sheela had been pregnant twice earlier, and on both occasions she underwent pre-natal diagnostic tests to dete rmine the sex of the foetus. "Donon time test mein ladki nikla to safai kara di" (On both occasions the test revealed it was a girl, so I had it aborted).
Kishan Devi and Sheela are a generation apart and, yet in their yearning for a son they are remarkably alike. Advances in technology over the years, however, make it possible for Sheela's wish to be fulfilled. But the sociological consequences of large n umbers of pregnant women resorting to sex-determination tests and undergoing selective abortions if the foetus is female are alarming.
"EVERYONE wants a munna," says Dr. Aruna Dhar, head of the gynaecology department at CMC. The obsessive yearning for a son is a deep-rooted social phenomenon in India, particularly in the northern States, and the demographic consequences of this s ocial bias are becoming increasingly evident. According to the 1991 Census, the sex ratio (defined as the number of females per 1,000 males) in India was 927. The 1901 Census recorded that males outnumbered females by about 3.4 million in India's populat ion of 238 million. Today, in a population of about one billion, males outnumber females by an estimated 48 million.
In many other parts of the world, females outnumber males by 3 to 5 per cent. There are 95 to 97 males per 100 females in Europe, the United States and Japan. In India and China, however, males outnumber females by 6 to 8 per cent.
Within India, the sex ratio is not uniformly distorted, and in some States such as Kerala it is quite healthy. A report of the United Nations Population Fund (UNFPA), "India: Towards Population and Development Goals" (1997), notes: "If the sex ratio of 1 ,036 females per 1,000 males, observed in the State of Kerala in 1991, had prevailed in the whole country, the number of females would be 455 million instead of 407 million (in the 1991 Census). Thus there is a case of between 32 to 48 million missing fe males in the Indian society that needs to be explained." No amount of under-numeration or migration variables can account for such a huge deficit. Social scientists assert that female foeticide is a major factor responsible for the declining sex ratio.
Many Indian communities have been known to practise female infanticide, the criminal practice of killing female children at birth or immediately thereafter. Misuse of technological advances in pre-natal diagnostic techniques, which were intended solely t o detect genetic abnormalities in the foetus, have made it possible for pregnant women to determine the sex of the foetus even in the first trimester - and follow it up with sex-specific abortion.
Amniocentesis tests, an invasive procedure to detect genetic abnormalities, were first conducted at the All India Institute of Medical Sciences in New Delhi. The procedure, in which a needle was inserted into the womb of the pregnant woman to withdraw a sample of amniotic fluid and test it, was unethically employed by some doctors and paramedical personnel in New Delhi and Punjab to assist in determining the sex of the foetus. In early 1979, North India's first sex-determination clinic was opened in Amr itsar; soon similar clinics mushroomed in Punjab, Haryana, Maharashtra and Uttar Pradesh.
When the clinics began to advertise their sex-determination services brazenly, women's rights activists raised a chorus of protests. In 1986, the Forum Against Sex Determination and Sex Pre-Selection was formed in Mumbai to campaign against selective abo rtions. Public outrage against sex-determination tests and sex-specific abortions led to the enactment of the Maharashtra Regulation of Pre-Natal Diagnostic Techniques Act in 1988, the first of its kind in the country. The campaign had initially focussed on the hazards of amniocentesis and chorion biopsy techniques and protested against their use in determining the sex of the foetus; these methods soon gave way to non-invasive procedures, such as ultrasound scans.
Under pressure from women's rights activists and human rights groups, the Central government brought forward the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act in 1994. The Act, which required ratification by individual State A ssemblies, bans the use of pre-natal diagnostic techniques for sex-determination purposes and provides for a three-year imprisonment and a fine of Rs.10,000 for offenders. Since ultrasound scans are useful in detecting a host of genetic abnormalities, th e procedure could not be banned outright; however, the law makes it illegal for the procedure to be used for sex-determination purposes.
THE social consequences of years of selective abortions are beginning to manifest themselves even at a micro level in some of the country's more prosperous States. According to the 1991 Census, the sex ratio in Punjab was 888, against the all-India avera ge of 927. The figures in three districts of the State were particularly alarming: in Amritsar the ratio was 881, and in Bhatinda and Faridkot it was 884. And according to Dr. Puran Singh Jassi, former Director of Health Services, a survey undertaken in 1997 indicated that the sex ratio in the State had dipped even further, to 751.
Another survey, conducted in 1997-1998 by the Voluntary Health Association of Punjab (VHAP) in 10 villages around Chandigarh, recorded that the number of boys born during that period was significantly larger than the number of girls born. VHAP executive secretary Manmohan Sharma says: "The survey showed that many pregnant women from these villages went to Chandigarh for scanning and for selectively aborting female foetuses. Female foeticide is rampant in Punjab."
Sharma traces the deep-rooted preference for sons in Punjabi society to its martial traditions, and a certain mindset that was reinforced during the traumatic years of militancy in the 1980s. Sons were preferred for their traditional roles as protectors during times of strife - they fought wars and defended communities and families - and as income-generators during peacetime. Given the prevailing patriarchal values, women were seen as a social liability; in addition, they were seen to be vulnerable to g ender crimes like rape, and had to be protected. Further, getting a daughter married entails huge expenditure - on the wedding feast and on dowry. Besides, sons are seen as having the potential to offer social security during the parents' old age: they b ring in wives to take care of the family. Daughters, on the other hand, leave home upon getting married.
Manisha Bhalla, who was on the VHAP survey team, says: "If a girl is born, women come to console you saying 'Rab tujhe changee cheez deve' (May God give you a better deal next time)." Even educated urban women who hold good jobs often have second- class status in society; at the time of marriage they are required to pay a large dowry. Debts incurred to pay for extravagant wedding feasts and meet dowry demands led to many tragedies. Sharma says: "Many farmers commit suicide, not because of crop fai lure but because they are unable to repay loans taken for daughters' marriages."
THE situation is much the same in neighbouring Haryana. Patriarchal values that underlie the preference for male children are deeply ingrained in the people's psyche. There is even a popular saying that reflects this: "Doodh aur poot se kabhi man nahi n bharta hai" (One can never have a surfeit of milk and sons).
This writer encountered a Rohtak doctor who carries his ultrasound equipment to adjacent villages and charges between Rs.500 and Rs.800 to determine the sex of a foetus. He has had no formal training in ultrasonography, but his clients, who include landl ess labourers, do not know this, and flock to him.
"There is no gender equity in Haryana," says Pramod Gauri, director of SEARCH, a literacy resource centre. "Women contribute 70 per cent to productivity in agriculture and in cottage industries. Yet they have virtually no say in decision-making."
Alarmingly, foetal crimes that are born of the obsessive yearning for a son are manifesting themselves in regions that were hitherto not affected by regressive gender preferences. For instance, in Garhwal and other hill regions of Uttar Pradesh, far from being considered a "burden", girl children were traditionally considered valuable because they labour both in the fields and at home, while the men migrate in search of jobs. And, equally important, at the time of the wedding, girl children fetched a br ide price.
But that situation has changed dramatically. Today, in a region where public health facilities are minimal, there are scan centres that offer sex-determination services. And people are willing to travel long distances to avail themselves of them. Dr. Ash a Rawal, president of the Gynaecological Association of Dehra Dun, says that people from Uttarkashi, Chakrata, Kotdwar, Tehri Garhwal, Nayaguam and Barkot trek for hours to Dehra Dun, Bareilly or Hardwar for such tests.
If the foetus is female, women press for abortions even if they are in the second trimester of pregnancy. Second-trimester abortions are illegal and are often done by unqualified medical personnel in ill-equipped clinics. Under such conditions, there is grave risk of the woman contracting septicaemia, which can be fatal, or facing other complications such as bleeding.
Instances of female infanticide and foeticide have also been reported in some southern States, where gender disparities, although they exist, are not widely manifest (Frontline, November 19, 1999). Female infanticide has been recorded in parts of Tamil Nadu as early as in the 19th century: the Kallar and the Toda communities have been known to feed unwanted female children with paddy soaked in milk or the poisonous sap of the calotropis plant. That practice has nowadays given way to female foetic ide.
The sex ratio in Tamil Nadu declined from 995 in 1961 to 948 females in 1991. In Dharampuri district, it fell from 993 in 1971 to 905 in 1991; in Salem district, it dropped precipitously from 990 to 849 during the same period.
ADVANCES in medical technology and techniques that cater to the needs of those who wish to opt for sex-selective parenthood have become increasingly refined. In the Ericsson method, the X and the Y chromosomes in the sperm are separated and only the Y ch romosome is re-injected into the womb. This procedure costs Rs.15,000 to Rs.20,000. The Pre-Implantation Genetic Diagnosis (PGD) procedure goes one step further in determining the sex of the foetus. Earlier, ultrasound scans could determine the sex of th e foetus only between the 26th and 28th weeks. However, newer ultrasound procedures are capable of detecting the sex of the foetus between 13 and 14 weeks through trans-vaginal sonography and between 14 and 16 weeks through abdominal scans.
Some medical practitioners defend the use of pre-natal diagnostic facilities to determine the sex of the foetus on the ground that "it gives couples a choice". Such a view, however, overlooks two crucial points: the use of such tests for specifically tha t purpose is illegal; and the declining sex ratio that results from such large-scale resort to sex-selective abortions is bound to have serious social implications.
Abortion was legalised in India in 1971 by the Medical Termination of Pregnancy Act, but the procedure was essentially intended to address concerns over the growth of population and the need for smaller families. There was little or no realisation then t hat advances in medical technology would one day facilitate selective abortion of female foetuses. The Pre-Natal Diagnostic Techniques (Prevention and Regulation of Misuse) Act, 1994 was an attempt to respond to the new situation, but even this piece of legislation failed to anticipate the rapid evolution of medical technology that would enable doctors to circumvent its provisions.
The implementation by governments of the provisions of the Act has not also been whole-hearted. Demographer and social scientist Sabu George says: "There are more than 20,000 ultrasound clinics in India and barely one per cent of them are registered. In Punjab, there are roughly 2,000 ultrasound centres."
Another problem with the Act is that it does not provide for action on the basis of complaints from a third party, that is, anyone other than the doctor who undertakes the procedure and the pregnant woman. Besides, it is virtually impossible to prove tha t the procedure was used to determine the sex of the foetus, in the absence of written test reports (doctors invariably give the results orally). Consequently, there have been no convictions under the Act.
Women Against Oppression, a Chandigarh-based group, has submitted a petition to the Human Rights Commission drawing attention to the "misuse of abortion rights" for purposes of selective abortion. Aruna Kumari, the leader of the group, said that new diag nostic techniques that had been introduced should be brought under the purview of the law. The Government, she said, had done little to reverse the trend of a declining sex ratio.
DURING the Decade of the Girl Child (1990-2000), the Central and State governments introduced various schemes aimed at enhancing the status of the girl child. However, they have had little impact.
In 1992, following reports of female infanticide, the Tamil Nadu government headed by Chief Minister Jayalalitha introduced a "cradle baby scheme" under which parents could abandon "unwanted" girl babies in cradles kept in noon meal centres, primary heal th centres and orphanages. The babies would then be brought up in State-run orphanages. But the scheme fizzled out because many babies that were "adopted" by the State died. Under other schemes, income-poor families with one or two daughters and no sons were offered monetary incentives if either parent opted for sterilisation. A sum of money would be invested in a fixed deposit in the name of the girl child until she turns 21.
In October 1994, the Haryana government introduced an "Apni Beti Apna Dhan" scheme, under which a small maternity benefit would be made available to the mother and a sum of Rs.2,500 invested in Indira Vikas Patras. At age 18, the girl would receive Rs.25 ,000.
In August 1997, Prime Minister I.K. Gujral announced a 'Girl Child Protection Scheme' for income-poor families. Under this, a sum of Rs.2,500 is invested in a fixed deposit; additionally some money is given to the girl at intervals to meet her educationa l expenses, and Rs.10,000 is paid to her at age 20. The schemes were intended to ameliorate the financial burden on the parents of girl children, but in effect they only served to perpetuate the social evil of dowry.
Alongside such interventions, there is a compelling need to undertake a sustained campaign aimed at challenging and changing societal values and mental attitudes that perpetuate gender-inequity. A beginning in this direction has been made in a little-kno wn Punjab village. An appeal by the panchayat of Begowal to its people not to undertake sex-determination tests and instead let the girl child live has met with a modicum of success. Birth records at the two anganwadi centres in the village indicate that a certain parity has been attained in the number of boys and girls born since the campaign began.
Sex-determination tests and sex-specific abortions cannot take place without the complicity of a section of medical and paramedical personnel. Aware of the fact that it is being perceived to be contributing actively to the perpetuation of a social crime, the medical fraternity has bestirred itself to intervene in the matter. The Indian Medical Association (IMA) has acknowledged that doctors are responsible in some measure for the continuing practice of female foeticide. On November 16, 1999, the IMA led a rally in New Delhi to raise awareness about foeticide; doctors, activists and 5,000 schoolchildren participated. One contingent, representing the Society for the Protection of the Unborn Child, had a striking presence: dressed in saffron robes, the pa rticipants claimed to espouse a rather different agenda and were opposed to abortions in their entirety. Swami Nityanand Giri from the Geeta Press, Varanasi, said: "Abortion is a sin; every unborn child has a right to life."
The United Nations Children's Fund (UNICEF) is facilitating regional meetings to raise awareness about the issue. The National Law School in Bangalore studied the 1994 Act and recommended amendments that would plug loopholes in it.
Recently, the IMA lodged with the Medical Council of India complaints against four doctors in this context; the doctors filed affidavits denying the charges.
Despite well-intentioned efforts to check the societal crime, female foeticide cotinues to be practised in many parts of India. Only if the initiatives address the factors that underlie the discrimination that women experience in society and the gender v alues that prevail within communities can any real progress be made on this front.
Madhu Gurung of the Women's Feature Service investigated the decline in the sex ratio and its links with female foeticide, with the aid of a National Foundation of India fellowship in 1998-1999.