Ms. BIJAYALAXMI NANDA is an Associate Professor, Department of Political Science, Miranda House Delhi University. She has been actively involved in different campaigns to empower women since 1990s. She has been waging a war against female foeticide since 2001 when she launched Campaign against Pre-birth Elimination of Females (CAPF) to fight the battle at the national level. In an interview with SHAFAQUE ALAM she asserts that pre-birth elimination of females is illegal, inhuman and unethical. It is not female discrimination but violence against female. She appeals to people in common and doctors in particular to shun their “favourite attitude” to selective abortion, the path of annihilation. Excerpts:
What is female foeticide?
The term refers to a practice of selective elimination of the female foetus after pre-natal sex determination or sex pre-selection, thus avoiding the birth of a girl child. It is commonly referred to as female foeticide. The politically correct terminology is sex selective abortion and/or sex selection.
Please throw some light on gender discrimination.
What is gender? Gender is when boys are told “not to cry like girls” and girls are told “do not walk like boys”. When girls are told to laugh with their mouths shut and boys are asked to physically fight it out to settle a matter; that is when gender is happening. So gender is a social construction where a fixed set of meanings is attributed to males and females. Fixing meanings is done in a manner when some characteristics are valued more than the other. For example, crying is seen as a sign of weakness, which is an emotional reaction, of ‘females’. In this process of attributing values to certain characteristics of both the ‘genders’, women come to be seen as naturally inferior to men. Of course this natural inferiority can differ across societies and cultures. Discriminating between men and women is based on this social construction and there is nothing natural or normal about it.
Gender discrimination against girl child was, in earlier times in certain parts of India, practised through female infanticide. Today, the new reproductive technology allows more hideous and sophisticated ways of eliminating the unwanted girl child. The technology, which was innovated with the purpose of dealing with general foetus and congenital health issues, came to be employed for sex selection.
Why does a woman go for selective abortion?
Willingly a woman never goes for sex selective abortion. In most of cases she is forced/conditioned to do so either by her husband or by her in-laws.
What the census reveals regarding the decline of females?
Sex selection is a pressing problem in India, as demonstrated by multiple decennial censuses. From 1991 to 2001 there has been a sharp decline in the child sex ratio (0-6 age group) from 945 to 927 girls per 1000 boys. In 1991, not a single district in India was recorded with a child sex ratio of less than 800, while in 2001 there were 14 such districts. The issue of declining sex ratio in India is not a new one; it has been identified from 1991 onwards with its worst decline noted in the 2001 census. This demographic imbalance has spread all over India and has been attributed to the practice of sex-selection.
What does the phrase missing girls mean?
The child sex ratio is calculated as number of girls per 1000 boys in the 0–6 year age group. The 2001 census reported a child sex ratio of 927 girls per 1000 boys. Therefore, there are 73 missing girls for every 1000 boys in our country, and soon it may become very difficult to make up for them. The practice of eliminating female foetuses is believed to be one of the main reasons for the adverse child sex ratio. Millions of female foetuses were and are still being terminated creating a serious imbalance in child sex ratio in the country. Pre-birth elimination of females (PBEF) seems to be more prevalent in urban areas than in rural areas, but the gap is fast decreasing because of the easy availability of sex-determination tests in rural areas as well.
Why is imbalance in the child sex ratio worrying?
A declining sex ratio has various socio-economic and health implications. A woman’s health suffers as she is forced to undergo multiple pregnancies and sex selective abortions. Decreasing number of females in the society can increase sex related crimes and violence against women. Imbalance is likely to cause a rise in social problems like dowry deaths, forced polyandry, rape, child marriages, bride-selling and kidnapping of women for marriage.
What about the legal position of abortion?
It is extremely important to understand that sex–selective abortions are illegal and inhuman. We need to make a clear distinction between the Medical Termination of Pregnancy (MTP) Act, 1971 and Pre-Conception & Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) (PCPNDT) Act, 1994. In our country abortion is legal, given certain terms and conditions as laid down under the Medical Termination of Pregnancy Act, 1971. Abortions can take place under certain conditions namely if there is physical or mental threat to the health of the pregnant woman or the foetus has congenital abnormalities which would make its survival difficult, all these conditions have to be medically certified.
When did various sex-determination teachings come to India?
Technology for foetal sex determination came to India in the mid 1970s in the form of amniocentesis. Other sex-selection techniques, both, pre and post-conception became available in the country as medical science advanced in later years. A study reveals that out of 15 million abortions carried out in the world in 1997, India accounted for four million, 90 per cent of which were intended to eliminate the girl child.
What are the common methods of sex determination, before birth as well as before conception?
Amniocentesis – (Amnion: membrane, Kentesis: pricking). In this technique, amniotic fluid is drawn from the amniotic sac surrounding the foetus in the uterus through a long needle inserted into the abdomen. Foetal cells present in the fluid help in determining the sex of the foetus. It is normally performed after 15–17 weeks of pregnancy.
Chorionic Villi Biopsy: This refers to the removal of elongated cells (called villi) of the Chorion, which is the tissue surrounding the foetus, through the cervix. The tissue cells are tested to determine sex of the foetus. This enables sex determination between the first 6-13 weeks of pregnancy and abortion can be carried out in the first trimester itself.
Ultra-sonography/Ultrasonic: Here inaudible (to humans) sound waves are used to get a visual image of the foetus on a screen. Normally, it is used to determine the foetal position or abnormalities, but it can also be used to find the sex if external genitalia of a male foetus is seen on the screen. It is the most commonly and rampantly used method for sex determination.
What about pre-conception techniques to select sex?
Ericsson Method – (X and Y chromosome sperm separation): A male child requires an XY combination of chromosomes. Sperms may have either X or Y chromosome, but eggs have only X chromosome. In this method, sperms are separated into – those bearing X chromosome and those bearing Y chromosome, by filtration when put in a chemical solution. The faster moving Y sperms penetrate the solution’s denser bottom layers. The egg is then fertilised with a high concentration of Y sperms to produce a male.
Pre-implantation genetic diagnosis – One of the latest technologies to be used for sex selection, it involves chromosomal analysis of a few cells taken from a test tube embryo (fertilisation is done outside the uterus to determine the sex).
Do sex-determination techniques cause harmful effects?
There are several ill effects of these techniques, for instance amniocentesis can lead to abortion or premature birth. The use of a needle while performing amniocentesis can lead to spreading of infection. In some cases, the foetus may suffer haemorrhage, bleeding or breathing problems. The needle can pierce the foetus causing death or permanent disability. The other methods like Chorionic Villi Biopsy, is also not free from risks. It can also lead to abortion, spreading of infection, limb defects and in some cases the limb may even come out. There can be bleeding when the sample is taken leading to mental and physical defects in the baby. Other physical risks include excessive bleeding, ripping or perforation of uterus, anaesthesia complications, convulsions, cervical injury, enhanced risk of miscarriages in future and long-term health complications. If multiple second trimester abortions are done there is a risk that the women cannot conceive again. Risks are also increased manifold because such abortions may not be done in hospitals under proper care and supervision, but in private nursing homes where the intention is to make monetary gains and there is no concern about the health of the patients.
What are the main provisions under the amended and renamed Pre-Conception & Pre-Natal Diagnostic Techniques Act (Prohibition of Sex Selection), 1994 (PCPNDT Act) to deal with Pre-Birth Elimination of Female Foetus (PBEF) issue?
The salient features of the PNDT Act 2002 are ––
- It prohibits sex-selection, both before and after conception
- It regulates the use of per-natal diagnostic techniques, like ultrasound and amniocentesis by allowing their use only to detect ––
Genetic abnormalities
Metabolic disorders
Chromosomal abnormalities
Certain congenital malformations
Haemoglobinopathies
Sex-linked disorders
- No laboratory or centre or clinic will conduct any test including ultrasonography for the purpose of determining the sex of the foetus.
- No person will communicate the sex of the foetus to the pregnant woman concerned or any relatives by words, signs or any other method.
- Any person who puts an advertisement for pre-natal and pre conception sex determination facilities in the form of a notice, circular, label, wrapper or any other document, or advertises through internet or other media in electronic or print form, or engages in any visible representation made by means of hoarding, wall-painting, signal, light sound, smoke or gas, can be imprisoned for up to three years and fined Rs 10,000.
- Any medical geneticist, gynaecologist, registered medical practitioner or any person who owns a Genetic Counselling Centre, a Genetic Laboratory or a Genetic Clinic where the test is conducted can be imprisoned for up to three years and be required to pay a fine of Rs 10,000. For any subsequent offence, the fine can go up to 50,000 and imprisonment to five years.
What are the different factors linked to the prevalence of PBEF?
There are a number of factors. It may be socio-cultural, political or economical.
Preference for a son by family and society, where they feel only a boy can carry forward the name of the family and be considered a source of support during old age and perform last rites at the time of cremation (in the Hindu society).
Lower status of women in the society, inheritance system, where a girl child has no right to her father’s property, and illegal practice of dowry are some other factors. The issue of grave concern fails to attract attention of political parties. Weak enforcement of existing policies and laws aimed at curbing the practice are also some reasons.
Which are the states that have the least sex ratio?
The declining trend is more prevalent in five northern Indian states and the economically prosperous states in India – Madhya Pradesh, Rajasthan, Himachal Pradesh, Punjab, Haryana, Gujarat, Maharashtra and Delhi.
Why is it not being contained?
To contain it is not so easy. Sex selection which is an extreme form of gender discrimination and gender violence is a complex issue with several stakeholders addressing it. The stakeholders include the government, international agencies, doctors, health and women’s groups and civil society at large.
It is an organised crime against women, encouraged by professionals where business interest takes precedence over public health. Collusion between doctors and clients makes the situation worse. Doctors are legally bound to report malpractice (under the Code of Medical Ethics, constituted by the Indian Parliament in the Medical Council Act, 1956).
Whom do you hold responsible for this menace?
Apart from the family, the medical community. The elimination of females by sex selective abortion cannot take place without the active misuse of new reproductive technologies. Thus, the medical professionals are regarded as the major culprits in this case. However, we believe that medical professionals and students can play a positive and active role if involved as a focus group on the issue of sex selection.
Sex selection is both a form of gender discrimination and an act of violence. It is important to understand that as members of society we do not partake in any act of violence and discrimination. The act of determining the sex of the foetus with the aim to abort it, if it is a female, is unethical and unacceptable not just on part of families but also doctors and medical professionals. This menace cannot be contained if the doctors and hospitals are not reined. There is a nexus among doctors, traditional values, and consumerism. So this nexus must be broken.
Should women like Sania Mirza, Kiran Bedi, etc. come forward to empower women?
They should come forward and they may be of great help, but why only Sania Mirza and Kiran Bedi? We have a Sania and Kiran in every house. Why don’t we let them come forward? There are so many women who propagated their family name like Indira Gandhi, Razia Sultana, Rani Laxmi Bai, etc. Hence we should encourage our family members, neighbours and relatives to assist the girl child, nurture, educate and make themselves dependent and also to recognise the value of the girl child and women in each and every sphere of human life and society. We should highlight the success stories of women and girls in our local communities who play supportive roles to their parents in their old age, who are economically empowered and are carving their own space in society.
Please tell us about your CAPF, its work and activities.
We, a group of concerned teachers and students of Delhi University, initiated The Campaign Against Pre-birth Elimination of Females (CAPF) in July 2002. A group of academicians, professionals and volunteers dedicated to the cause of protecting the rights of the girl child and women form CAPF. The campaign seeks to create a movement involving students and teachers to increase awareness about PBEF. It strives to make our society a more secure place to live for the girl child and women by fighting against one of the most horrible forms of gender discrimination & violence.
The government has enacted the law. What should one do now?
Follow the law and keep informed through newspapers, legal sources and organisation working on the issue. If one knows any person violating the law, he should inform the legal authority in his area (that is the appropriate authority, usually the chief medical officer of the district). As a citizen one can help in disseminating information on the issue of PBEF and can participate in different activities that the campaign organises from time to time. As a teacher one can become a member of the campaign and provide valuable information to students about the issue and encourage them to join as volunteers.
A parent can make an invaluable contribution by not differentiating between a son and a daughter. She/he can encourage gender equality at home. She/he should not seek medical intervention to conceive a boy.
As a husband, one should not put pressure on his wife. The decision to have a child (not a son or a daughter) should be taken together keeping in mind his wife’s health. And he should not seek medical intervention to conceive a boy.
As family members and relatives they should not force a woman to undergo pre-natal sex-determination or pre-conception sex determination. Rather they should support the woman if other persons in the family are insisting on sex-determination and be an advocate of gender equality in family.
What should be the role of medical professionals?
As medical professionals it is their responsibility to give correct information to their clients and assist them in making the right decision. They can help the campaign immensely by NOT carrying out sex determination tests, NOT revealing the sex of the foetus to parents or family, NOT performing abortions beyond permitted limits under the law.
And the role of media?
A media person should not publish advertisements offering sex determination facilities. Instead, make a positive contribution by publishing articles in magazines or newspapers to generate awareness about the heinous practice of PBEF, the law prohibiting it and difficulties in the implementation of the law. Support the girl child through their writings, photographs, films or any other medium.
So according to you, what is the solution?
Strict implementation of law, women’s empowerment, shattering the stereotypical myths about women and men and monitoring of the doctors and hospitals where sex selection is done can wipe out this menace. The highlighting of the value of the girl child and women and recognising them as absolute equals in society will bring about gender justice for all of us.