Pressure from the medical community is obstructing action against doctors in India involved in illegal sex determination and selective abortion of female fetuses, government officials said last week, echoing concerns expressed by health activists.
More than 300 doctors have been prosecuted in India for violating a 12 year old law that prohibits doctors from disclosing the sex of a fetus to parents, but only four have been convicted, officials said at a conference on sex selection technologies in New Delhi.
Birth registration figures show that sex determination and selective abortion of female fetuses continues throughout the country. Doctors in ultrasonography clinics divulge fetal sex to parents after scans for birth defects.
When informed that the fetus is a girl, parents who favour boys claim contraceptive failure and seek medical termination of the pregnancy. Health activists believe that hundreds of thousands of female fetuses are aborted in India each year. The average sex ratio for children under 6 years old dropped from 945 girls for every 1000 boys in 1991 to 927 in 2001. The ratio has since fallen below 900 in several areas.
Figure 1.
Government officials, who have conducted surprise raids against ultrasonography clinics, said that they have encountered “pressure and lobbying” from the medical community not to act against doctors who have been caught (through hidden cameras) divulging the sex of the fetus.
“There is confidence, almost arrogance, among some doctors that they can get away with this,” said Arvind Kumar, the senior administrative officer in the southern city of Hyderabad who has prosecuted 18 doctors, the largest number of cases in a single city.
Surveys in the past two years in several states have shown that the richer the district, the higher the density of ultrasonography centres, and the poorer the sex ratio. Birth registration data in New Delhi shows that the affluent southern district had the lowest sex ratio at birth in 2004—762 girls for 1000 boys. One doctor has used the municipal data to estimate that 20 000 female fetuses were aborted in the nation's capital during 2004.
Doctors battling against sex determination have said that awareness campaigns to stress the equality of sexes have not worked.
“This should be seen as nothing but genocide—a law enforcement problem. It's unfortunate that the medical community continues to deliberately trivialise sex determination by calling it a social evil,” said Puneet Bedi, a consultant obstetrician and gynaecologist in New Delhi.
Health activists have argued that punishing guilty doctors is the only effective deterrent.
Supplementary Material
Longer versions of these articles are on bmj.com
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.