3075.pdf
Media
- extracted text
-
r
tfOMtM ONO BfOWH
Hyd©rab©dv 13° 14 Morsh® 1993
*
issues neimiNG to
Compiled
PsibOc
V^I&fflftQrv HeoSte OssecicAiosi ©f Imfl©
1
I
~ fl V
SEX DETERMINATION TESTING AND THE PRIVATE
ENCES FROM DELHI.
SECTOR:SOME EXPERT
of" involveAn effort was made to ascertain the1 extent
diagnostic
clinics
homes^ and (
ment of private clinics, nursing tests
by
employing
amniocente■_
in conducting sex determinationFor
. this purpose * preliminary
sound
in
Delhi.
sis and ultra
co nursing; homes and diagnostic dims were
forty
survey of randomly and the owners of these enterprises were
selected
if they do carry out sex determination tests and
asked aie the methods they
they- employ for. this purpose, The
what
institutions were conducting
survey. revealed that 27 of these
Of the 27 institutions performing
sex determination testing,
sound for the purpose
this test, 24 of them used ultra
of
these
tests ranged from
of sex determination. The cost was done between three to
Rs. 800 to 1500 and the testing
is concerned
six months of pregnancy, As far as amniocentesis
cost of
The
testing
.
only six- institutions provided this^
conducted
was
and
to 4000
this test ranged from Rs. 800
There were only thirteen
weeks
of
pregnancy.
from 8-11
services.
- * ‘i did not offer either of these
institutions which
findings
the
matches
broadly
observed
The trend c
--, in Delhi .
the
eighties,
of a similar study conducted m Bombay during
testing centres have probably
If* anything, the number of these
of the private sector.
increased due to the burgeoning
out, • amniocentesis is not
As some activists' have pointed determination and that even
the only technique for sex for
the same purpose. This
ultrasound1 is being misused
in Delhi clearly shows 'that
------ ultrasound
private clinics isurvey of
<
used for the purposes of sex
is being more extensively
that
is extremely
important
determination. Therefore it registration of equipment being
there be proper systems iux
brought into the country.
Rama Baru
Public Policy Division
*pr:16.4.93
\
FOR THE WORKSHOP ON WOMEN AND HEALTH, HYDERABAD.
Sex Determination Testing:
(1)
•What
(2)
History
are
the
technologies
for sex determination?
of
campaign
that
against
are
misused
determination
sex
women's groups and other organisations.
(3)
The
Bill
Testing
natal
is
the
has. been
that
role
passed
against
Pre-
What are its loopholes? What
women’s and activist organisations
can play in the proper implementation of
this
Bill.
f4)
A
preliminary
survey
of
40
nursing
homes
during
January
’93
to
ascertain
for
the
if •they
Policy
Division
Delhi
use
ultrasound/amniocentesis
of sex determination.
(5)
The
compilation
of
Public
in
purpose
on Amniocentesis.
(6)
is
well
testing
is
private
sector
It
established
being
that
carried
What
need to be addressed?
are
sex
out
the
determination
mainly
the
in
issues
that
* * * *
o r UVjn-”-
.
'j
5
amniocentesis and female foeticide
Misuse of Medical Technology
vibhuti patel :
..
femaie child is not new in India. This practice still continues, only the methods of commitM Jh murder have changed. Such practices reflect society's attitude towards the female sex. The
S,-Thal Ze dominated system has evolved modern methods to perpetuate women's oppression in today's
P ■
nnnmc svstem The author analyses the reasons tor the popularity of one such modern medical method.
S0CI°ZnZis as a pre-natal sex determination test and argues that it is meant to exterminate women end
ZpeZ feir oppression, she also emphasises the need to fight sexist abuse of this medical technique.
A mniocentesis, a scientific technique that was
•^supposed to be used mainly to detect genetic
deformities has become very popular in India for
detection of the sex of a foetus. For that 15-20 ml
of amniotic fluid is taken from the womb by prick
ing foetus membrane with the help of a special
kind of needle. After separating foetal cell from the
amniotic fluid, a chromosomal analysis is conducted
on it. This test helps in detecting several genetic
disorders like mongolism, defects of neurotube in
the foetus, retarded muscular growth, 'Rh' incom
patibility, haemophilia and other types of abnormal
. babies. This test should be conducted on women
above 40 years because there are higher chances
Lf mongoloid children produced by such women
In some cases, a sex determination test is required
to identify sex-specific deformities such as haemo
philia, retarded .muscular growth which mainly
affect males.
Limitations of Amniocentesis
This test can give 95-97% accurate results.
Thus it is not totally reliable. In Harkisandas Hospital
and Pearl Centre, Bombay, where this test is con
ducted on thousands of women, it was noted that
the test had affected foetus adversely to 1% of the
total number of cases. Thus the test may lead to
spontaneous abortions or premature delivery, dislocation of the hips, respiratory complications, needle
puncture marks on the baby (Chhachhi & Sathyamala, 1983).
The testis conducted after completion of 16
weeks of pregnancy and within a week the findings
are available. In ourcountry, the facility of amniocen
tesis is available only in big cities like Bombay,
Delhi, Chandigarh etc., hence patients from villages
and small towns get the results by post; that takes
one more week. By the time they decide to abort
the foetus, it is over 18 weeks old. Abortion
at such a late stage is quite harmful for the mother.
Popularity of the Test
The amniocentesis tests became popular in the
last three years though earlier they were conducted
Socialist Health Review
in the government hospitals on an experimental
basis. Now these tests are conducted for sex deter
mination and thereafter extermination of female .
foetus through abortions, in private clinics and
hospitals and government hospitals in many cities of
India like Bombay, Delhi, Amritsar, Chandigarh.
Baroda, Ahmedabad, Kanpur, Meerut etc. This
perverse use of modern technology is encouraged
and boosted by money-minded private practitioners
who are out to make a woman, "a male-childproducing machine
As per the most conservative
estimate made by a research team of Women's Centre,
Bombay, based on their survey of six hospitals and
clinics, in Bombay alone 10 women per day undergo
test This survey also revealed the hypocrisy of
"non-violent**, "vegetarian", "anti-abortion" ma
nagement of the city's reputed hospital - Harkisandas
Hospital, that conducts ante-natal sex-determination
test. Their handout declares the test as "humane and
beneficial". The hospital has out-patient facilities
and there is such a great rush for the test that one
has to book one month in advance. As the manage
ment does not support abortion^ they recommend
women to various other hospitals and clinics and ask
them to bring back the female foetuses after abortion
to them for further "RESEARCH ". (Abraham &
Sonal, 1983). .
In other countries, this test is very expensive
and is under strict governmental control, while in
our country this test can be done at between Rs. 80
to Rs. 500. Hence not only upper class people, but
even working class people can easily avail this
facility. A survey of several slums in Bombay
showed that many women had undergone the test
and after knowing thatthe sex of foetus wasfemale,
had undergone abortion in the 18th or 19th week of
pregnancy. Their argument was it is better.to spend
Rs. 80 or even Rs 800 now than give birth to a
female baby and spend thousands of rupees for her
marriage when she grows up.
Controversy Around Amniocentesis
Three years back a controversy around Amnio
centesis started as a result of several investigative
69
-
—A
"TT
reports published in pOoular magazines.- like::India t
-194 i ; ‘V.; 319
Today, Tve's I'.'eeTtly. Sunday and ’ other. : regional '
1951."a 361
-language journals. One estimate that shocked every- .
•1961439
one, right from plannesj and policy-makers to the >
.1S71,
548
academicians and activists was: Between, 1978 and
dno
1983, around .78000 ievsiejoetuses’^wer^abortedI-8 - 684
after sex determination test in our..country. (TOI .
June, 1982).
• u.-rV
.
164
186
226
284
353
155
175
213
264
331
945
946
941
930
935
' Source"- f
Paper 1?~
.. .. Census Report. 1981. Series 1,
-------
Tbea»„,acB,im,r<:;;olved."
3„’.£
«•
' ■ Ftk
■ is conducted on women Without giving anviconsi-'-'v
b.jeC’ W‘
nOt ,real women in a more 'humane-
. deration.to the harm ca-uSfid by the research.-o the
''lh' ' -u^-3'6 SCa'C.3 In suPP|y- On the contrary
women.concerned. Advocates, for population con
i'
T?' ' b/ ,nC'eaSed ,nciQ'ences of rape, abduction
. trol will continue cashing in on socio-cultural values
force8 polYandry- ln u- p- Haryana, Raiasthan
'•! that treat, the birth o: t craftier in the familv as a .’. an8Pu"jab amon9 certain immunities. sex-ratio is
t great •.calamity and-perpeiuaU modern method of . ’ exUemely a??,er^e for women- There a wife is shared
by patri< massacaring female-foetus^ on a massive scale.
..fm . by 'aa set of brothers'
brothers (or
fnr some times
— even
----------- - •
lateral
parallel
cousins)
(Dube,
1983\
India has a legac of killing female'children ,i|.
To think that it is better to kill female foetuses
ylcudliapiti) by ■ putting c::um on the mother's nipple • ■
than giving birth to unwanted female children, is
or by putting tne afterb -t -. over the child's face or by
illtreating.daughters. (C.=<t, 1983). These days'also (. very fatalistic. By this logic it is better to kill the
poor rather than let them suffer poverty and
■
female members of,the-fomily get inferior treatment
as far a's food, medication, and education is concer- i' ; deprivation. How horrifying I
ned (Research-unit on Women’s Studies, 1981). When
mat in cases where women
Another aiyumciu
argument is that
they grow up, there is further harassment for dowry, Iu have one or more daughters, they should be
'Then, is n not dqsirabfe that she dies rather than ba ■m
nr i\allowed
allowed to
to have
have amniocentesis
amniocentesis done
done so that they
i ,illtreate'd?" ask many SOciat scientists. In Dharma:’»uA can plan a 'balanced family'by having sons. Instead
I :Kumar’s'(EPW, June,. 1933) words : "Is1' itreallymbivof going on producing femalj children in the hope
better to be born and 'left to die’ than to be killed as-tw’l of getting a male child, it is better for the family's and
foetus? Does the birth of lakhs or even millions ’of .* - uthe country's welfare that they abort the female
unwanted girls improve th$ status of women?"?!) > .tnnn.? foetus., and have small and balanced families with
But what can be ihe long-term implications if
daughters and sons. This concept of 'balanced family'
such a trend -continues ? Will it not aggravate the iv,. als0 has a sexist bias. Would a couple with one or
already -disturbed sex-ratio? There has . been con-. r.<- more sons undergo amniocentesis to get rid of male
. tmuous decline in-female,'male sex-rationbetween fl of foetus and have a daughter for balancing their
.1901,and 197.1. Betweeri-1971 and-.'1981 there-:was
'family? No, never I
' slight, increase,-but instill continues to be adverse
-1 ' VThis' frenzy of having a 'balanced family- I At
for vyonten.,^.; '
' y :-;f-'AHr-nAifr<R.O^:!?:|:,,s.;.-!t,what cost ? How'many abortions (between 16 to 18 '''
1 (li'Demographic Profile of India (in millions)" ■'mli.^weeksfcan a woman bear without jeopardising her '
\
vil"-
‘>-1901-1981
f,
'■■■■■■
health ?'’■?
>r
:..
■....■
'
.■■
■■■
^Year
Total . Male . .Female. B..Total No of '*- ’
/rime 8nd a9®!n 11 is stated that women themsel-',’'
", i.’' Fopula - Popuia-'Population1 women^oer"'-"''1 Ven 'entblJS'aStlCallV 90 ,or ,he test out.of their.free
■ ■ /
lion/tion ■
' ''^"looo'm en'""0' W‘" 1115 a quss-l0n of women's own choice. But"'
^'i’Vfe 's&x'rat^ ;
theS' choices made
a social vaccum ? These '
*!'i901 - ~21R ’ • '171'-'- ' li,-,
•
‘
Y110,' gy-womencare socially conditioned to ; accept that '"
'<■1911
;II '■'<■'
r < upl^sithsY produce one or more male child ,|.hey
^9Z1^Cfel28^^'^lS-' •7'
^aye;;no:;;?ocial worth....They , can ,be/ harassed!
.
'
;’'.aSO950‘‘^
^‘Ahted. even deserted bytheir husbands and in-laws.iV
to do so. Thus their -choice?-: depend on •'
^;lh^ fear of society. It is true that feminists all over the
world have always demanded "the right of women
3‘
r Vheif °Wn bodies/fert'li‘y and. choose
Census flepot. 138!. Series k paDef 1 Cn ' 198L
»*yheth(^or>f not to have child/children and -have'*’
Delhi.
P P
3 Government
feacilities^ ; free, legal and safer abortions• .6. Chachhi, Amrita and C. Sathyamala •
n
^While^f understanding these issues in the third woridWA'
India
^contextwepusvsee it in the background of the role*' 6.
. Clark, Alice: ''Limitations on Femalr* life
feOf imperialism and racism that aims at the control of
K coloured populations". Thus : "It is all too easy for
population control advocates to heartily endorse
7’ Dub°' Leel°
J women s rights at the same time diverting attention
L^n?e/eaJ CaUS6S °f the popiJ,al‘on Problem.
Lacirof food, economic security, clean drinkina
1633-163«'
9. Jeffary, Roger and Pauicia JeUe,; 2! '
water and safe clinical facilities, have led to a situa;
tion where a wopan has to have 6.2 children to
10. Research Unit f°n Women-a Studies :
.have at least one surviving male child. These are
,,
Womens University, Bombay,
. the roots of the population problem, not merely the
:^a
OI
11. Kumar
Kumar., Dharma :
.......le ^pdesire to have a male child'" (Chhachhi, and
end Political Weekly. Bombayf
---------- —r/ Jan. 1984
. Sathyamala, 1983).
12. Kumar. Dharma : -AmnIOcon.Bsis Aeain..
--------- : "Amnioccntesii
And
Meetings called by Women's Centre (Bombay)
(C„,„uay.
P°'“'cal^'r- Bombay, June,
1983,
and various women's organisations in Delhi,
hi discus^y 8-14, 1983.
’J.r-sed this problem at length and three positions ’ ' «4. Times of India, Editorial on Amniocentesis, June, 1982.
emerged. 1.’Total ban on amniocentesis tests(Contd. from page 68)
2. Support to amniocentesis tests; and 3. Amniocenbehin^L^io^ofm^S D^Tok^'
’ ^tesis tests to .be allowed under strict governmental
assume that because ! JZame^X^?"
";
atnd°2ly fOr detectin9 9ene,lc abnormalities. 5
h M
• ° -the WOmen's organisations feel that the-»’ my contribution to a joint production k m I
n'
3rd position is most advantageous even if one ' ac-i'A ( = negligible — zero ) 1 | would be gratefuTSf "he
cepts the fact that illegally, the tests will be cond- t;*'
could clarify what lies behind this e a nf
$?upted by unscrupulous people. To avoid this,
male chauvinism - for we can only Lqi ’to
.3 women's organisationsand other socially conscious
towards correct action from correct analysis
vy1^ have to act as watch dogs,
e.d
°n" «*-»■
The ,ssue of amniocentesis once again shatters
Uhe myth of neutrality of science and technology. 1 '
Hina Sen
..^Hence, the necessity of. linking science technology
DHRUV MANKAD REPLIES:
i^with socio-economic and cultural reality. Class rac-*‘;li
I tender my sincere apology to Ilina <Un
^ist and sexist biases of the ruling elites have crossed
her name in the editorial perspective white ret n0‘ m0n"Onint;.
all boundaries of human dignity and decency by
Article by her and Binayak Sen The error r.
fefernn9 t0 a ioinf
that before wri,in8
pXX',O
-j.^jnakmg savage use of science. Even in China after"
article referred to above. I knew ahk . /
lhe actua'
,,i;10 years of 'cultural revolution' and ‘socialist thinkdiscussions with Binayak at Calcutta and / ° Con,ents on,V from
gmg^ sex determination test for female extermination
Manisha Gupte Awasthi, Padma Prakash a^,th.Anant Phadke.
;;?:are largely prevalent after the government's campaign
Till I saw the article in print in SHR i ’
at Pune’
for one-child-family began (Sunday, 1983). Chinese
' impression that it was" indeed w^el hTl Und:r ,h0 hOn°rl
, couples willy-nilly accept a system of one-childerhat Iles behind 'trthls e.B. of Marxist Mate chauvintem°'
vfamily but the child has to be a male. This shows
Despite this apology, | do wish to state that i’r
c
■ protest- is petty and unprincipled. She has thrown wild aheo T’" '
•.how adaptive the -system of patriarchy, male
_______________
_
lls'.
< ^“c7t:^T:L:Vhtei;in:2fLmvaru", wi,hou, ,im 9ivin°
^rememacy is. It can establish
and strengthen
Its
,vf?,r00^S *n all kinds of sorinl
social structures, _____
pre-capitalist
.. ..
Apf '8”JmP“ons ‘ 'b’1 ,oo‘ '"correct ones, woXTad’us ne°"i m°r0
fJost-capitahsts,
chaifengedMI
’0
bu' 4wbi"X^
Ic^sisUnJy, POSt
-Capitali£ts'
if not chalienged
v;.
References
B l. ’ Abraham Amu and Sonal:
‘
. Sei osll>ll„i„eL
ests , Women 3 centre, Bombay, 1983
Vimal :"WOmen'
And^ Male
ei.fe..
Ul°P,a • frwiMw tnd Political Weekly,
........ Bombay, Oct., 23,
iry . ’ ’S8’••
Healti Review
sr1' .
I-tm^lraining myself in my reply with.the intention not to
ailand this^ issue i
I*
a
'U'Ure' 5UCh efrOr5
^voided and if and1 when
I when 'hey do occur the reactions thereto are
noro responsible.
[WORKING EDITORS* REPLY: The
omission was our faul't
ather than Dhruv’s, because we were
ha final proofs and were of course awarerespc^isible for checking
9 of the Joint authorship.
^We-fearorrhe-iTradveTWit-^irT ------------------
«ir*
/•
Public
Voluntary
27
only whence girls continued to protest and
home thaton hunger strike, they were
Id be evenLverely beaten up.
□ugh threef
A
home : she When the agony eventually came
Archana could hardly
presecu- > ani end.
her
new environment,
Id to forgetlpond to
when
she sensed the
■ head, her was only
•d look, herfare, the concern that she realis.;fd that here was another chance
are languishing in jails or govern
ment-run remand homes ?
The officials apparently made the
allotments on paper, while the girls
just learnt to live with the de
gradation and constant denial
Twelve-year-old Shikha has now
let her laughter mingle with that
of the other children. Till recently,
the bitterness had infected her
entire existence.
Initially, the 10-year-oidI failed
to comprehend.
Wtjat
was her
What v.
crime, she once dared to ask.
But in return she was beaten up.
Her question remained unanswered.
And she slowly began to accept
the cruel treatment metedout to her.
After the sudden death of her
mother, Shikha's world collapsed.
the nighty
Her father, an employee at the
Fortunately for her, the Supreme
Mission of Delhi airport was away on duty.
has beei| The InternationalI
Court
directed the state govern
her
home
for
the
from thq ope has been I
Her grandmother decided to get
ment to release all innocent children
.
Now,
she
has
thjist
three
years,
rid of the child. Shikha pleaded
On
,.j of
c. a_ home and a family, in vain. Her grandmother was con from jail.
or can
c. be|yeams
»me agalnsffiut Ibefore
-------- that she must be inde- vinced that she would be a burden.
No one can bring back to Shikha
•wen de nt.
They would be better off without and her friends those lost years
Shikha was sold to a gentleHer sordid memories are tucked her. who was leaving for Calcutta. but the IMH is giving them another,
again
chance. The bleak desolation Is
stiljfway In the inner-most recesses- man
can
behind them:-They stand with
A week later, Shikha found her
her mind. She does not want to
* , steps on
i the threshold of
Filled with. faltering
nnember. And talks on one con- self in a new city.
a new universe, their eyes bright
•
j| Ition;
Would It help others ? fear as to what he intended to do
with hope.
Archana ither innocent victimes who are with her, Shikha ran away.
anguishing
in
jails
or
governmentin to live?
Initially, the 10-year-old Shikha
But the 10-year-old child was
Lin remand homes. For no fault
■failed to comprehend, What was
f
' -Bf theirs.
caught by the police, And then her crime, she once dared to ask.
the all too familiar story: the In return, she was beaten up.
jihild
of 12,
JllliU Ul I
actually
meant
to
be
guardians of the low took her into
d loitering What was
.Her question remained unanswer
r ParuipuSafe custody' turned out to be two 'safe custody'.
custody’. She was held capcap
.
—
. •
...
b* - j—jail.
ic.i, She
she too, ed. And she slowly began to
tive •in Presidency
:nas. LosWears of misery
in Presidency
jail.
accept the cruel treatment meted
an
the horrors
spotted b?for Archana, it seemed like c
“ like all others, relates _the
out to her. Novy, at 12, free from ;
i----- Despite the . the bleak desolation, she lets her
Isctose h®ndless sojourn in hell which she of the prison cell.
even basic
yas takengoes not want to remember. She government provision
laughter mingle with that of Jhe
and
clothing
k
^^^Iks on one condition: Would it necessities like soap anu viv*"*"*
allotted to the girls. - *6ther children. ^
^jjxnocent,,victims who were not
I > I5ve-
where sfia.
known Tj
i
■ ■
......... ........ ——
------------------- -------
Amniocentesis - a SCIENTIFIC FEMALE FOETICIDE
ant to
■’residency
-emed likj
The living body is composed of
ell.
. Jails, the basic units. The nucleus
ub-humafl if the cell contains the genetic
to them ^formation passed from parents
iere wer!| p child. In the cells of all humans
• complaij here are 23 pairs of chromosomes
□us retort umbered 1 to 23; The 22nd pair
?at them p sex chromosomes either XX or
[Y. Al! the cells of women carry
lth* whej
TECHNIQUE ?
XX chromosomes where as male
The
cells carry XY chromosomes,
sperm can have either X or Y
chromosomes while the ovum carries only X chromosomes, The
fusion of sperm with ovum results
either in male child carrying an
XY chromoseme or a female child
carrying XX chromosomes.
The human foetus lies in uterus
_
sac und
contained in amn|otic
surrounded by amniitic fluid. Cells
from the foetus are passed Intd
the amniotic fluid. These are collected by a simple method ; of
passing a needle through abdo-^
minal wall of .the mother after
fourth month of pregnancy (amnioj^
1
28
centesis). Earlier, the test used to
be carried out in third trimester (the
nine months of pregnancy are
divided into thr.ee months).- How.ever, it is now carried out in second1
trimester most often after 16 weeks1
of pregnancy.
after detecting chromosomal abnormality, abortion of foetus should
be carried out or not.
During amniocentesis fifteen to
twenty millitres of amniotic fluid
are taken from the womb by
pricking the foetal membrane with
a special kind of needle. After
History :
separating a foetal cell from the
amniotic fluid, chromosomal analysis
Ammiocentesis was first advo is conducted on it. This helps in
cated for diagnostic purposes in detecting several genetic disorders
1930 by Meenes etal in 1937, Aburel like Mangolism, defects of the neural
Used it for midtrimester pregnancy tube in the foetus, retarded muscular
terminations with hypertronic saline, growth, Rh — factor incompatibb
In 1951. Rosa and Fanard described my haemophilian and other types
a method of foetal sex, determina*
deUrmina- qf
pf physical and mental disorders.
disorders,
.
..
■
-j foetus
tion by amniotic fluid (AF) cytology; for detecting
whether
the
' '
In 1956 Bevis suggesied AF analysis *s hoy or girl, the uncultura or
in Rh'immunisation. In 1965 AF cultured cells from the amniotic
studies were started for antenatal fluid are studied under the microsdiagnosis of hereditory diseases cope. If it is a girt the X chromoby amniotic fluid analysis -and some shows up as a dark spot
bio chemical procedures done on against nuclear membrane of a cell.
cultured and non-cultured cells. If it is a boy the V chromosome
Technique for genetic diseases :
Amniocentesis is a technique to
determine genetic abnormalities at
the pre-natal stage (i. e. when the
child is in the womb of the mother).
Although other methods are avail
able to determine genetic diseases
or abnormalities, Amniocentesis is
today the most widely used tech
nique all over world.
There are approximately 1500
known genetic diseases. Most of
these such as haemophilia are due
to genetic mutations. Others like
the Down's syndrome where there
are three no. 21 chromosomes,
instead of the normal pair and
which occurs in one out of 200
births results from genetic defects.
. Sex determination is essential
only in cases of genetic diseases
which are sex linked such as
be
haemophilia, which
cannot
diagnosed by other means. In
such cases it is arguable whether
shows up as a white spot using
fluroscent techniques. The test is
used routinely for women after 40
years of age. Since they are more
likely to produce deformed children.
A sex-determination test is required
to identify retarded muscular growth
which mainly affect male babies.
This test is comparatively more
hazardous than pre-selection and
sex-determination tests such as
Chlorian-villa-Biopsy (CVB) In 1%
of cases of amniocentesis women
may be induced to abortions, pre
mature delivery, hip dislocations,
respiratory complications or needle
puncture marks on the baby.
under strict Government contr^ has if
unlike in India this test can bte c/vryirh
done for Rs. 70/- to fRs.
. aV
Hence not only upper middle cla.^ f aVe
but even working class people the tet
of
can
avail themselves
procedure.
The availing partrnw j sex
argument being, it is better Either ina
spend Rs. 200/- or even Rs.
bogt
I
now than give birth to femaiL^d as
child and spend . thousands <gnca the
rupees for their marriage whorL be? fe?'
Lychoiog.
they grow up.
(nd famih.
s W abd*
The researches indicate that ferrial
infanticide was practised by Rajpuw
and Jats dpripg the previous centurf Medical
in lo/uremaie inja^
’
and consequently In-1870Temafe
fanticide was banned.
- And
- - over thjat‘on !S'
fast cent^y science has,, not on!ir0 s^x 1
quickened the force of jdeath cTn
®
female child from born to unbor?uch
abn|<
v
child,
child, calling
calling into the questio^Sows thS;
role
role of doctors and of scienc/,nder sec<
and Technology. As per the censu/8 substa^
ratio of the year 1981. In Uttasu^8‘ ^r0!.
Pradesh and its district Bijnar th?^norma’’l
sex ratio were 886 and 863 foOf0un^
every 1000 males. Innumerably
j
number of clinical services offering On the
amniocentesis have appeared irpoctors fe’
several places of north India durinfthey am t
the past 10 years.
Some doc.
Is an effq
Amniocentesis is usually Carrie/01’0*}co™
* •
-.ci
i
£
nent s D<
out in 16th week of pregnancy,q achieVii
For accurate determination of
' n'
sex, culturing of the amniotic cells,
' u
x
o
j
. .
. .
r.if mothen
for 3 weeks must oe carried. On. .
occasions the test has to ba carried .
*
out again. Chromosomal analysKanc<SeXf P
without culturing the cells are
01
subject to error in nearly 10—20%V
en rr,<
of cases. But if abortion is to bt
1
carried out after culturing of th< The Gof
Abusal of Amniocentesis
cells then it would have to b^° ban th
carried outside 20 weeks of preg*racy whe!
nancy. But under MTP act arac‘lhies
But Amniocentesis
in
India
abortions
after twenty weeks ar^re9nant '
has become synonymous with sex
illegal.
In
order to avoid this Has lrage<
determination test.
It is being
lot
of
doctors
do not culture th«e^uesls 1
used to first determine whether
the unborn child is female or male cells for three weeks. There havfnsP*te of
and if female child then it is also been reports of sex deterniP^th of g:
Poisom.
aborted. In other countries amnio nation tests not being carried
The patient is told, thfr^*s scient
centesis is very expensive and at all.
29
contr^
cont^st has been carried out and she not used for humanitarian purposes
organisations which is 1nothing
,.a but
can
carrying a female baby. Written nor because of empathy towards
mockery of people's participation.1
n?
___
Rs. 500jpOrts are hardly ever given to poor Indian women as has been
Experiences of all
-J such
bodies
iddle clasie patients.
* . No records are kept claimed.
established
by
government
have
58
|peoplj the test or the
name of the
shown that they merely
of thiptient or the reasons for carrying
remain
A forum was formed to ban SD paper bodies and even for this
0 parem bt a sex-determination test. Thus
and
SP tests comprising of women's function they are highly inef. i
better tjther inaccurate reports or absolu.. .I •>.,
Rs. SOOljy bogus reports are made and organisations, feminists, lawyers, corrupt and elitist, Now an expert
The committee 1was formed by Canfral
to femalfced as the basis of abortion. scientists, researchers etc.
sands c|nce the sex of the child is certified forum approached several members Government to introduce
------------- j a bill
of applicable throughout India.
jge whe] i be female given the dominant of legislative, assembly and
ychology prevailing in society parliament to put forth a bill and
#id family in parricular, the pressure in April 1988 the Government of
Maharashtra introduced LC
Bill
to abort the female foetus.
A.I.D's endeavours :
thatfemaj
Nos. VIII of 1988, In June 1988,
this bill was unanimously passed
by Rajpul
us centuJ Medically the only category of by the
the Maharashtra
Since past few years the pros
Legislative
female irdPses In which above sex determi- Assembly and became an act.
and cons of amniocentesis are
d over thlstion
ition is necessary is where there
being published In many news
i not onfi’0 sex iinked genetic diseases,
papers
and magazines but the focus
LC Bill VIII requires regulation
death
order to avoid children having
had always been on northern India
to unbol^ abnormalities, the MTP act of use of medical or scientific and greater emphasis was laid on
questlol,ows the termination of pregnancy techniques of prenatal diagnosis its pernicious practices in clinics
purely for purpose of detecting
»f sciem ider section 3(2) (ii) (where there
of metropolitan cities of Bombay
genetic or metabolic disorders or
the censi substantial risk that child would
and Delhi. The investigative team
chromosonal abnormalilies or certain
In Utt; iffer from physical and mental
o AID felt that an investigation
Bijnar thfknormalR*ss)« There is no other congenital or sex linked disorders should be carried out at Madras
and for prevention or misuse of
i S63 fJround for sex determination,
as well and bring to focus the
pre-natal sex-determinatipn leading
numerabll
hidden realities of the city espeto female foeticide ; and for matters
cially with regard
rs offering Qn the other hand a majority of
„ I to amniocentesis.
connected there with or incidental
reared /doctors feel by providing this service
As
first step we approached
there to. The acts purview is limited
dia durin®ey are doing humanitarian work.
the Government i
and child
to SD tests and does not say Welfare hospital women
at'EgmorZ
#>me doctors feel that the test
First
anything about SP Techniques. I.
11 day we iwere
------ denied
j • • permission
p
^ff^Ptive measure for popu- admits medical technology can bq
to meet doctors and were very
ly carrii ition control. The Indian Govern- misused by doctors, by banning
?.
five
plan aimed SD tests have taken away their bluntly and rudely told that we
xognanc
>.
achieve
a
.
“
cannot approach a doctor without
lorr of tl
Net ^Reproduction respectability.
.. Not only this but
irotic cel ®te <NRR) of one (Le. replacement in the eyes of law both the clients written permission from the Dean
rried.
rried. 0*
0 mother by only daughter). For and practioners of SD tests are the of the hospital, We again attempted to meet the concerned doctors
be carriet’! objective also, sex determination
culprits.
However, the act has
the succeeding day and since the
I analysi d sex Pre-selectionI are seen as many loopholes.
Dean was away we were directed
being that fewer
cells ar >ndy, for logic
to the next superior in - charge.
10—20J omen means less reproduction.
Two major demands of the forum, The doctor was kind enough, to
n is to b
that
no private practices be allowed listen to our queries and requested
ig of tf|Tha Government while refusing
to
do
SO test and that in no case
us to meet the Genetist who would
ive to t? ban the test exposed its hyposhould a woman undergoing the
be
in a better position to give us
3 ofpregjacy when it failed to provide
SD test can be punished, are not feed back to the Information re
’ act qcilities
for
amniocentesis to
included in the act. On the con
quired by us.
The Genetist was
veeks arfegnant women during the Bhopal
trary, the act intends to regulate
very enthusiastic and explained us
id this IS tragedy inspite of repeated
them with the help of appropriate
in depth about amniocentesis and
ulture th Quests by women groups and
authority made up of two govern
further remarked that so far in
here hav spite of many reported cases of
ment
bureaucrats
from Indian
Madras even the government hopdeterm- rth of deformed babies as result
Council of Medical Research, one
sitals have
not
acquired
the
earned 01 Poisonous gas- Thus it is clear
Gynecologist, one Genetist and
equipment
necessary
for
amnio
told, thj,s scientific technique is infact
the representatives from voluntary
centesis and they were in the
30
process of acquiring the same.
The cost factor of the equipment
the
was mainly responsible in
same,
delay in
acquiring
the
....... ..
hospitals
She stated government
Sonography only
at present use l_
When we
for medical purposes.
requested her to rationalise why
amniocentesis
had made deeper
inroads when other tests such as
Chlorion villa-Biopsy and Sono
graphy could also determine the
sex of the child, she replied that
this has been a question probing
'the faculty of doctors as well but
so far thay have not been able
to arrive at satisfying conclusion.
sb. ..m.-K.d lh.,
knowledge no such practice is
going on in private clinics in
Madras as well.
Our next step we approacqed
several reputed private hospitals in
Madras to interact with
their
issue
to
gather
doctors on this
their view points. But except for
Apollo Hospital, all other hospital
either ignored our pleas or acted
as silent spectators.
In Apollo Hospital Dr. Vasanthi,
was kind enough to share her
view points on amniocetesis. She
affirmed that the hospital had the
equipment necessary for carrying
out amniocentesis test but was
being used only for detecting
genetic deformities and two or
three cases had come to their
hospital requesting them to conbut were turned
duct SD tests L-.
She acknowledged that
down.
SD tests are being conducted at
few private clinics 'in1 Madras as
in
in other
other parts
parts of
l. the Country and
further these clinical facilities have
so far been made available to the
upper elitist groups only.
a male or female foetus. And^^yg^t
was through this method it Wvirghj:'
predicted by village Dai that
Kodi was carrying a female
n.
She was eager to give birth
ou|r
this test. She approached a doctg
a .
•
•«B
L. . .. A -tffc
' '4?
in the neighbouring village but
doctor was unable to furnish $ wh.M I
under!
details where she could
such test and coming to km
about the workshop she approachIdaily
Tend
us with earnest hope if we cqi
harmfu
help her.
f of pearl
coursQ
of
National Workshop on Girl child
and alternative Modes of Develop
ment conducted
at Mullikadu Dharmapuri district of Tamilnadu,
we
alloted
one session
for
amniocentesis.
To our surprise
90%
of
the
participants all
representing from rural parts of
Tamil Nadu, Bihar and Orissa were
notayyare of such existing practices
•
------- - u'*'d us
asking us to give more details and
whether they can avail such faci
lities. This had been a rude shock
to us and realised that in areas
which are not so far under the
baneful influence over emphasising
and publicity has its
negative
effects as well. The media also
plays a crucial role in this aspect.
Our encounter with an young
pregnant lady,
Malar Kodi in
Dharmapuri District of Tamil Nadu
gave us another jolting experience.
She came to know abour amnio
centesis through the newspapers
and was therefore very eager to
know the sex of her child. In
villages few crude practices exist
whereby observing whether pregnant
women sleeps towards her left side
or right side and by seeing the
enhanced beauty of the women
during this particular time it is
predicted that the women is carrying
Child Marriage - A Boon or Bane?
(A case study conducted
in
Giridih
District - Bihar)
MAHAVIR KUMAR
The patriarchal society in India
cannot allow women the right to
sexual self-determination for seve-
reason
ral reasons. The prime
the
necessity
to
produce
being
legitimate male legal heir, purity
son and therefore wanted to autho r
ticate
the sex
of child
throu|'
fstresse
On closer interactions witjj,
as to ' why^Mie Was str ’despan ^giris
to get rid of her
foetus s f the la\
narrated that in her family sinee pi
two generations if the first :cf| [t''Subs
was male then the family's \by
' slogan:
ness prospered well, but if it hi ’of Pih.
pened to be a female than 1 ‘ ment.
family was buried in debts a Govern1
therefore girl child would Olf offices.'
bring misfortune. She was v€^ do noi
too didn't pij grass-r
unhappy that we loo
vide the substantial informatij on|y a
and failed to rationalise our log| t0 the
We only hope that
that such
such bane^
banof?
publicised
efforts v. on|y t
and over
not disturb many more Mai Courts;
f COuntry
Kodi's whose otherwise life |
blissful.
I hue a‘
< pra.:[ic(
credits ai{ the Bil
given to Dr. P. Phantnatf class
and Vibhulj* phenotf
Anand Grover
coinedr
Patel from whose articles
above article has been rep§ The rol
duced in concised form ] 5 archal H
j deep ri1
J constiti
} ing fon
■ honour i
of caste, complete
control ’* its abt
women and position of women respond
liability which is imperative. TN early ;
are always cautiously watched N corallam
the honour of the family wou marriag
be tarnished. The girls are cot over tf
sidered transitory beings and th* cular it
are sold with virginity being t district^
commodity, The anxiety to 0 Dhanbi.i
[* This article due
90
As/an
^l,,c Wuiwn's / lusumco and a.
Ethics of Contraceptive Research
Women activists in South Asia are concerned
about the way in which testing of hormonal
contraceptives, such as the Net-En injectable,
is being carried out. Women who participate
in testing are usually poor women who are
not aware of the effects of the technology
they aie trying. Vimal Balasubrahmanyan
of India comments that the concept o
informed consent for participating in chnica
trials is practically ignored in medical
research programmes. If there is any token
conseht it is certain that not enoug
information is given to make it genuinely
informed consent as it is understood in the
West. Elitist medical researchers generally
argue that informed consent as a concept is
not feasible when the subjects are illiterate
and that in any case all medical
experimentation is only being done for the
good of the people at large.62
research testing, is cliredeil by the goals and
priorities of the population-control establish
ment '...one of the most significant links
between population-control programmes
and the contraceptive industry occurs in the
initial stages of contraceptive development,
long before the contraceptives reach the
villages of Pakistan and Bangladesh. ■ The
interests and priorities of population-control
organizations and women are not the same.
Hormonal contraceptives are said to be a
big money-maker in the contraceptive
market. In 1983, USA oral contraceptive
market, for example, was US$520 million and
the world-wide market has been estimated
at US$700 million to US$1 billion."4
^new reproductive technology
In the Asian and Pacific Region, two new
areas of social control over women's repro
duction have caused particular concern
among women activists and researchers.
One issue is the use of medical technology
Analyst such as Cary LaCheen contend that
the development of contraceptives including
I
O
C
Xiri >
O
f mo£€
.
Ci
eFfccrivc.;
0
Q
v4C.«E'S
a
0
(D
V^i"
\ CH0IC€i»‘
&
Public Policy ©Mskra
Voluntary Health Association of India
i
Control of Heproduction
to determine the life or death of a fetus
depending on its gender.
Sex-determination and sex pre-selection tests
using amniocentesis have gained popularity
in India, to the great concern of women
activists and researchers. Information here
on the situation in India is derived from one
of the main writers and activists i iu i
Patel. The procedure of 'll ammdcentesis
involves the taking of : fluid from the
amniotic sac surrounding The fetus and
analvsis of the fluid to reveal genetic
abnormalities and the sex of the baby. This
has complications and some risks, including
risk of infection, fetal and placental trauma,
and the possibility of spontaneous abortion
of the fetus. Amniocentesis is a procedure
previously only used when fetal abnormality
or other problems were suspected.
In India, the unequal status of and social
attitude to females have resulted in the use
of amniocentesis for sex-determination tests,
with the results of the tests being used by
people to determine whether or not to abort
the fetus It is female fetuses that are being
aborted generally. The spread of sex-deter
mination tests in urban and rural areas m
India has led to abortion clinics being set up
in Bombay and Delhi, and even in small
towns. Women's groups have protested
strongly against the practice; Sex-determi.. , ...c.,tests and clinics
p.rp are
continuing
as
nation
continuing
pulous
medical
professionals
exploit
unscnq
’ i women to make a
social attihides towards
profit.
i'’' ’A
o
si
I)
■; are profoundly
The implications of the tests
The
tests
result
in the destruc- )
disturbing, f--------lion of the female fetus; medical practitio
ners are profiting from the practice caused
by social attitudes to women; a previously
rare and expensive test has been made,
cheaper by the medical profession (the tests
cost Rs.200-500), bringing amniocentesis
within the reach of poor people who are
now using the tests. (It is interesting to
note that the medical profession is not
adverse to popularizing use of medical
technology and making it cheaper, where
accessibility will result in greater personal
profits) The number of female fetuses
aborted between 1978-83 as a resultof the
tests in one report is estimated at 78,000.
There is implicit government support for
the sex-determination tests which achieve
population control by the simple fact that
fewer female children will supposedly re
sult in fewer births. The government has
banned the test only in Maharashtra State
in 1988. In contrast, after the Bhopal disas
ter when toxic gases were likely to cause
fetal abnormalities, the Indian government
is reported to have refused requests from
women's groups to do amniocentesis tests.
Reports have been made of deformed babies being born after the Bhopal disaster.
The use of amniocentesis for sex-determinalion and female abortion succeeds in refm-
mg and making more efficient the tradi
tional practice of killing female children
(dudhapiti).
The use of sex-determination tests rein
forces social attitudes towards women. Ac
tivists have argued that women are not to
blame for using the tests. Society is to
blame for negating female life so that such
traditional and 'modern' practices are forced
on women and people.
Use of amniocentesis is reported to be
prevalent also in the Republic of Korea. In
the conservative city of Taegu, 80 per cent
of hospitals had already in 1986 installed
the expensive supersonic wave machines
which detect the gender of fetuses.67 Son
preference is deeply rooted in Korean cul
ture, even though family planning pro-
grammes are trying Io change Ibis allilude
through public education.
‘l*1
*
a
For this reason, people have undergohe
various methods to assure the birth of male
children such as visiting fortune tellers, alkalifying one's body, taking medicine, un
dergoing amniotic fluid check jamniocentesisl, or supersonic wave check and abor
tion.68
In Australia, and some other countries like
Japan, Singapore and Malaysia among oth
ers, a technological response to infertility in
women (intra-vitro fertilization or 'test tube
babies') has given rise to a range of repro
ductive technologies that have social, legal
and moral implications and could affect
women's status and reproductive rights.
There has been little written in Asia on this
area. ,
//
Have you killed your daughter lately?
»
Thtnk about it
Do you support bride burning "J
Or Female nfan<<ide’
I
I
Then wtry allow sex determination tests’
i hey ensure that only female children
are aborted they enable daughters to be killed
,n ,hc womb Without gwM, wrthcul «i«mdal
Without the shame of social disapproval
Silently
But does tfiat make it less of a crime
ii daugtners are considered a burden today.
Then ttie answer is Equality
liberation Not Elimination
S*0-1"
Sex determination tests mean the slew decimation of Indian worndnliro
Stop this slaughter today
Of 8000 abortions following
•mntocentesli 7999 foetuses
were found to be female,
lime* U« kx*<» 9J. Jur< 190S
fAI <1
Eliminate inequality, not women. IVomeirs
Centre .
MWWMMt, iMMJhf it |, <$$ 0$>
Control of Reproduction
93
Campaign Against Sex-Drfer^|®
STRATEGIES AND ACTION
Women's groups in India, Bangladesh, Thailand, the Phihppines and Australia are known
to be taking action to gain more
i reproductive rights for women
f in controlling their own fertil. Strategies developed include:
[?
I
'
ity
•
.lld and demonstrations
Campaigns
unsafe contraceptives and
against is
_
reproductive
t-’chnoloEV m
new
technology
South Asia and New Zealand,
®
Research projects
medical practices;
to
document
Public education to discuss family
planning practices and contracep
tives in Thailand;
Setting up birth coritrol services for
.1 women-centered
women from a
Bangladesh,
Philipperspective in I
pines, India a nd Australia.
This is a new area of concern in the mid1980s for most countries of the
chiding Australia where action began in the
mid-1970s.
Case Studies of Action
The following case studies document the
way in which women's groups have strate
gized and acted in order to gain more
control of reproductive processes. Focus is
on Asia, as materials for this section have
mainly been sent by this region. Ibis case
study of the still-in-process campaign against
sex-determination and sex pre-selection is
given by Vibhuti Patel, of the Womens
Centre, Bombay, one of the initial groups
which planned the national campaign.
d Sex Pre-selection
and
Pre-selectwn
;
co^
In 1982, Wonien^! Centre
...... .. activists had
Women
nau noticed
an
in theirail
ind advertisements of the test m
he
■
-■
stations
and.
in
the
compartment^
way stations and in the c— r
research finding?
n trams.
,from
h,A.,b„,tan
three government hospitato^n^|
from three g------a,
ospua'. ^and
-.J two small
8U^“^i
private hospital
small subi
.nfirmed that —
amniocentesi^twa
clinics coniiruied
------leading to female foeticide wasT
aMddg
wasr afwidely
------1
the
di
prevalent phenomenon
in the aty
prevaicHt
-------- ’
bay
bay. Two meetings organized by the Centre^
generated debate among femm^. .^
that concerted efforts should be mad^
stop the abuse of scientific technology
: sex-selective abortion.
jnal dallies
Around the same time, the
i carried
advertisemente vi
of the ‘New
d advertisements
’w
; dari ante-natal sex-determination|eUruc
sex-determinataon^bmc|
And for
first time,
frgroupwna
Ana
tor the
me mov
***••«/ women
----i Delhi (Sa/re/fi,
(Saheli), Bombay (Worn®
(Womms SJW^ag
. Calcutta (Sabala) and Pune <
i
> 94 i Aslan and PacHic VVonnjn's Ik/souict) nini /\ciK>n
I
/r
gW^rgaruz.ed protestTactfonsJagainst f
P^earphfiratltations siicbf as’the Re- ’’
* Women's ’ Studies (Delhi) j
(A
registered . their; protest. I f®fJP^M^dicqTriends.Cirde.anddlte people's «
Al^enc^Moyement.came out openly against
H^Jhe 'highly educated',' enlightened doctors
al
j
j
^The debate pn sex-determination tests has f
l&^ep^ra.te^ ? ^Ot °t controversy among aca- i
fe^erniciai^-ilfand . policy-makers. Most
feel that: amniocentesis, I
: sonography and’fetoscopy should
KgbOi permitted only under strict governmenp|al control and;only for detection of genetic
^abnormalities^ i We are also aware of the
pjact that even then, unscrupulous doctors
conduct the tests...
l¥05??s*s,tently campaign against the noto-
1
Phoney-minded doctors
thefeantipathy of the government to^ ;wardsrincreasing female foeticide. Forum
Sex-determination and Sex-preseHection was formed in Bombay in March
| '1986; doctors, scientists, lawyers, researcherrand women activists are dealing with
fe ithis?. issue through their talks, researchh based papers,,media coverage, poster cam| ipaigns, petitions, exhibitions, files/publicar•••{lions and slide shows and dhamas [demonf- I /' ’
|!C?'
$
I
0’
s__e
stration] in front of the hospitals conduct
ing tlie tests.
As a result, the issue has gained nation
wide publicity. Concerned groups in Ma
dras, Baroda, Bangalore, Mysore, Delhi,
Calcutta, and Pune have created hue and
cry. Mrinal Gore and two other legislators
have submitted a private bill in the legisla
tive assembly of Maharashtra. Despite its
earlier antipathy, the government of India
has responded favourably. In March 1987,
it appointed an expert committee to study
the recommendations of the expert com
mittee of Maharashtra state and to pro
pose comprehensive legal provisions to
stop misuse of sex-determination tests by
mid-May 1987. The expert committee ap
pointed by the government has completed
its work and recommended that sex-deter
mination tests should be banned for pri
vate practice and can be used only for the
identification of genetic deformities in se
lect government identified hospitals under
strict vigilance. In the monsoon session of i
parliament, the government was planning
to introduce a bill
The Forum organized a parents and
daughters demonstration. It was inspiring
to see little girls leading the demonstration
with flags in their hands. There were
daughters of three generations protesting
against extermination of women in the
name of sex^determination.
Vibhuti Patel
"Action Against Sex-Determination and
Sex Preselection*69
Public Pol icy DMflfofi
Voluntary Health Association of Indk
Control of Reproduction
Sex Detemilnation tests don’t
95
W> S^s
IT
womankind
Eliminate inequality, not women.
The Mehareshlra parha™... 'a®
the bill in May 1988 to restrict the use or
amniocentesis for sex-selection
new act (Maharashtra Act No. X
,
Z passed. The eampaifin has n.» br«dened S demand cenlral rather than stale
legislation, as well-off couples can easily
travel interstate to obtain the procedure.
i December 1988 from
The latest update in
Sex-Determination and
the Forum Against L
Sex-Preselection and Snheli Women's Resource Centre in New Delhi notes that.
■ t, the alarming rate
In spite of public protest,
productive
technologies
at which new rep ''q-’
are penetrmmg
...e
core
of
Indian
society is
penetrating the
ally nightmarish. Sex determination .s
Sy one. menace... Since all these technuiues an' now internationally paten td,
3 IS,; ......
......
...... ..
Wdmenfs
Centre
build international resistance on these B
Slies. it is time for all concerned mdmdu
a]s to pressurize the government to take a
principled stand on science and technology
Ked to reproduction. The government
must show the political will to create
effective and innovative ways ‘0
and regulate these technologies. Women s
organizations, consumer groupsi and hnTn righis organizations need t • ujcnHy
pool their resources to momtoMhese ec
nologies and act as a watchdog.
■w-iaaa
iSZsk—««-■>
.......
iw-»*
IXZ...... ......... in. Cimr^v, 1"
t : ■• ■"»!
-.-
•■
'• <!
.■•
’
;
:
<
~
■
■;■;■■■
-.
..
.-■:
.■
?
'
’
i
5a.
I
ii
.....-
AMNIOCENTESIS
'
silSpsHaO
. •••:-? •:«-->>.!^r<3r
9
zA’/C® 1 ■! ■
SBiSSS^sal
9
B»agn
•'•■-.
■•
■'?'"
'■
................. •; .■•
-■-■■
:
-7 ■
4r>^..«W._
ss
ii1
HEALTH Er FTTFUESS
AMNIOCENTESIS
^WIVERY couple wants a norICwLasmal healthy baby. Sometjpnes nature balances the
ri^^j^Wndds against this. In such
cases, parents are naturally
apprehensive about whether or not
their children would inherit the de
fect. Amniocentesis is one of the
methods by which certain genetic
diseases can be detected at a stage
early enough to terminate the pre
gnancy if the parents want to.
Amniocentesis
The term amniocentesis originates
from two Greek words—amnion the
sac containing the foetus and kentesis or puncture. In general, it benefits
older mothers (women over 35 years)
and people with & family history
of genetic defects. It can also be used
to detect the sex of a foetus, an aspect
that is widely abused in many parts of
India.
.
Amniocentesis is merely a techm-
sed for analysis of genetic defects.
The technique is safe in expen- j
enced hands, though there ic some
risk (1 in 100) of inducing a spon
taneous abortion and the foetus
could also be punctured
RICHA S. CHANDRA
Amniocentesis has
received bad press as a
sex-detection test but
it is much more than
that, it can be used to
discover and in some
cases to treat inherited
disorders
Normal and defective genes
To understand what comprises a
genetic defect it is necessary to know
what is normal. Each cell in the
human body contains 46 chromo
somes in its nucleus. Chromosomes
are arranged in 23 pairs. Each mem
ber of a pair is inherited from one of
the parents at conception. Of these,
22 pairs are common to both sexes
and are called autosomes, while two
(one pair) are sex chromosomes.
Normal females have two X chromo
somes as their sex chromosome
complement while normal males
have one X and one Y chromosome.
Each chromosome contains several
thousand genes. Simply put, a gene
week of pregnancy. (Another techni
que, chorion villus biopsy, can be
performed even earlier, in the first 12
weeks or trimester of pregnancy.)
Amniocentesis is carried out after
ultrasonography (echosounding)
which locates the
placenta
by
means of sound waves. The proce
dure consists of inserting a sharp,
Supernatant (liquid)
fl
Cultured foetal cells
Viral analysis
Amniotic fluid
A,’-A <
*
Ay
—I Biochemical
analysis
/
Chromosome studies
Biochemical studies
j
Y\ \ J
Centrifuge
z
X
a
a.
2
Foetal cells
§
How amniotic fluid is used for prenatal detection of genetic disorders
7-15 cm long needle attached to a
que for withdrawing foetal material
syringe through the abdominal wall
for study. It does not give any indica
into the uterus. A small amount (ab
tion whether a genetic defect is pre
out 30 ml) of amniotic fluid is with
sent or not. Defects come to light only
drawn. It contains mainly urine and
after the material withdrawn by
cells sloughed off from the skin, re
amniocentesis is analysed by proce
spiratory and urinary tracts of the
dures known as karyotyping (chro
foetus. This liquid is centrifuged
mosome studies), direct analysis of
(spun at high speed), so that the
the amniotic fluid, enzyme studies
foetal cells settle down. These cells
and dna (deoxyribonucleic acid)
are then introduced into flasks con
analysis. The procedure chosen for
taining appropriate nutrients and
analysis depends on the type of de
other chemicals which sustain their
fect suspected.
growth. After about two weeks of
Amniocentesis is performed be
growth, the cells are further procestween the fourteenth and sixteenth
60
2001, MAY 1988
Cell studies
is a blueprint for development. Each
gene is a sequence of three dna
molecules. So chromosomes are
made up of genes which are in turn
made up of dna.
The group of three dna molecules
(codon) which represent a gene,con
tain information for forming an ami
no acid (small fraction of a protein).
The dna content of a human cell
contains enough genes to encode 1
million proteins. However, only a
small fraction of this (3 to 5 per cent)
actually do form proteins. These are
known as structural genes. What the
HEALTH & FIT MESS
. of the dna (which is non-coding)
jes, is not clear as yet.
z Structural genes 'express' them
selves to form amino acids which are
joined together to form proteins. Pro
teins, in a sense, form the basis of life.
They are present in blood, muscles,
skin, hair—in fact in every living cell.
Each protein produced in the body
has a specific role to play.
If a protein has a faulty structure it
functions abnormally. The repercus
sions of this can be far reaching and
serious enough to cause, among
other conditions, mental retardation
and even death. The faulty structure
can be traced back to a defective
amino acid which can in turn be
traced back to a defective gene or a
defective chromosome.
Genetic disorders
Genetic diseases fall into three
categories: chromosomal, Mendelian
and multifactorial disorders.
A. Chromosomal disorders occur
when there are less, more or abnor
mally arranged chromosomes. Most
autosomal disorders are lethal, re
sulting in spontaneous abortions.
Down's syndrome^r mongolism is
a chromosomal disorder in which
there is an extra copy of chromosome
21. Affected people have characteris
tic mongolian features and are men
tally retarded.
Sex chromosome imbalances have
relatively milder clinical manifesta
tions. For instance, Klinefelter's syn
drome shows itself in the form of
poorly developed gonads and a femi
nine body. It is due to one or more
extra X chromosomes in males.
Another sex chromosome defect,
Turner's syndrome is due to the abs
ence of the second X chromosome in
females. Affected women have
under-developed sex organs, a web
bed neck and certain heart defects.
Karyotyping or chromosome stu
dies of cells collected by amniocente
sis can be used to detect chromo
somal abnormalities.
B. Mendelian (or simply inherited)
disorders arise when a person pos
sesses a single gene which is mutant
(changed) as compared to the same
gene in normal people. The disorders
may be:
i) autosomal dominant which
means that the individual shows
signs of this defect even if only
one gene (from a chromosome
pair) has this mutation or change.
ii) autosomal recessive where the
defect becomes obvious only if
both genes (in a chromosome
CHORION VILLUS
SAMPLING
HE past two.decades have wit
nessed a virtual explosion of
biotechnoiogicai advances which
have affected every aspect of human
existence. It is now possible to di
agnose hereditary diseases and con
genital defects in an unborn foetus as
early as seven weeks after conception.
This is done by a technique called
chorion villus sampling.
Chorion biopsy is performed in the
first seven to eleven weeks of pregnan
cy under strict aseptic conditions. A
plastic cannula (small tube) 21 cm long
and 1.5 mm in diameter is passed
through the cervix upto the edge of the
amniotic sac and a few chorionic cells
which occur at the site of future placen
ta, surrounding the sac are aspirated
(removed by suction). The cells are
collected in a special fluid and sent to a
laboratory for culture. Examinations of
these cultured cells give information
about the growing foetus, besides re
vealing the sex. To facilitate aspiration,
the gestational sac is visualized using
an ultrasound machine.
Chorion biopsy has certain advan
tage’s over'* amniocentesis. Since the
procedure is done early in first three
months of . pregnancy the waiting
period is less, the pregnancy is hot yet
obvious to others and the social and
psychological stress is less. This allows
early and safer termination of pregnan
cy if indicated.’'^/' ■
' T ’
Such a procedure is not without
risks. There is a 4 to 12 per cent chance
of precipitating a spontaneous abor
tion.- The genetic diagnosis may be
wrong in 4 to 6 per cent of cases. There
is also a risk'of introducing infection.
However with' experience these^risks
have been reduced to a minimum.
.
AJIT M.VIRKUD
pair) have the mutation.
iii) X-linked which means that the
genes responsible for the disorder
are on the X chromosome. As a
result of this, the risk of getting
such a defect and the severity of
the defect differs betv/een the
sexes. (Since males have only one
X chromosome while females
have two X chromosomes, one of
which could be normal and com
pensate for the defective X chro
mosome with the mutant gene.)
Marfan's syndrome shows auto-H
somal dominant inheritance. A cla--- j
sical case is Abraham Lincoln. He had !
the characteristic tall, thin frame, ex
tremely long slender fingers (spider
fingers or arachnodactyly), a con
genital weakness of the connective
tissue showng itself as hype: - !
extensible joints and a heart we -k
ness (aortic aneurism). It is sa.d th ..' *
Lincoln (who suffered the sever-.', j
acute chest pain that the heart abr -jrmality causes), would have died witn !
in the year of his assassination from a
rupture of the aneurysm, even if John
Booth had not shot him.
Thalassemia, a disorder of the
tiaemoglobin, is an autosomal reces
sive disorder. It is also known as
Cooley's anaemia. The word Thalassa
refers to the Mediterranean Sea since
the trait is commonly seen among
people in that region. In India the
gene is highest in the Lohana com
munity (10 per cent) from Kutch and
Sind, according to an Indian Council
of Medical Research study. The tha
lassemia gene confers some resist
ance to malaria. The red blood cells in
affected people are very fragile and
most are destroyed in the bone mar
row before ever reaching the
peripheral circulation. Children rarely
survive beyond the age of 15, dying
of liver or bone marrow failure
(caused by the accumulation of large
amounts of iron released from the
ruptured cells).
Haemophilia and colour blindness
are X-linked. Haemophilia is a defect
in the blood-clotting mechanism and
affects many individuals in the royal
families of Europe.
Amniocentesis can pick up Mende
lian disorders when there are labora
tory tests available for quantification
of the normal protein (which should
be produced but isn't) or detection of
the abnormal protein. In cases where
the protein itself cannot be detected,
the dna can be studied using a techni- •
que known as dna hybridization.
C. Multifactorial disorders: These
disorders include essential hyperten
sion and cleft lip and are caused by an
interaction of genetic and environ
mental factors. The risk of transmit
ting the condition to one's children
and grandchildren is less than in
simple gene disorders. Amniocente
sis is generally less useful for di
agnosing these disorders.
Techniques used after
amniocentesis
After amniocentesis, the. foetal
_____________Continued on page 65
2C01, MAY 1988
61
method. The method cannot be used_x
not take place. Certain enzymes play
z' sontinuedfrom page 61
for diseases where the site of th6
a critical role in the body.. If they are
defective gene is not known (as in
' material may bn subjected to several
defective, the consequences are se
Huntington's Chorea, a disease lead
fests each designed to detect specific
rious. For instance, deficiency of an
ing to premature death through repe
kinds of defects. These tests may be- ;
enzyme known as glucose 6ated respiratory infections).
broadly classified as: •
.
phosphate dehydrogenase leads to
B. Restriction Fragment Length
1. Direct analysis of amniotic fluid.
anaemia, as the red blood cells rup
Polymorphism (RFLP)
If the substance which indicates the
ture very easily. If another enzyme
Another technique in dna analysis
presence of a genetic defect (for
called tyrosinase is deficient the per
is
restriction fragment length poly
instance, a faulty protein) is present
son will be an albino.
morphism (RFLP) and genetic linkage
in the amniotic fluid, then a,study of
Enzymes studies estimate the
analysis. This method is used to
the fluid itself may be diagnostic. For .. quantity of particular enzymes in the
detect sickle cell anaemia in thalasse
instance, neural tube defects may be
amniotic fluid and accordingly it is
mia. It looks for what are known as
indicated by the presence of Xpossible to know whether or not the
genetic markers or genes responsible
fetoprotein. This substance is pro
foetus has a genetic defect.
for obvious differences such as va
duced in the foetal liver at the six
4. dna analysis: This method deals
rious feather colours in poultry or
teenth week of pregnancy and ex
with the actual material of life, the
variants in the abo blood groups tn
creted into the amniotic fluid when
dna itself. It is used to diagnose
humans. Markers chosen must also
the foetus urinates.
genetic diseases due to mutations
be present near the defective gene
2. Karyotyping or chromosome stu
(changes) in the dna by pinpointing
which is being studied. So by detect
dies: By this procedure the number
the exact place where these changes
ing the marker, the abnormal gene is
and structure of the chromosomes
occur.
.
,
.
.
identified.
are studied under a microscope.
Hybridization: Normal dna exists as
Thus amniocentesis is not merely a
Chromosomes differ on the basis of . two tightly-coiled strands. One of
sex determination technique. When
their size, the location of a centro
these strands is separated and label
performed along with other Prpc®“
mere (which divides the chromo- - led with a radioactive material to
dures it is a powerful tool for detect
somes into arms of equal or unequal
become a dna probe.-These probes
ing genetic defects. All genetic de
length) and the way in which they
sre mixed with dna strands obtained
fects are not life-threatening and
absorb a specific colouring agent
from the foetal material. If the probe
some can be treated with encourag
known as the Giemsa stain. X chro
and the foetal dna 'recognize each
mosomes look different from Y chro
ing results.
other and pair off a hybrid dna mole
A case in the point of phenylketo
mosomes and both can be identi
cule results. The number of hybrids
nuria, which occurs (because of the
fied—thus the sex of the child can be
formed is checked out and this gives
absence of the enzyme phenylalanine
known before birth. If an X-Imked
an indication as to whether the foetal
4-monoxygenase). If untreated it re
• defect is suspected, by knowing the
dna is abnormal or noUThis method
sults in severe mental retardation.
sex of the foetus one can know if it is
allows detection of a single abnorma
However, if a child with this defect is
affected or not. Down's syndrome
gene among thousands-of normal
fed on a special diet from birth, the
and other chromosomal abnormali
child grows normally. Thus, genetic
ties are spotted by karyotyping.
A specific disorder known as X-itesting has immense potential tor
3. Enzyme studies: Enzymes are
antitrypsin deficiency, which leads; to
constructive use or abuse. The choice
proteins which allow certain specific
fatal respiratory disorders in child
reactions in cells to occur. If the
is ours.
__________ _ _ —
hood, can be detected by this
enzyme is defective the reaction will
2001, MAY 1988 65
Stoisgk odor, what is pyorrhoea?
Pyorrhoea is discharge of
_
'rrrr £7 pus in pockets formed between the gum and the tooth. Here . •
bacterial growth gets activated, and ' ’•
causes infection and inflammation of
the gums. Commonly called a peri, Do you have bad
dontal disease, pyorrhoea is a dis
ease of the teeth-supporting struc
breath?
ture. That is, it eventually upsets the
Something even your
integrity of the structures between
best friends can't tel!
the gums, roots of the teeth and the
you!
bone. As the condition worsens, it
results finally in the loss of tooth.
Only your tooth brush
I
C.D.S. LAKSHMANAN
What role does bacteria play?
Normally, all kinds of bacteria are
found in the mouth. Bacteria come
under two groups—those which
thrive in the absence of air and those
which thrive in the presence of air
• (aerobic). In.gum diseases, anaerobic
bacteria are found. When present in
the mouth anaerobic bacteria may
activate the inflammation of gums.
How do you diagnose pyorrhoea?
Initially, there is a deposition of
plaque on the teeth. Plaque is an
accumulation of debris on the teeth
where bacteria proliferate. (Though
many plaque solvents are available in
the market, plaque cannot be re
moved unless the teeth are scaled
thoroughly and the patient is given
instructions on proper cleaning of the
mouth). This is followed by gums, pus
formation and swelling, foul smell or
bad odour in the mouth and destruc
66
2001, MAY 1988
knows for sure.
Regular dental
check-ups and proper
care is
the only answer
tion of the bone around teeth. It is
then that the patient comes to the
dentist complaining of bleeding while
brushing, bad odour in the mouth or
of a pale yellow discharge when the
gums are pressed. All this leads to
gum margins receding and damage
to soft tissues and bone surrounding
a tooth. The tooth looses its support
and begins to shake. It requires to be
removed when the condition
worsens. It is possible to see, with the
help of a probe, that the attachment
between the gum and the tooth has
developed a gap, forming a pocket.
What causes poyorrhoea?
The causes are many. It, can start
With normal gum inflammation
known as stomatitis whidh a patient
can get from contaminated glasses
used by others who have the disease,
and also from contaminated tooth
brush exposed to infectious bacteria,
cockroaches, flies, etc.
Diabetes, indigestion, constipation,
lung diseases, infections in the nasal
passage and throat etc cad a!.;u cause
bad-breath.
In women, hormonal change . m the
body are often related to gum }prob
lems. Hormonal changes could aggra
vate gum injury, there could be bleed
ing of the gums and there could be
rapid deterioration of dental health.
These changes could take place dur
ing pregnancy and at certain times
during the menstrual cycle.
Inflammation of gums can also be
caused when there is no proper ad
justment and correlation between the
upper and the lower teeth. This leads
to irregular pressure on certain teeth.
You must have noticed that children
or adults, who have protruding upper
teeth not in contact with the lower
teeth (called wrong bite), cannot
breathe through their nose-when
asleep. They breathe through their
mouth which causes the saliva to dry
up, giving rise to plaque formation
and activation of bacteria.
Zlf what age is pyorrhoea more
common?
57 COLOUR
rwr 11 ■ ’magazine
■■■'■1 ■ <-: ■ fcrJIWn? Hi
Over 25 lakh female foetuses
are aborted every year
Because the parents want
only male children
Originally designed to detect 4
- genetic disorders and for
diagnosis, most
doctors are now using
•
amniocentesis and
ultrasonography solely to
determine the sex
of the foetus ^B
The lure of the fast and easy
.,
■ • ?.
buck has led to an explosion ’W
of sex determination and *
• §ffl "
abortion clinics. Their k
favourite catchline is: “Pay
^.:-v
Rs 500 now rather than
Rs 5,000 later
wt ■
■ So far, only one state,
Maharashtra, has passed
legislation against Pr®"n£l ,
sex tests. But even that is full
A
of loopholes: in two and a
•■i
half years, just one
cgmplaint has been lodged
p
s®
-*,’ fj’.- (>
lnf^.1 ■' J
■
' . Si
^*9
wQiSriW
/
:■.:' li
:-:'-^Sj
o
'
• -®£2
<\'^hESF
1
1
■.<-
: i'i-:
R ■
Vv>.
’A1
*
A.(j. r
;
■’?■-■ !■
. -..i-
'' v‘ '
1 I
,
J
F
-'Ji
J
w
BOY OR GIRL?
‘j t mu§t be the oldest cliche in the world,
| Foundation for Research in Community
j but the tension wound up in the quesAtion, "Boy or girl?” would reduce
Health was commissioned by the secretI ary to the Maharashtra governments deAlfred Hitchcock to one big yawn. The
. partment of public health and family welheart misses a beat when the lady misses
I fare. The study. Pre-natal Sex Deterniinaher period*; The gjmaecologist examines
too Tests and Female Foetidde in Bomher, prescribes the urine test—and the
bay City, discovered that most gynaeco
coil begins- to wind itself in the guts. The
logists performed amniocentesis solely for
test confirms that the lady is expecting and
sex determination and even when they
the gynaecologist’s congratulatory advice
were done for the detection of genetic
is the first round of silent apphuse you
disorders, they formed a very small per
; hear for the goodness of God.^ i ■’ r- ?centage. A near 100 per cent of the 15,914
The mother feels the movements of the
| abortions done during 1984-85 by a welllittle one inside and the father gets the
| known abortion dime in Bombay were
greatest kick; the crosswords are no lon
undertaken after sex determinaticn tests.
ger done together, they have been reI There are truths, shocking truths and sta• • placed by the jotting (town and cancelling
I tistics like thia.
' ' of two separate lists of names: the boy's
The turnover of a diagnostic clinic on
arid the girFs. The blue and the pink wool haemophilia or chromosal abnormalities in
fen balls are all ovS1 and so is everything the child; the chances of a woman above Rafi Ahmed Kidwai Road in central Calcut
34
having
a
mongloid
baby
are
also
higher
ta ran into Rs 10 lakhs in a single month of
else in two separate colours.
:
, But the bad news is that amniocentesis I 1987 after it started amniocentesis for the
By the time the mother is in her sixth
is now used primarily to determine the sex first time. Of course, in the subsequent
month, the old wives confidently predict
*. the sex of the little one by the amount of of the foetus and, shocking as it may |I years, its annual turnover was barely Rs
sound, j murder the innocent, helpless | 10 lakhs, Ihe reason was simpler than one
j weight she is putting on or the vertical line foetus
if ft happens to be female.. At least • would think: almost every pathological
do,wn her swollen belly and the younger
one
popular
textbook of obstetrics de laboratory in the city took the cue from the
friends assure the parents-to-be that it will nounces its use.
for sex. determination,' I young, enterprising Dr Piyush Aggarwal of
j be a girl by the glow on her cheeks (more saying, .. amniocentesis. . should not be
- by heads-or-tails, actually). The question ' offered for such trivial reasons as choosing I the central Calcutta clinic, and the fast
buck was quickly split It wasn’t as if Dr
Z uppermost in everyone’s mind by the ninth thesex of the offspring.
j
I! AggarwaTs clinic ushered amniocentesis
>. month 7s the oldest cliche in the world.
In India, however, the earlier the female mto Calcutta; the unique feature was that
< Very very few are concerned more about
can be done ip, the better. And what he introduced the test exclusively for the
the welfare of the new arrival than its sex
better way
than
foeticide?
Pare is the father who paces the floor Amniocentesis for sex determination with purpose of sex determination. His public
v outside- the labour room or operation the sole idea of aborting the foetus if it is I ity literature spoke of amniocentesis solely
^ theatre not wanting to know what the female has been' a regular practice for I as a test for determining the sex of the
foetus.
nurse wiD come out and tell him first
more than a decade now in a country I
In Calcutta, again, a women’s organisa
K-.Then, the multiple explosions of strung- where even the "broadminded" man and
V together DiwaB bombs go bang-bang in the "liberated" woman is over the moon with tion donated a foetal monitor to a hospital
• head and suddenly the prolonged pleasure joy if ft is a boy and at best gulps with and the doctors there officially claim that it
of the Great Mystery is over. You know much bravado, "I always wanted a girl; I only informs them of the wellbeing of the
what the next set of nappies will be: pink they are much cuter." Ask the female foetus. But since the monitor also indi
cates the sex of the foetus, it is a foregone
or Wuefrf^
nurse whose monetary gains outside the
Science, however, is a double-edged operation theatre are not according to the conclusion what it is used for. The doctor
r- sword, While ft can unravel many Great success of the delivery or Cae&ariarr se- I supervising the monitor says: "We never
foetus. ” But
.• Mysteries, ft can also take over life com- ctionor to the weDbeing of the mother and tell the parents the sex ofathe
of the
ft is reliably
Jeamt private
that a seccon
section
of
' pletely so as to make the personal compu- chfld, but accor^g to the ’colour' of her I hospital
staff makes
deals with
the
to lhe
°f man,.
announcement
Pink
or
blue.
.
parents..
In the West the inexorable juggernaut
Sex determination tests were widely 1
* arguments' *against this misuse of
AU
devised a test called amniocentesis some done in Bombay, unquestionably the most
30 years ago, mainly for the detection of 'modem' of our otiea, and there was a amniocentesis are countered by vehement
genetic defects. Amniocentesis involves rampant growth of such clinics in the smal statements such as Nivedita Chakrabort/s. “Since I already have a daughter, why
the insertion of a hollow needle into the ler cities of Maharashtra in the decade
should I not be given the choice of ha ring a
uterus of a pregnant woman to draw out a preceding 1988. According to R. P. Ravinsample of the amniotic fluid in which the dra, a member of the Forum Against Sex son?" she asks angrily. “Maybe we will
;; embryo is suspended. This fluid is tested Determination and Sex Pre-selection manage to pay the dowiy of the first
for foetal abnormalities, specially in the (FASDSP), these clinics were a dime-a- daughter; the second will probably die in a
cases of expectant mothers who are above dozen in places like Dhule, Jalgaon, Amra- | stove accident after marriage, anyway."
Many doctors also ethically justify
34 years. The test is vital to determine the vati, Nashik and Nagpur.
possibilities of mental retardation, ■ A study by Dr Sanjeev Kulkami of the I amniocentesis and subsequent abortion as
long as it is done within 20 weeks of
The need to know the
answer while the mother is
carrying has led to a boom
: in the sex determination
7 test business. And, of
bourse, to a mass murder"
of female foetuses...
•
—^Tlhl ni 11 II
6' ’ J-'-;
)
zum
UVUtd.
'
.
,
e
l
I
I
Q oregnancy- *at is, merely the medical
i
I ssAjasress.w-x
ter A male child was also necessary to run
query of Malim
Kumar, 25, married and readent of the
cosh Ballygunge Circular Road area or • j
cutta: “Cut the drama, yaar. Why snouM.(
not have the right to dedde the sex of np
child if 1 nan have the right to dearie
whether or not to have a child/
!
'
A her nearly 10 years of relentless camxlDahuW by various concerned groups
indS die FASDSP. the state governmeat m Maharashtra enforced the Mahar
ashtra Pre-natal Diagnostic Technique.
Act, 1988 (May 10)f thus making that
state the firat in the country to legislate
anything of the kind. In eSect, it attempts
to regubte the use of modem me^. .
technology in India. On
the State Appropriate Authority (SAA) and
the State Vigilance. Committee (SVC)
were set up, but so far only 14 have
applied to the &AA to registration to conduct pre-natal sex determination tests for
the fimited purposes permitted under the
Act The SVC, too, has had just one com
print lodged with them so far: about a.•
dcctor in Bombay continuing such testa,
according to the Maharashtra state health
department It does not mean that the
Dictiire has become rosy, groups which
fought for and won a legislation against. these tests contend that they are still
•
going on to a large extent r
.
,
Dr Sanjeev Kulkanu’s study found that,
the cost of the amniocentesis ranged rrom
Rs 70 to Rs 600 and though most doctors
admitted that their “market” was largely
the upper income groups. a^ver5seI?^2S like, “Pay Rs ^00 now than Rs 5,0C0
later,” did help to convince people that a
sex determination test and abortion were a
nirtanry compared to the cost of marrying
.
off a daughter.
;j
Medical techniques like amniocentesis,
chorion vilfi biopsy (CVB).and dtrasc^
nography were blatantly misused, Be
radars to identify, the ‘enemy’ and destooy
her The Erikson Method, which entails
the separation of the chromosome and
.
artifida! insemination, was also practised
by five doctors in Bombay before the ban,
some women’s groups allege, in fact. Dr
Erikson the pioneer erf this method was
invited to Bombay by a local doctorAt that time, apart from such cluuca and
abortion centres, there were at least 30
laboratories doing chromosai analysis, and .
half of them were in Bombay alone, ,
AJter the Act came into force, the whole
gamut of sex determination tests were
supposed tri ^thrown out of.the purview
jeip os sAep sf jajre ajaqaasp ouop si
uorpoqB aq’ pup saj^uao juauimaAoS aqj
je auop ajE sjsaj jeio si saaddeq
•uaddeq giM Sunpoa ‘uopiquauiaita
pujs si ajatp ssapfl iKxpe 8uppj m
pajsajajui maas ;,usaop luaunuaAaS aqj
puy •wotpe (xs ma waq? ing *aoQaa^*e
sto 03 31 ^qgnojq pue jopagod jndBi|p)j
aqj oj uopeSapp b tn juaM 9/^ -boti
-rp asatp aprejno spreoq aapoo snoiAqo
Xioa bjb ajaqx, treq aip gqidsap sjsa;
©qi ftotst^aApe Ajusdo uaaq oabij
.-iidBqpjj ui sarap aws p aftaxa’ce
saA0 aqg "a^-puE-^q-iaded ge potneuraj
teq q jmp qaaj ^nq ‘umo jaq Stapnptn
sdnoj® 8(aamoM ujo^ ainsga.?d japtni
• padarep sm treq aqj jbcjj sairep Xppa^
t,:' ;>■k • ’ ; < '-•■.*
'* up© ro
1°° 3 J!
aap Xiaqipeui iusuhusaqS
W s* W&,
P nosEjapa^
pnopex ©qj p qoirejq eijqmreqBj^ aip
jo Xrejaxoas p^anaS ’/Sppag eiB£ sjapisnq^ I
/soisaptA® saiS ptre pieMJOj aoioo jqiwqs
aftfoa^ aq^ sspisqj jj luamtMaAoS aip joj
, asrma pooS » grqj^ ^ggj
^3^
. ano Xpio sraaq ssq ajaq; put? sjurqdmoo
jo aonasqe aqj m pe piraeo qXs
I
pqj sXe® juso^jBdap qqeaq aq£ *(X)O‘S
P satsj pra joaunzosudiu! snwoSu |
fiieaX aajip Rnpaaoxa jou suuai p8
03 afqqj a^ £$n8 ponoj asotp poy - rq os
m amoo seq piqdiwo ano jsnf -suogejoiA
jq paqsnmd Suiaq asotp p qooj b aqh
noX uaqM pqaqnop Xpajajqxa si EjiqsB
re nop^aj atpp Xoe^ja
r>»
'A.
Set-*
?3®b®S
I
•5
•JE^auSirejj sXbs M<TOABaq 04 3nio8 asnesaq,, SuipoqB sbm aqs jEqj ftnjjnnpE “
p souEip ou si ajsip ‘uos b si areqj ssajnn aemoM sip asgo rpsa ® ‘uopjcxp p Bases
W
snp si aroqj^ wqbtqis atp £ [ paxaAtwsjp puB e£te sqiuctu jos XaAjns
tn aguetp on sq ppco aratp ‘OAtpajp sem b papnpuoo peq ‘psa; oip ^uib8b pao8red
usuiom otp 3houib u^iBduieo gq} ssspm
-rap Eqcps qrqBjq jpnEjrc asotJM 'jcpa ’
^rp peouiAtw sbm yq^ jspciBj^ aqx
i/Aiuado pa .‘aqArnn—uo Sujo8 t
M<rpi8 pucms b ipiM op aa nja are s^sa? aqj, •pasnran aq ueo.oopBajdcte
’ poiainnoo Aatp ‘uraip asodm!j P^WI tnxiX,, naPE3i (jvj'ijo ftq
paaopsonb
uaq^l 'Ojupid
a<R JiKputa jj sXgqy sXBg :>*
jaiBap b 9ab3 ‘jOASMoq aME[-tn-8jatpoiu
- •'SunajS 84uauiQa am aSage
Ji^qi *£mGoj afraiaj b sbm ji asneoaq
“ssanS s/poqAus q aq gja asooind atp
jsnf SuruoqE jo uiBajp ;ou ppoa pug p^raif moh •Bjapjasip.opaugg Surpajsp
MdArSS9j2oJCl Aj9Aw 9JdM Asip pies *p3J3B} 9-® ^sasodmc.
ejsa? asaqj
-uoo uaqM ‘uauida
-pig e'sem pjnp pnpuoo o; nopsrauad aAjg saop yyg i
j&ig aqj ‘sasK) n sip jo ipua in jsip paxaA aq? poe sajGqdooj aq ‘asmoo jo ‘giM ajaqj,
-oosyp osjb jKjfau&nQj ;(nEuis 601 si ppp
-spjidcoq jirotJuiaAoS tq Xp® pat
puooas pin? isjg atp naaAqaq somqsrp gqj aq pra sorinp pus ep^dsoq qBAi
i
Another doctor, who prefers to remain
anonymous, goes one step further.
According to hhn amniocentesis gives 97
per cent accurate results, but with chorion
villi biopsy it is 98 per cent And CVB is an
aesthetically better procedure. Tm wait
ing for the opportunity to use the business
principle of lower margin of error. Earlier I
who wantec
ly. "Now it win have to be the less effec
tive word-of-mouth publicity."
A pathotogh^ who nas set up his clinic
lx in one of the elite areas in central
Calcutta, requested anonymity for fear of
Selling abortion
Maharashtra. This wSs around the tims
t them? Abortion is permissible in India, but
two children per couple has to be com-1
municated to the people. Unwanted babies
arning the wrath of his gynaecologist
friends and losing lefereuces. Tm - .rsonally agajnst anmiocentes!? used solely for
the direct interest of d gynaecologist.
‘ Ten cc of fluid is requh d fc. the test and
it is difficult to extract this fluid without the
traces of blood in the fluid, the result will
I
also avoid ultrasonography before
amniocentesis for the simple reason tha
t^n/cak^Ukm' we
the first test might provide s-Jfiaen
■& wten ttt’ghxiye to have a boy or? ■
knowledge for the parents andithe® tnigh
to- _j_.
Mping te coupb; I
&&J k basically
g thdr. famflyl;.Tboughj not return for amniocentesis.
Ultrasonography is accurate onty site
xnetrisejr.w d? not.dder^ I 20 weeks of pregnancy while ^nmo^te
SEqfthefcetas
sis can predict the sex of the foetus With
aii-erefore the quests* c£
^harper accuracy in the 12th orll4th week
Yabortfai
drjes
not
arse.^
eiim. ik
Aborting in the 20th week is fraught wit'
greater risks than m the 14th week arJpat iffl date mey «*y5?
according to the W, too, abortion is per
r.<ic?»30
aaiss&te only within 20 weeks of pregnan
aS^erirout
of
tese30^
t ce«B.x»i
cy. Many doctors are of the opinion tl J
•F.'l
;only:4j ■v^nte4 daughters,* ^
abortkra even after the 12th week is risky
The Medical Termination of Pregnant.
Act lays down several grounds on wliid
«ne io us already
-jwtoha;
can be done; but as with mos
laws, there are as many loopholes as then
desSibeten system or
grounds. Most parento who want b
'ifiming*-aMifety dd^fe are
loll a female foetus allege that the pregnan
jttla^Says Mrs
cy was a result of contraceptive failure
spted W usis hi^ly .scife
The pathologists and radiologists alter th
JtWtHn^fested, and
medical reports to say that the mother wa
'2000 years. I haye
sufiering from disease which threatens
PM.
wfcji I have decoded after coo^- I the Health of the foetus and the child ma;
1,
Wsuftihgafot ofddbooia. Jcalculatete,
yfcfflFdga proved to me by te parents au I have been bom abnormal or that carryhj
j the foetus was a danger io the mother;
I® gxl; ‘
life.
f^^wtieh
to
In India, nearly 60 lakh abortions are
MfAsltt^^^*she
got the dj^ l® I
carried out every-year; of these, only
re w^e ip a joint fan^
about 10 lakh. in Ecensed clinics. As many
as 25 lakh foetuses are destroyed because
idonot reaBjp..
they are female. The effects of such
l his. wifeC.tSglarge-scale female foeticide are tellings Id
"S for her to>
1921, for every 1,000 men there were 972
women. When the last census was taken,
v-about? Mr^I in 1981, the number of women per 1,000
men had come down to 933. In West
Bengal, the situation is still worse—the
.des&B«j.Togiyey^
mate-fomaJe ratio in the 1981 census was
eemjfebe
found to be 1,000:91L ’
are.'
In 1971, the total number of men m the
^^^newi>er8 Had (feqded: efajid
country exceeded the total number of
I women by 1.99 crore?- By 1981, the
difference had grown to a staggering 2.38
crores. Such frightening imbalances are, in
turn, certain to lead to even greater social
problems. ■ V1**5*’’ 7’ L .
.
,
A spokeswoman of the Missionaries of •
rt»neacs
Charity says: *Tf there can be an anti
dowry Acu why can’t the government
bring in national legislarfon to ban sex determination tests? Side by side, the abort
ing of female foetuses should also be
I checked.” Another social worker attached
^rriage or prena- to a government family planning clinic
“Ever/ couple should be asked for a
tore labour. There is also the possMty oi adds:
Herbratfon stating the reason for seeking
the foetus while extracting the fluid and causin haemorrhage tote pheenta
often an ultrasonogram is recommended to the amnionic sac perforaUon of the I abortion. If the reason is found to be false,
there should be a punishment clause. An
ascertain the^ exact position of the foetus placenta may lead to significant
prior to the extraction. In fact, the sex of foetal blood to the mother which may irftt- expectant mother said: "Not banning sex
the foehis can be determined in the ultra mately cause haemolytic disease m the I determlnatfon tests in the country means
sonogram and ’amniocentesis done as a foetus. Therefore, location of the placenta I the government is encouraging coldI blooded murder. It is female foetidde by
confirmatory test; v-.;
• •>
■>'<
through ultrasonography u abo rwom’
Doctors admit that there are three ma mendek but many doctors slop this if they I the government”
jor risks in amniocentesis:. (1) trauma to Xt to cut'costs for their cases. Mort Anil Grover with LeklwDhar
the foetus, to the placenta, to the^imbihcal pathologists. who take up cases directly I and Monimoy Daagupts
cord or to maternal structures; (2) senous
tCREATINO
7
I ■■-<-.
i
I*
hiWt
itan
<<*
QI
UNITA Chaturvedi was 2'. hen she
became pregnant for the '.bird time.
Already ‘burdened’ with two daugh
ters, aged three-and-a-half and oneand-a-half her husband Girdhari, and her
in-laws were anxious to know the sex of the
third child. It certainly was not going to be a
aid again, they had made up their minds. It
would have to be a boy this time. If, unfortunatefy it turned out to be female, they would
' aet rid of it, they told a bewildered Sunita.
Having heard of the flourishing trade in
amniocentesis in Bombay, they decided to
come here from Mathura, where they lived, to
find out the sex of the the unborn child. They
arrived in June ’86, when Sunita was about
four-and-a-half months pregnant, and con
sulted Dr. Meenaxi Merchant at an Opera
blouse nursing home. Dr. Merchant performed the, amniocentesis test and on finding
that the foetus was female, advised Sunita to
death was given as penetration or blunt
injuries to the abdomen associated with
post-operative rupture in that region or due to
the injury while doing amniocentesis.
Consequently, Mahila Dakshata Samiti has
filed a writ petition in the Bombay High Court
seeking to prohibit amniocentesis or any
other sex determination test from being car
ried out and the selective abortion of the
female foetus. The petition, filed as a public
interest litigation, also seeks to punisn those
who had indulged in the illegal practice
resulting in the death of Sunita.
The petition raises some vital questions. It
points out that under the MTP Act, while one
medical practitioner is allowed to give an
opinion in favour of abortion, if the pregnancy
is less than 12 weeks, two medical practition
ers must give their opinion if the pregnancy is
more than 12 weeks but less than 20 weeks.
The rules also provide that while abortion
«JL hough
amneocentesis
should be performed
only after 16 weeks of
pregnancy, doctors
M'
-
O''
FEMALE FOETICIDE
undergo abortion under the Medical Termina
tion of Pregnancy (MTP) act.
The abortion was done on July 15 by the
suction method or dilatation and evacuation
method. Sunita was discharged the same
evening and was advised to take ampicillin
and pain killers.
Sunita returned to Andheri where she was
staying with some relatives. The following
day, she developed pain. On July 17, Dr.
Merchant was informed of the incessant pain
and she advised Sunita to continue with the
pain-killers. That night, Sunita’s condition
became worse. She suffered from breathless
ness, palpitation, severe pain and general
weakness.
The following morning (July 18), both Dr.
Merchant and Dr. Rajani Arya in whose clinic
the abortion was performed, were contacted
and they asked the relatives to bring Sunita
over to the clinic.
Sunita and her relatives immediately left in
a taxi, but on the way Sunita became unconscious.The frightened relatives took her to the
nearest hospital, (Nanavati) where she was
admitted.
Sunita died on the 19th. The cause of the
36
FEMINA DECEMBER 23. 1986-•JANUARY 7. 1987
A'
making capital of the
obsession for a male
child exploit the
weakness of society
thus perpetuating the
gruesome practice of
killing female babies
even before their birth
court harnoTgfanted it because the govern
ment counsel promised to produce the reI
levant
documents. a method used to detect
‘■Amniocentesis,
A 21-year-old woman died
recently after undergoing the
i
oenetic abnormalities or deformities, is being
amniocentesis test and
misused to find out the sex of the oe us^
abortion to get rid of a female
leading to selective abortion of the f?maL
foetus. Mahila Dakshata Samiti,
foetus, says Sudha Varde ol the' MahHa
a charitable organisation, has
Dakshata Samiti. "Though the test should be
performed only after 16 weeks of preg.
now filed a writ petition in the
doctors making capita! of the obsessioj for a
Bombay High Court seeking to
male child, exploit the weakness
v---------- in society,
’ ? °f
prohibit amniocentesis or any
thus perpetuating the gruesome practice
before
”
other sex determination test
killing female babies even bof~
’~ their
1 iair birth,
1
she adds.
from being carried out and the
. \ termination of
Moreover, she points out,
selective abortion of the female
under certin cirpregnancy is to be done u..
the
life
foetus. It also seeks to punish
cumstances to save I------- and healthj. of the
pregnant woman
woman or
or child. Howevuh the
those who had indulged in the
provision of
the
act
is misused by many
of the
illegal practice, resulting in the
unscrupulous doctors
doctors and misguided! mem
unscrupulous
death of the young woman. In a
bars of society to eliminate a female foetus by
using^sex determination tests," she points out
society obsessed with male
. children, the Samiti says,
10 The MTP Act does not aim at abortions for
women are forced to undergo
getting rid of female foetuses, she avers
adding that notwithstanding the provisons of
abortions when the foetus is
the ac^, no person has a right to take away the
found to be female. The
life on the basis of sex and it is discnminating
government has failed to take
and violative of Article 14 of the constitution
Meanwhile, a bill has been introduced in
stern action despite several
the
state assembly by Mrinal Gore
appeals to forbid the test from
Shvam Wankhede and Sharayu Thakur (both
being used for this barbaric
Conq) seeking a ban on amniocentesis
Feading to selective abortion of the female
practice. The petition has been
foetus9 A similar bill has also been introduced
filed to prevent recurrence of
in the Lok Sabha by Sharad Dighe (Cong.). It
such gruesome crimes.
seeks to amend and MTP Act to prevent
Abortions being done with a view to ehmmate
SAROJ NATARAJAN reports
■
This press campaign by Times
artist Nana Shivaikar was
displayed at the 1986 Ashok
Jains Awards for National
Awareness Advertising
,e The state government has also appointed a
before 12 weeks can be performed by dilata
tion and evacuation or suction method abor_
committee to examine the legal implica ions
tion between 12 and 20 weeks must be done
of the existing provisions like the MTP Act, the
IPC and the Cr. P.C., their adequacy and
bv other safer methods.
yYet the petitioners point out. the abortion
recommend additional safeguards if neces
on Su'nita.who was over 20 weeks pregnant.
sary It will also examine the present physical
provisions (like the number of clinics, hospitwas performed by the suction method which
is unethical and constitutes grave negligence
als) available for performing amniocenteses, n
on the part of the medical Praclltl0n®rsv
this test could be regulated, and if so, how
Sunita's discharge the same evening they
Tne committee' will also suggest a way o
educating people on the med.cal and social
add was an act of further negligence.
The petition urges that all relevant docu
ills existing in society.
ments and reports at the nursing heme
A.sked why Dr. Pai, who blatantly promotes
the test was also taken on the committee an
relating to amniocentesis and abortion and
papers9 and death register at Nan^at) h°^n
official of the health department said the
al where she died, be seized. The petibon
objective was to include people with different
also prays for a directive to the Maharashtra
shades of opinion on the committee.
It is interesting to note that the foundation
Medical Council and the Indian M®^a
for Research in Community Health a c.tyCouncil to enquire into the matter of the death
of Suni'a as well as the doctors conducting
based voluntary organisation, which has bee
ffie sex tests, especially Meenaxi Merchant
asked by the government to collect data on
and Rajan. Arya, and debar such
i
ffiis had earlier sent circulars tp the governlous doctors for encouraging such pract.ce o . merit and civic health departments to find out
(
the number of public hospitals conducting the
eliminating a female foetus.
test Ironically, the
replies sent sa.d
The petition has also sought by
y
interim belief, prohibition of amniocentesis or
•amniocentesis facilities are available in all
any other sex determination testt from being
the hospitals'. [3
carried out pending the final order. But
37
FEMINA oeCEMBEA 23. 1986-JANUARY 7. 1987
Bio Medical Interventions:
Young Women's Future Choice or Control?
Wendy Harcourt
Public Policy DMstot.
Voluntary Health Association of India
Wendy Harcourt examines the issue oj the rapid introduc
tion ofreproductive technology in both the North and the South
by critically examining the way in which medical intervention
is developing. She argues that in considering future choices for
young women, medical intervention should be developed along
the lines determined by women themselves rather than being
left in a scientific ethical vacuum.
Young women are now offered a potentially far greater
range of medical choices to exercise control over their fertility,
the timing of pregnancy and reproductive health. In this article
I would like to raise some questions about the implications ol
these new possibilities by examining the medical intervention
inicproduction from I wo aspects. I •it st the debate (hugely in the
North) around the not-so-unambiguous benelits reproductive
technologies have brought to individual women. And second
|y, the social and political implications of an uncritical acccp
lance of these technologies for developing countries. In look
ing at young women’s future role as mothers and workers,
these issues of medical choice or control are critical to promot
ing an equitable development which empowers all people in the
future.
Defining reproductive technologies
I’est tube babies, amniocenlesis, (be “pill”, family plan
ning. medical delivery are all increasingly familiar terms ol
20th century reproductive technology. 'I hough reproductive
technology is an ancient concept and practice - women in all
cultures and ages have sought to prevent or increase their Icitility - we have seen in the 20lh century an increasing number
of scientific and medical techniques to intervene in the
“natural’’ processes of pregnancy and birth.
Reproductive technologies can be divided into lour
categories:1
1. fertility contiol (luvhnologics preventing conception:
i.c.,
family planning, the “pill’’, interuterine devices,
sterilization);
2. management of labour and childbirth (the technologies
monitoring and continuing the process of labour and delivery:
i.e., medicaliscd childbiith, hospitalising of childbiilh, loelal
heart monitoring, instrumental and caesarean deliveries),
3. health and genetic chaiadeiistic of foetuses and new
borns (the techniques for neonatal caie, experiments foi human
genetic engineering, i.e.. amniocentesis, human cribs);
4. conccptive technologies (ptomolion ol piegnancy
tluotigh techniques lot iv\vising inleitility: i.c., in vino let
tilizalion, surrogate mothethood, “lest tube” babies, embryo
transfer and artificial wombs).
Ineachol these loin aicas. Wcsicin sciencehasestablished
a domain of expertise which has deleimined the picsent
reproductive process in the North ahd the lines along which
third world governments and multilateral agencies have and aie
developing. Given the often unchallenged dominance ol this
medical diseomse we nerd m < lai it V fmlher the ns-amiplinir;
undeilying. Hi.- iiikiiIh al u-.r ..I m pio.luelivr ha h.i..lopy.
First, the aura which suuounds modern medical and scien
tilic discoveries obscuics the complex ethical, political and
social Held in which medical science is embedded Removed
from every day life in laboraloi ics and hospital clinics, medical
innovations ap|xar to be outside ol the ordinary person's com
prehension despite the impoitance medical intervention plays
in modern society. One teason there is so much controversy and
debate over aspects ol icpioduclive lechnology is that scien
tific technology is, like any other social process, lor med in a so
cial. historical and cultmal context. I Ins is even more so in an
[)cvdopincnl 1990:1 - Journal ol SID
60
;fA
area dealing with such socially significant events as pregnancy
progress or misogynist repression. Given the big i-powcrcd
and birth. However, in our 20th century rational discourse of
development of reproductive technologies, I would begin by
asking the basic question: who decides what for whom?
science which divorces scientific facts and progress from social
and ethic.nl questions, we are too often confronted with innova
Reproductive technologies
have the potential to give
tions in scientific technology which are adopted without
reference to the wider social and ethical milieu.
women a greater control over their fertility. The “pili”,
heralded the so-called “sexual i evolution” in the 19ft0s.as well
When one looks at the effects that new technologies have
as an easy way Io space families, challenging many religious
had on individuals and society we can see that the medicalisa-
and cultural norms. Tcchiii(|iics to produce fertility offered the
tion of child birth, the wide spread use of contraceptive devices,
the large number of routine medical interventions in childbirth
chance for previously infertile parents, or women not in
heterosexual partnerships, to have "biological” children.
have had direct implications forchanges in religious, moral and
Medical techniques in childbirth have allowed once dangerous
social behaviour. Despite the hi-tech cleverness, the choices
complications to be handled routinely.
The rider is that all of these advantages were ushered in by
a medical science whose aim was not so much to impiove
women’s life choices, but rather to perfect techniques which
often ignored the patient as a holistic subject. Medical science
to use these innovations cannot be safely made in a scientific
vacuum. This, however, is precisely what some critics argue
has been done.
The first part of this article takes up the debate surrounding
reproductive technologies by examining how, for individual
women, particularly in the North, reproductive technologies
has constructed the modern notion of the patient as a clinical
subject which treats the body, removed from the patient’s
have been introduced without enough awareness of the social
issues, resulting in some ambiguous benefits for women.
individuality and social background, to be studied as an
anatomical object affected by disorder and disease. The doc
tor’s assessment of the patient docs not take into account the so
cial environment, nor the patient’s perception of the disorder.
Ambiguous benefits
I his medical “ga/e” has enabled a certain type of medical
treatment io become dominant, one which is based on expert
Two polarities have emerged in recent assessments of the
knowledge and interventions performed in a clinical environ
impact of reproductive technology. The first, as claimed by the
majority of its practitioners, is that reproductive technologies
offer parenthood to (hose who would otherwise be unable to
have children, fertility control for those not wishing children,
the previously unthought of choice of whether or not to bear
chromosomally abnormal children, and safer, more controlled
ment. The medical setting is not designed to take into account
the diverse backgrounds of individuals but rather to diagnose
and treat disordered iMxlies regardless of personal dillctences
or social context. Social events such as birth are strictly
monitored in clinics far removed from the home environment,
with the woman lacing treated as a patient rather than as an in
childbirth with a far higher chance of premature and neonatal
survival. In this view, reproductive technology is a triumph of
dividual mother experiencing an important life event. In fact
the medical domain, as recent literature4 suggests, constructs
science over nature and offers boundless possibilities for
the reproductive body as if it were a mechanism removed from
science and the women who are its beneficiaries.
The opposite v iew ha$also emerged of the dangers of medi
cal science stepping beyond ethical bounds and public control.
The right-to-life campaign in response to abortion, the public
reaction to surrogate mothering, the “legal rights” of “orphan”
embryos and “brain-dead” women being delivered of children
are examples of this view.2
everyday life.
This medical way of viewing the brxly leads to medical
interventions treating pregnant and birthing women not as
individuals with choices but rather as socially undifferentiated
medical cases. This is a medical approach not limited to
women, but with the peculiar consequence that fertility, preg
more acute focus on the impact of medical technologies on
nancy and birth arc seen as medical events with the foetus (and
eventual child) treated as a foreign object in the women’s body
(in medical texts the foetus is not infrequently described as a
tumour).5
women’s lives than on the ethical dilemmas. 7 hey argue that far
from offering women more possibilities, present reproductive
practice is a restrictive, indeed repressive practice. In this criti
que, (male) medical science is seen as victimizing women;
Ihis way of approaching birth, with the accompanying
reproductive technologies, has lead to increasing intervention
in the birth process w hich focuses on the female body removed
from any social or cultural context. Many thousands of dolkus
using them as vehicles for experimentation and reproductive
arc spent on techniques which focus on foetal health and the
technology is characterised as an attempt by men to reap
new born rather than on the overall health and well being of the
propriate women’s unique source of power: reproduction.
mother in a “normal’’ pregnancy. Scientific curiosity and in
Somewhat ironically, feminists have also joined the debate
from a negative viewpoint? though their arguments have a
My view shares none of these positions though it is guided
novation docs not necessarily have general social weilare as an
at least in part by the challenge raised in the feminist critique.
aim. Meeting ordinary women’s needs — access to health care,
Instead, I enter the debate by raising a different question as to
education — is not one of the "spin offs’’ of medical
whether reproductive technologies arc signs of triumphant
experimentation.
■ i ; * 'b;1
Development 1990:1 - .lotirnal of SID
61
The resulting ambiguity of this approach for women is that
while reproductive technologies appear to offer benefits,
medical practice and policy, as its stands, does not allow for
women’s greater understanding or knowledge of their own
bodies, but rather treats the female body and its needs as
removed from everyday life, to the extent that pregnancy is seen
as a disease to be monitored and hospitalised, with (he foetus a
foreign object that can be safely explored, handled and ul
timately jemoved.
In thus describing the medical way of seeing, 1 do not wish
to ascribe to doctors any lurking misogynist motives, but rather
to show how the medical model as applied to reproductivity has
lead to a curious set of ambiguities which could well mean that
, the prospective modem mother can actually be less in control
of the birthing process than before reproductive medicalisation.
She is subject to treatments and procedures which are not well
explained and do not allow her real choices. In fact, as has
been well documented,6 ignoring women’s responses has lead
to reproductive technologies being tried out well before their
safety has been proven. Indeed, techniques still in practice
today produce side effects and difficulties for lhe women- both
physiologically and mentally - which have been disregarded in
medical assessments of success.
On an individual level then, reproductive technologies
while leading to some benefits have produced at least a ques
tionable set of medical practices for individual women. Cases
1 of brain- dead women “delivered” of children, routine uncom
fortable and perhaps unnecessary foetal monitoring, inade
quately tested use of the “pill”, thalidimide or other drugs
where reported side effects are ignored long painful
procedures with very low success rates form vitro fertilization,
have all been reexamined from asocial context and found want
ing - even if the medical techniques themselves may be classed
as brilliant in the laboratory.
From this analysis, we need to think not only about the
viability of the techniques themselves, but also about (heir
social implications. Who operates them and who controls their
use? Who is responsible for their evaluation? Reproductive
technologies which enable experts to introduce untested con
traceptive techniques and to have more and more direct control
of the foetus and women’s reproductive organs could threaten
(and some would argue already have done ) to create a politics
of indifference with regard to women’s health, self-identity
and life choices.
Social conirol or grcaicr choice?
In the second half of lhe article I would like to move from
the effect on the individual to the social context in which
reproductive technologies are being practiced. In particular
I would like to shift from what has mainly Ixien a Northerncentred analysis to look at some of the more disturbing
social consequences already seen in the South where repro
ductive technologies are given even less careful attention
than in the North.
62
1 o reexamine reproductive technologies in a social context,
we move from a set of practices with consequences for in
dividual women discussed above to a social process centra) to
human rights issues, management of lhe population, economic
interest of multinational companies, and stale investment in
public health and education. Seen from this perspective,
reproductive technologies can be left even less comfortably to
the scientific ethical vacuum.
Often lhe choice of techniques exported to lhe South is
made not so much because it is more suitable or adaptable. On
the contrary there can be mote questionable motives.
'I echnology, rejected by develo|)ed countries, is often dumped
on lhe Third World markets (sometimes as aid).7
The nature of (he use of lhe technologies needs to be ques
tioned: who is deciding what for whom? In this case we have the
Northern scientists making use of a wide field of research sub
jects under lhe less critical supervision of Southern govern
ments, and multinational companies “expanding’ their out
reach in lhe less restrictive markets of the South.
Nor do these questionable initiatives come only from lhe
North. There are examples of developing world governments
adopting techniques which are applied as measures of social
control as much as pur|X)rted population management (such as
i. the enforced sterilization in the 1970s in India).'l he use of conI Iraceptive devices such as Norplant and other injectable con
traceptives have been banned in lhe North but widely used in
I the South with lhe encouragement of governments following
i lhe advise of multilateral agencies.*
'l he coercion used and lhe way in which costly techniques
are recommended raises a numlicr of questions. First, the
problem of local corruption and inadequately monitored tech
niques (not an infrequent problem in lhe development in
dustry). Butrhaps more serious, is the problem of reproduc
tive technologies being heralded as part of lhe scientific
wonders of western medicine. Over-zealous technological in
tervention, abuse of the public through continued use of banned
drugs has been possible through the uncritical acceptance of
medicine as part of “development” and “progress”. A well set
up hospital for neonatal care can be enthusiastically funded by
governments as a symlx>l of development and technological
knowhow, whereas, as iccctii studies show, less money chan
nelled into ensuring that girls have belter education would un
doubtedly increase women’s ability to monitor their fertility
and their family’s wellbeing and more securely guarantee im
proved infant survival.
I’cihaps then, lhe question ol individual choice and social
wellbeing is not so unrelated when it comes to assessing the so
cial impact of reproductive technology. In uncritically adopting
lhe techniques of western science, the Third World is also un
critically taking on board the way in which western medicine
o|>crales. In other woids. the undcilying assumption is that
reproductive techniques can Ik* separated from the social and
cultural context in which they were produced and simply trans
ferred as useful knowledge to the South.
Amniocentesis is a telling example of how reproductive
Dcvvlopineiit 1990:1 - Journal of SID
•>
(
technology is not a culturally neutral phenomena. 1 he lech
nique was introduced in the West for women over 35 to ascer
tain genetic defects (Down’s syndrome) at an early stage of
pregnancy in order for the defective foetus to be aborted. (In the
North this technique is already a questioned procedure as some
claim the line between this as a routine procedure and wider
eugenics is a fine one and others have documented that the
choice to abort is not always the parents’ — many doctors ask >
parents to sign a document agreeing to abortion in the event of
a defect before the results are known.’) An incidental result of
the test is that it is also possible lo know the sex of the foetus.
In developing countries which highly favour male children
- in particular India and China - the test has become a routine
practice - for those who can afford it - to test not for Down's
syndrome but for fcmaleness. In one survey in India only one
case out of one thousand aborted foetuses was male.1" This
practice, introduced as a medical technique to improve social
wellbeing by producing healthier children has been misused in
'-this case to promote “female foeticide", in effect to dis' criminate against girl children while they are still in the womb
- a rather questionable case of adapting scientific technology lo
(he cultural domain.
Another issue to examine when asking who decides what
for whom is whether the western model of science increases the
knowledge and skills of the local users of the technology. The
model of expert instructing beneficiary (or doctor instructing
patient) fits well with the prevailing practice of developing
countries adopting developed countries’ models of in
dustrialisation and scientific progress regardless of traditional
customs. Development thinkers are now beginning to chal
lenge this practice which has lead to some disastrous results in
the Third World.
In the same way as those interested in development arc now
beginning to see that sustainable development needs to
preserve the local environment and culture and allow for the
existence of future generations by relying on local expertise,
knowledge and ability as well as external expert knowhow, the
medical model of the western trained doctor applying techni
practices, greater knowledge ot their own bodies and greater
ability to choose their roles in life. From our discussion in the
first half of the article, it is clear that even in the No th effec
tive choices are not necessarily being offered by the? nlroducntroduc-
lion of reproductive technologies. Introducing inadequately
,L..i
tested medical procedures in the South is undoubtedly ques
tionable from an ethical perspective. Based on the above
analysis, we should extend this to qur-dnning the underlying
assumptions of medical practice. Transfer of knowl
know! dgc
dec in
m-
stead of developing more choices for women with regard to
mother
their economic and social role has reinforced the role )>f..........
as passive, with woman subject to the expert skill of l(x.|or,.or
the aims of the government social planner. Though out: docs
*
•not
’
wish to dispute the development gains deriving frnm some
medical procedures, development agencies are now recognizing that public health and education for women whic i is sensilive to the local environment is far more effective than the few
hi-tech innovations the same financial outlay could
practices should not I* replaced by western innovations, but
rather that these innovations should be introduced sensitively
with the goal to give women
women access
access to (he knowledge ol their
own bodies,
bodies, control
control o.
of their fertility and safer birthing prac
tices. The technological methodsof populationi control dear
ly offer an important and necessary development lor global
economic and environmental
of reproductive technologies in the North, we need to pose in
the context of developing countries questions about the social
location and meaning of reproductivity. T he point here is not lo
argue that we leave fertility, pregnancy and childbirth to "na
ture”, whatevcr“nature” is. the reality is that reproductivity like
all human behaviour is historically specific and our modern
reproductive process is embedded in medical techniques and
the scientific approach. In transporting ibis technique to die
South, we also need to transport some of the critiques which ask
that medicine be seen as a social phenomenon.
If we arc talking about development as scll-susiaimng, em
powering people to have greater food security, access to
economic resources, health and longevity, we should also lx?
talking about empowering people to have access to safe health
sustainability.
11 c change
needed is to establish this new knowledge of womet ’s bodies.
fertility and childbirth within parameters which those most
closely affected can actively shape and carry out.
In balanced development planning, funds used to control
fertility, develop contraceptive techniques, foetal transler and
artificial wombs, need to be assessed in relation to funding
available for adequate testing outside laboratories, basic
knowledge of available family planning techniques and
wider adequate nutrition and health. All areas which
would enable just as effective and in the long run less costly
means, in economic and human terms, of improved reproduc
tive technology.
I
ques oblivious of local traditions needs to be challenged.
This challenge is not so much about the validity of the tech
nologies as about their context. Following on from the critiques
allord.
The point then, is not to suggest that traditional medical
Bi<)incdic;il revolution?
The development of reproductive technologies should not
Ire seen so much as a revolution but as a combination of the
prevailing 20th century scientific medical approach with in
creasing complex technologies, brom this perspective this
‘revolution- in techniques may not necessarily benefit those
whom it purpons lo iKiiclit: women. A true rcvolul on then for
young women of the Inline, would not lie a super d<‘vi lopincnl
of reproductive technologies as man triumphs ovei haiiiie (one
thinks of the sei fi scenatios conjured up by the pin: se lest lube
babies). Ralher il would Ik- a Immblei and mole wide sweeping
revolution ol changing the process of medical pract ce in older
to allow the subjects and consumers of these tech lologies to
determine its practice and use. Money devoted to the improve
63
Development 1990:1 - Journal ol SID
\T.
ment of medical technologies should be channelled into giving
young women access to better education, better public health
and awareness ol ilicir own bodies’ fertility and functioning.
To conclude slightly tongue in cheek, one further, even
more revolutionary step, would be to turn the focus away from
female reproduclivity to techniques tor greater choice and
control of men's reproduclivity. Pciliaps this is the future that
young women and men will Ik* determining.
Wendy Harcourt is Assix imc Ediior and Cooidinann oj die
women'spt oi>rafninc at SH > hitci natiomdSect etariat in Rome.
Notes and References
• See Michelle Slanworth, “Reproductive Technologies and the Deconstruction of Motherhood” in Repntductiw 7c< luu
(jcitdcr, Minhri hood ami Midintie
(ed) M. Slanworth, Polity Press, London, 1987, pp. 10-11.
1 Sec Janet Gallagher “Eggs, Embryos and Foetuses: Anxiety and the Law" in Slanworth (ed) Rrpradiictivc leehntdoffics, pp 138-150; Michelle Slanworth
"Reproductive Technologies and the Deconstruction of Motherhood” in Slanworth (ed) Reproductive Techmdoaies, p. 28.
1 See for example Brighton Women and Science Group (eds) Alice Through the Microscope (London. Virago. 1980); II. Roberts (ed) Women's Health and
Reproduction, London, Routledge and Kegan Paul, 1981; Corea, G. Duelli Klein, R. (el al) Man-Made Women: How New Reproductive Technologies Ajject
Women, London, Hutchinson, 1985; Arditti, R. Duelli Klein R. and Minden S. (eds) Test-Tube Women: What Future for Motherhood? London. Pandora Press,
1984.
4 Sec Foucaull. M. The Hirth of the Clinic , (I .i>ii<ion, Tavishfck. 1975; t •»»n< anti. M Ihstoi v nJ Sesmday ,
IViigum Ilks I .hl, l9/<», vol I, Saycis,
J., biological Politics. London, Tavistock, 1982; Amstrong. D.. Political Amitomy of the Body , Cambridge, Camlxidge University Press, 1983; O’Brien. M..
The Politics o/ Reproduction , I .ondon, Routledge and Kegan Paul, 1981; also I larcourt W. “Medical Discourse Relating lo the Female Body”, unpublished PhD
Thesis, Canberra. Australian National University, 1987.
* Rosalind Pollack Pelchesky, "Foetal Images: the Power of Visual Culture in the Politics of Reproduction" in Slanworth (cd). Reprodm live Terhnohniies,
pp. 57-80.
* Klein, R and Rowland, R., “Hormonal cocktails: women as test-sites lor fertility drugs". Women's Studies Intel national I- oium .Vol I2no3, 1989, pp. 333 348.
’ See " Our Health", Echo, Issue 9-10; pp. 10-17.
• Examples again from my own research are of the Fijian. Phillipinvs and Indonesian Governments Sec issues of Populi, Journal ol the I Iniird Nations Population
Fund for clear statements of encouragement. UNFPA and Finnida (Norplant is prixluced in Finland) are strong stip|»oilvrs of Norplant banned in almost all
countries in the developed world with the exception of Finland.
M Barbara Katz Rothman .The Tentative Prcf>nancy: Pienatal l)iuitno\i\ and the l uiiire of Moiln ihood. New Yoil.. Vd.iiig Penguin. |9X6
10 Hilary Rose. "The Politics ol Rvpioducfivc Science" in Slanwoilli M . cd . I\<i>iudm live I<•< luiuloi>ies . p In/. Wdli.imR I mcly, ( 'Inna's ()nc f luid Polk y
in (lender and Society . Vol 2 Number 2, June 1988. pp. 24 I -242.
64
Dcvclupineiil 1990:1 - Journal of.S!I)
The Role of Women in Building the Future
Eleonora Barbieri Masini
Eleonora Barbieri Masini examines Ihe ways in which
women influence the future as educators of their family and
conveyors of their own historical experience. Data and ex
periences are drawn from both North and South, and women's
influence is seen as deriving both from inter-generational
relationships and the historical process.
In examining the role of women in building the future, we
can describe women as:
(a) contributors to the economic structures;
(b) carriers of a specific mode of participation in fxiliiics;
(c) builders of an alternative fuluie;
(d) having an indirect influence on the future through the
new generations.
The women’s movement, which came into being at the end
of the 19th century and developed more dynamically after the
Second World War, has been a unique historical stimulant and
promoter of awareness of women by women, a process, which,
though at times not fully recognized, is nonetheless irreversible
and worldwide. The awareness that women have of their role in
society as mothers of future generations is evident in the in
dustrialized countries; it is becoming increasingly important in
the developing countries.’
Young people under the age of 15 today represent 22 per
cent of the 1,191 million inhabitants of the North and 37 percent
of the 3,836 million inhabitants of the South. It is important to
understand the influence on this vast population exercised by
women as mothers and the effect of that influence on the future.
The young of I lie North
This article focuses on the age group between 18 and 25. the
children of women now aged between 40 and 50, who were pills
and young women in the years following the Second World
War. These young people had their childhood in the 1970s and
Development 1990:1 - Journal of SID
hence can be seen loosely as the younger brothers and sisters
of those who participated in the years of great change and tur
bulence in the late 1960s.
In the 1970s. their elder brothers and sisters keenly felt the
influence of the events of the late 1960s and were socially con
scious. They fought to create a society that was diflcrenl from
the one in which they were living, and certainly different from
the society in which their parents had lived, and actively par
ticipated in the right to obtain more equality and justice in the
world, freedom of expression, information and political par
ticipation. They liked to work and live in groups and discuss is
sues and problems. They were concerned with the marginal
ized, the handicapped, the ethnic minorities. They worked lor
the Third World and were, without doubt major promoters of
the growing awareness of development issues in the I bird
World which we w itnessed in the 1980s.
This generation is now aged between 35 and 45. Although
some still cherish their ideals, they have for the most part been
co-opted by the present highly-industrialized society. They
have found jobs which arc perhaps not to their liking, but they
still maintain certain links with their past. Some arc in positions
of political and economic power, and continue to conlribule
elements from their own experience; yet, in general they have
abandoned the ideals of the 1960s and arc taking part in the
development of post-industrial society.
Young people between the ages of 18 and 25 were very
young at the lime of the more recent explosion of social and
political interest and involvement in 1977-78. They are. non
etheless. the childien of the late 196Os. I heir mothers aie the
women who lived through those limes of revolt and exhilara
tion, but this younger geiictalion has not been able to express
the same commitments not have they pailk ipaled in any ptcal
numbers in political activities. They find themselves in a situa
tion of gieal unccitainty which is linked to a dillercnl histori
cal moment.
If. lor example, we look al the employment stalisfii s. 19.2
IK’rccni of the active population in Europe of the age group 18
65
to 25 is either unemployed or is looking for jobs. These data
refer to ten nations of Europe and therefore mean that one in five
is unemployed. If we include Spain and Portugal, we see that
22.2 percent of IK Io 25-ycar olds are unemployed.
In Italy, 34 percent of the active population under 25 are
looking fm jobs, or have lost a job I bis irpicsrnls 1,17 I IMU)
ynung people In the I H-., it H IH p‘ »• • ul 11,1 'II.IMMI \ouup
people). In Hi*' I rdiuiil lb pnhlh oMI' imum. 10 I |" •' • "•
(503,000 young people), and In the USA, 13.0 pco« ul
(3,105,000 young people).
It should also be noted that many young people in Europe,
including Italy, have what are known as precarious jobs, which
means that they may earn wages but lack security in their jobs.
This situation certainly is not likely to give young people
a sense of confidence in lhe future. Although those between 18
and 25 continue to prepare themselves for the future through
education and alternative forms ol training, yet they appear to
have little confidence in society and what education can do to
prepare them for the future.
Research2-’ has shown that this generation docs not expect
much from the jobs that society will offerthem and is not great
ly interested in social or political commitments. Their interests
more often lie in sports, music, and in social contacts with their
peers.
A future fraught with uncertainly and the prospects ol
failure impels the young to cling to the present and seize what
it has to offer. The ulopian future their parents had envisaged
and worked for—a future of equality, social justice, etc. — has
not come into being and, in their opinion, is unlikely to do so.
The vision of their personal future and that of the society is
often dichotomous: their life is one thing, lhe future ol society
quite another. On the one hand, they see themselves following
in their parents’ footsteps, pursuing lhe same profession and
way of life, with little awareness that this no longer possible. On
the other hand, they have no great hope in the future ol society;
what they do see is the danger of national and internat ional con
flicts, the uncertainly of employment, (he precariousness of
emotions and family life.
How to solve this dilemma is a major issue for the young,
and we of the previous generation have done little to help them.
This, perhaps, may be attributed to the contrast between the
ideals cherished mainly by their mothers and the "real” society
in which they live.
A closer look at European students reveals considerable
awareness of the conflicts which exist at the international level
and the growing economic and social gap between the North
and the South. Some students from Northern Europe and f rom
my own country, Italy, still appear to have some social con
cerns, but they are in the minority and demonstrate only a vague
reflection of the commitment of their elder brothers and sisters
of the 1970s, and certainly of their mothers who believed that
change was possible. Is this lhe result of their mothers’ disil
lusionment? Although young women are aware of the victories
and conquests of lhe feminist movement, they realize that it has
failed to change society as a whole, which is still unequal lot
66
women and ollen cinel lowauls human Ix-ings in geneial. Hie
generation that I am describing certainly feels incapable ol
changing anything; the only iniricsl remaining is itsell.
i he. miii)! ul‘ llie ‘miilli
z\ I miipli !• Iv din. I. Hl ph mti • n»« M'l'S With n giud !.• lbsame gciivialioii ol young p< oplc horn the developing
counli ies. I am always sti tick by the strength and the deles mina
tion which is present in young |x:ople between the ages of IK tc
25 in the developing countries, in marked contrast to lhe more
selfish and hedonistic altitude of lhe young people in indusi'n
ized countries. What is clear is their determination to acquire
what was denied to their fathers and mothers, their non-accep
tance of lhe past and their firm belief that the future will at least
not be the same as lhe past. My views are based on my ex
periencc with students from developing countries, many from
Africa, at the university in which I am currently teaching in
Rome.
The same strength and determination is also apparent
among Chinese students, who are prepared to give up a great
deal and make many sacrifices to prepare themselves for enter
ing what they refer Io as lhe “outside world”. The more clear
ly voiced non-acceptance ol the past ol African youth and the
constructive atliludes of the Chinese are both strong promises
for the future. Thcic is of course a much greater need for
employment and education for lhe young in lhe developing
countries but in compensation, there is a strong determination
among young people to conquer their right to knowledge, to un
derstanding, to be part of the future.
Il is possible to detect here, as well, lhe influence of mothers
in Africa and Asia, and in particular China, who had no educa
tion and who are therefore very ambitious for their children.
Research has shown that they wish their children to be techni
cally equipped for an economically advanced society. History
seems to pass through the aspirations of mothers lor their
children and it is often they who influence lhe life choices of
their children?
S he very young generation
If we tumour attention to the very young, i.e., those between
the ages of 10 and 15, we sec that in the industrialized nations
this group spends moie hours in front of the television (han al
school. This has produced what Harold Shane has called “the
loss of childh(x>d by information, with information equal to
all"?
Whereas information from television— equally available
to all__ degrades critical altitudes, itcan also stimulate a desire
for knowledge. This generation, while very electronically
minded, has difficulty in applying itself, in reading, lor lhe
image has substituted for lhe wi illen word. What is lhe role and
inlluenceol women, of mothers? Are they, too. mesmerized by
Development 1990:1 - Journal ol SID
put>flC
lion. There is a distinct coni Het here.
.
The mothers of the young in the developing conn tries arc
those who must value, above all other priorities, those ol ced
ing and educating their children. This emerges clearly from
research in which I have been recently engaged for the Um leu
Nations University." The aspirations of the mothc.s ol th.
young people of the 18-25 age group in the developing nation',
are strongly motivated, first and foremost, to obtaining an
education L it is this priority which prrrduces the strength and
images? Are they awed by the electronic capacity of their
children? Or have they nevertheless been able to transm. to
their children the concern for. and greater scns.tivHy Io global
"^incxamining more closely the aspirations and the inner
feelings of these children, one sees a keen awareness of th
present and, even more so, of the dangers of the present and the
future, especially in relation to environmental tssues, wor d
conflicts, etc. There is both fear and hope, an awareness of the
need for solidarity between different cultures, and the desire
to find alternatives, as emerged clearly in a recent mee mg he
in Assisi, Italy, with images of children from
s ’f
(l,c wor|d — from about 30 countries — in a debate on the
fUtThe cultural level can still prevail over the technological
and economic levels, and the values, which are embedded n
what may be called the collective memory and which d nve
from mothers, seem to emerge and create a link with
ex
pcrience of the past as well as with the future. 1 his awareness
mises from those women who realize that there are problems
which go beyond themselves. e.g„ the destruct.on o the en
vironment and conflicts between regions of the world.
Women and the young
the world. It is their experiences, suffering and mstghts that
have an influence on the children. It is the direct or unconsc'ous
influence which we have to examine. The children of tl
mothers of the 1960s are uncertain and looking for security i
the material area, wanting more and countmg more on thcmsc ves than on sentiments. It could be argued that it is a general onal issue and, as such, involves both parents. But m mdustrial
society, it is still the mother who is most responsible fo I ansferrinfc values, fears and hopes. On the other hand, lhe chddrcn
of thedate 1970s are realizing, along wilh their paren s oa
more important than goods and services are environmental sur
vival and solidarity with those in need.
Let us examine the dynamics more closely in an effort to un
derstand. The mothers of the young of the mdustrmh/ca!
countries have grown up in a soc.ely winch, whde charat
terized by a number of movements (lhe women s moven ent.
the peace movement, the ecological movement, etc.), is also a
society of consumers and highly technological commiimca-
the determination of the young people in developing count, u s
and which influences them in their delenmnation to expres.
their needs and to fight for their rights.
Although it is undoubtedly important to look at the young
in discussing the future, this must lx- done by groups that me dll ferentiated, each having a different historical experience, a d.fferent impact from historical events, a different kmd of mHuencc from their mothers and fathers.
The impact of women is certainly great, for whether llxsc
women were girls in the post-war |x-ri<xl, in the turbulent late
1960s. or in the feminist years of the 1970s. they are the earners
of their own values, cxjxriences and historical changex.,
women specifically in lhe first three or five years rnithe life f
the child, as has been widely dixumcnted. who mllucnce
children through their way of being.
if all the different elements-historical, gcneratmnal and
even temperamental - are taken into account m looking at
the futurLrough the eyes of lhe young. H is very much the mfiucncc of women, in Icons of generation, but also in turn
their historical context which is im|mrtant. 1 Ins >s es|x<ia y
true for the mothers ol the past 40 years, for it ts they who base
experienced in these years the greatest process of change or
women in all of history. If the young are the mam actors of I
future the influence of their mothers and then way ol ex
periencing history will determine the attitudes of the young
mwards the future. The women of lhe 1980s. who have sear
ched for themselves.can well project, through ‘he'rchiKI.en an
alternative vision of the luturc, based on a search for equ.di y
and solidarity, litis might well represent the countervailing.! temative to the com|x litive. aggressive .society, which has been
(
dominant for the past 200 years.
Eleonora Barbieri Masini « Vi<r/’»
m of A/S/
at Ute Gh Ko'tana University. Rome. Italy.
This article is adapte.l from her eontnlmtion to the
pMicalitm'Tutuics”, I cbnidty 1^9.
Notes and References
‘ Elise Boulding.
of the 2ht Crn/nry.
|<»’ (4). August
.... ............................. . ............................
......... ......*......... ...........
................... .................... ........
67
Devrlonment 1990:1 - Journal of SID
Toll oj Horinjiil rractices
Zeiichcwork Ikrhane
National Children's Commission, Ethiopia
In the land of ethnic diversity,
with civilization adorned with variety,
traditional norms Ixistow life on one
and prey on others, sparing no one.
Where voiceless children are taken in stealth,
having no status or power to resist.
going through extraction of premolar teeth with nails and wires, or both,
my heart beats fast and I tremble,
shocked by the noise of a groaning child. 1 sympathize and curse.
Herbal potions and roots down the throat they force
as witches and frauds, who cure no disease
are the experts in these,
and are known for fatal cases,
Following the death of a baby they all cry.
To what avail is the ado, the sigh,
that mourning, that wailing, that lip biting,
when children die due to ignorance?
Practices like that of burning skins
or female circumcision and its akin,
they are too many to count or record.
May God protect us from actions of the ignorant!
A wedding day should be a joyful day,
with memories to be chei ished and recalled.
Behold, it can also be day filled with pangs of death,
for an innocent, infibulated girl.
What trauma! Hoping for sympathy, she appeals for help.
But how can they hear or respond.
Their inner eyes are veiled with custom.
She wears the same scar for a lifetime as her own mama.
Women, mothers of heroes,
women, mothers of scientists, researchers and all,
why should women suffer and go through pain?
Why should they die in vain?
U.C. 1.1, mMlmUm, I.
..........
Dcvclopineiil 1990:1 - Journal ot SID
68
COMMENT
Public Policy ©tvialan
Voluntary Health Association of India
Law Relating to Pre-natal Diagnosis
y n recent years the practice of Amniocentesis aimed at female foeticide, has become a flourishing
JL business. Thousands of such clinics have sprouted all over the country while the government has
turned a blind eye. In fact, the majority of such centres are set up in government hospitals themselves.
However, in April 1988, the Maharashtra Government enacted the Maharashtra Regulation of Use
of Pre-natal Diagnostic Techniques Act. What are the provisions of the Act and how effective will it
be in dealing with the problem? Nilima Dutta elaborates.
he Maharashtra Legislature
has taken a radical step by en
acting the Maharashtra Regulation of
Use of Pre-natal Diagnostic Tech
niques Act, 1988, which was notified
in the Maharashtra Gazette on 28 April
1988 followed by the Rules notified
on 7 June 1988.
Purpose of Statute
The female foeticide
which this Act strives to
abolish is still possible
under the MTP Act.
which defines a pre-natal diagnotic test
is not an exhaustive definition. It men
tions the current range of tests used to
detect genetic or chromosomal or
metabolic disorders or other congenital
diseases. Therefore tests are not li
mited only to those mentioned but
would include other pre-diagnostic
tests as well.
Regulation of Centres
The Preamble to the Act which in
Only registered genetic centres, labo
a succinct way reveals the purpose
ratories or clinics can carry out pre
of the statute states that the Act has
been passed for the regulation of the accuracy. However, for sex determi natal diagnostic tests. The Appropri
use of medical or scientific techniques nation, even the uncultured amniotic ate Authority has discretionary pow
of pre-natal diagnosis, solely for the fluid is studied under the microscope ers regarding registration. These regis
purpose of detecting genetic or meta as the X or ¥ chromosome tells tered centres cannot use the services
bolic disorders or chromosomal ab whether the foetus is female or male. of persons including gynaecologists,
normalities or certain congenital ab Chorion Villi Biopsy is another test who do not possess the medical quali
normalities or sex-linked disorders and for chromosomal abnormalities done fications prescribed in the Act itself.
for prevention of the misuse of these during the eighth week. These impor Further, the qualified medical person
techniques for the purpose of pre tant diagnostic tools used to deter has to carry out diagnostic tests only
natal sex determination leading to fe mine sex-linked genetic abnormahties in a place which is registered under
male foeticide and for matters con such as haemophilia or Down’s Syn this Act (Section 3) (See Box). Rule
nected therewith or incidental thereto.
drome, where the child would be born 20 makes it mandatory for the quali
mentally
and/or physically retarded, fied medical person to locate the foe
From the title and the preamble
of this new piece of legislation, it is have been clearly misused to carry out tus with an ultra-sonography machine
clear that the Act does not ban pre selective abortion of even healthy fe before doing any tests or procedures,
natal diagnostic techniques but only male foetuses. Surveys conducted by in order not to damage the foetus.
regulates the use of the latter to cases various groups at clinics where such Regulation of Pre-natal Tests
where genetic abnormalities are sus sex determination tests are carried out
A registered Genetic Counselling
pected. Secondly, the Act valiantly showed that women and even their Centre, clinic or laboratory' cannot be
family
members
are
not
aware
that
tries to prevent misuse of these tech
used for pre-natal tests unless one or
niques for pre-natal sex determinatio.i, pre-natal diagnostic tests can be used more of the following conditions are
particularly amniocentesis which on to detect genetic abnormalities.
present.finding of a female foetus would lead
1. The pregnant woman is over 35
to termination of the pregnancy by de Pre-natal Tests Defined
years.
liberate abortion. Amniocentesis in
Section 2 of the Act provides defi 2. She has a history of two or more
volves the removal of a small amount nitions. For the first time, genetic abortions or foetal losses.
of amniotic fluid from the sac by in counselling centres, geneticists, pre 3. She has been exposed to terato
serting a long needle through the ab natal tests and procedures have been genic drugs, radiation infecupn or haz
domen of the pregnant woman, and defined. Section 2(i) says that pre-natal ardous chemicals.
culturing the cells for about three diagnostic procedures means any proc 4. A family history of menial retarda
weeks for chromosomal analysis.
edure which involves testing the tis tion or physical deformiues such as
Amniocentesis is usually carried sues of a pregnant female for carrying spastic or deaf-mute child or any other
out after 16 weeks of pregnancy for out tests on the foetus. Section 2;c) genetic disease.
The Lawyers August 1988
VolihZ ’.i v i Icairh Ar-sociatioE of Indk
35
J
COMMENT
nancy constitutes a grave injury to the
seems laudatory but a closer analysis
health of a pregnant woman.
5. Any other condition approved by
reveals lacunae. The pre-natal diag. nostic tests are to be used only for Conflict With MTP Act
the appropriate authority.
that pre-natal
.on of certain abnormalities, geSection 4(3) states L
Clearly an anomalous situation ex
diagnostic techniques shall
' -----------be carried
netic diseases and similar problems
ists here. On the one hand, the Ml 1
out only for the purpose of detection1 which would affect the normal physi Act allows abortions on the grounds
of any one or more of the foUo^8 cal and/or mental development of the of contraceptive failure and on the
abnormalities i.e. chromosomal abnor foetus. Women over 35 years of age, other, these very legally sanctioned
as has been medically proved, are in abortions become a ground for pay
malities, genetic metabolic
a greater risk group of having
haemoglobinopathies, sex-linked ge
ing the use of pre-natal diagnostic tests
netic diseases, congenital abnormali healthy, normal baby. Any woman which are otherwise forbidden to a
ties or any other abnormalities or dis over 35 years, can under family pres
pregnant woman. Very often, people
eases declared by the appropnate sures, always make a statement of hav don’t bother to use contraceptive de
authority. These procedures or tests ing some genetic disorders in hei: fam- vices for several reasons, psychologi
cannot be carried out unless the per ily to get the tests carried out. A his cal, sociological or sometimes medi
son qualified to carry out such tests tory of two abortions or foetal loss cal resulting in a woman resorting to
has obtained the consent of the also entitles a woman to have a test
abortions as a means of contracepwoman patient after all the possible done. It is quite common for a worP^ tion. Doctors working in government
side effects and after effects of such to have two or more abortions when and private hospitals have cited in
she wants to terminate her unwanted
procedures are explained to her
stances of women, pregnant beyond
20 weeks, asking for abortions which
pregnancies.
Here, the Medical Termination of are carried out by inducing labour, re
Sex Determination Tests Prohib
Pregnancy Act, 1971 plays a guilty ro e sulting in the birth of premature ba
ited
as it legally sanctions abortions upto bies who are then callously left to die.
Section 5(1) prohibits the use of twenty weeks. Section 3 of the MTP
Section 4(2)(ii) could have been
nre-natal diagnostic techniques includ Act permits abortions by registered
more expUcit by stating that a woman
ing ultra-sonography for the purpose medical practitioners if they beheve
with a history of two or more sponta
of8indicating the sex of a foetus with
that the continuation of the PreSnancyf neous abortions or natural miscar
or without the posstMe ob)ecl °{
would cause grave risk to the life of riages only, can be a candidate for
male foeticide. Secuon 5(2) P>^ubl‘s a pregnant woman or grave injury
pre-natal diagnostic procedures^
advertisements by centres, laboratofor her physical or mental health. Accord Women who have had two or more
ries or clinics about procedures 1ing w the MTP Act, failure: of a con Znions under the MTP Act must
pre-natal prediction of sex.
traceptive device or method used by have certificates showing the reason
any married woman or her husband why the abortions were carried out.
The Loopholes
which results in an unwanted pregThe purpose of Section 4 and 5
' <l“ Maharashtra Regulation of Use of Pre-natal
Excerpts from
Diagnostic Techniques AcU
laboratory, clinic gynaecologist, medi3. Regulation of Centre, Laboratory,
Clinicand Pre-natal Diagnostic Procedure and Techniques
(B No Genetic centre, laboratory or
clinic, or place, unless registered under
this Act, shall carry out or associate or
help in carrying out acuv.ties relating
to the pre-natal diagnost.c
with the help of procedures such as Am
niocentesis, Chorionic Villi,
or
any other pre-natal diagnostic technique.
(2) No registered centre, laboratory
or clinic shall employ or take s«rv'“I’
whether honorary or on payment, from
persons, including Gynaeco^ogtsts
ho
do not posses the prescribed quabfica
tions.
(3) No Medical Geneticist or Medi
cal Practitioner or person shall carry
out or help in carrying out or cause to
carry out either himself or though his
assistants, agents or associates, my pre
natal diagnostic technique at a place
other than a Geneuc Counselling Cen
tre, a Genetic Clinic or a Geneuc Laboratory registered under this Act.
ratory, or clinic.
““”jVNo person or members of family
(3) No person
of
ale shall seek to get
of a pregnanI
pregnant fem
f-----the pre-natal diagnostic procedure
a purpose other t— (1) No GeneucCentre
Counselling Centre, m Sub-secuon (3) of Seen ----- ----------
5. Prohibition of pre-natal diagnostic
techniques for certain purposes.
The Lawyers August 1988
36
diagnostic techniques including ultra
sonography for the purpose of indicat
ing die sex of a foetus with or without
the possible object of female foeticide.
(2) No centre, laboratory or clinic
shall give advertisement in any manner
regarding facilities of pre-natal Prc<{^‘
Jon of sex available at the centre, labo
I COMMENT
If it was on grounds of contraceptive
failure, the kind of contraceptive used
and reason for its failure must also
be recorded. Of course, none of what
has been stated above is aimed at con
demning the woman who usually is
a victim of her circumstances. After
all, if husbands and other family mem
bers welcomed the birth of a child,
irrespective of its sex, the need for
legislation such as the current one
would not arise.
Informed Consent
Section 4(4) is valuable. It makes
it mandatory for the person carrying
out pre-natal tests to obtain the “in
formed consent” of the woman. In
formed consent is an important con
cept - it means a woman is a knowl
edgeable and voluntary participant to
the invasive procedures carried out
on her body. She should be aware of
the possible after effects and side ef
fects - the risk of spontaneous abor
tion of the foetus, chronic backaches
and other ailments. Prior knowledge
of such unpleasant side-effects may
be a crucial factor for the woman to
decide whether she wants to partici
pate in sucn tests. An undertaking is
also required from the woman to the
effect that she will not terminate the
pregnancy if the diagnosis shows the
possibility of a normal child of either
sex.
Section 5 which prohibits tests used
for the purpose of indicating sex can
be easily circumvented because the
tests including ultra-sonography can
be asked for on grounds of ignorance
about the possible date of conception.
Under the guise of determining foetal
age, ultra-sonography may be used and
thus an unscrupulous medical practi
tioner may roughly be able to predic*
the sex of the unborn child, making
this legal provision redundant, al
though one of the Rules state that a
person who is in charge of a centre,
laboratory or clinic has to undertake
not to disclose the sex of the foetus
to the patient or her relatives.
Vigilance Committees
The Act doesn’t leave room for the
self regulation of centres using pre
natal diagnostic techniques and pro
cedures. Under Section 13, the State
Government has to appoint a Vigilance
Committee consisting of persons from
several fields and also includes medi
cal personnel. The functions of the
Vigilance Committee are stated in Sec
tion 14. These are quite wide ranging
and adequate, for they authorize the
Vigilance Committee to do the follow
ing necessary acts essential for im
plementing the provisions of the Act.
i) pay periodic and surprise visits to
the centres, laboratories and clinics
to check whether the provisions of the
Act are being complied with.
ii) to investigate complaints from the
public, press or Institutions about vio
lations.
iii) to seize incriminating evidence or
records for taking appropriate admin
istrative or legal action.
iv) to recommend to the Appropriate
Authority, the cancellation of regis
tration or prosecution of a centre, labo
ratory or clinic.
v) to check and prevent unauthorised
centres, clinics or laboratories.
vi) to take such action as the State
authority
government or iappropriate
.. .
may direct.
Punishment for Offences
A statute such as this has to nec
essarily be a penal one. The penalties
for offences committed by medical prac
titioners who have forgotten the Hip
pocratic oath are quite heavy. Medi
cal personnel who are qualified in the
manner described in this Act, shall,
for committing an offence under this
Act be punished on conviction, with
at least 1 year’s rigorous imprisonment
and fine of a thousand rupees or more.
The conviction may extend to 3 years
RI and fme upto five thousand rupees.
The name of the medical person shall
be reported to the State Medical Coun
cil who may take suitable action such
as suspension of the name from the
register for 2 years for the first of
fence and permanent removal for a
subsequent offence.
Section 19(2) also punishes any per
son who brings a pregnant woman for
pre-natal diagnostic tests for any pur
pose other than for detection of con
genital or other rabnormalities. This
is a negative wa^of stating that any
person who brings a woman for such
The Lawyers August 1988
Public Policv DWsioifi
Valuo’. •’'' i f
• *-•‘‘•sociatioE of Ind&
tests, for the purpose of determining
the sex of the child shall on convic
tion, be liable for rigorous imprison
ment between 1 and 3 years and fine
between Rs. 1000 to Rs. 3000.
There is a saving clause for the
woman involved. It is presumed that
she was compelled to undergo such
tests by her husband or liis family mem
bers, unless this presumption is re
butted by proof. However, on a con
viction of the woman’s family mem
bers, the woman is unfairly fined Rs.
50. The offences punishable under Sec
tions 19(1) and 19(2) are cognisable,
non-bailable and non-comiToundable.
Like other statutes which were en
acted as social welfare legislation this
one too should not remain in the stat
ute book. The Vigilance Committee
has to be really vigilant, constantly
monitoring genetic centres, laborato
ries and clinics, irrespective of how
reputed the name of the gynaecolo
gist or geneticist who owns and man
ages it is. Records must be scru
pulously examined and duplicate cop
ies of pre-natal diagnostic tests and
procedures duly attested with the veri
fication by the pregnant woman on
whom carried out must be immedi
ately filed with the Appropriate Author
ity.
The female foeticide which this Act
strives to abolish is still possible un
der the MTP Act. A woman can be
made to undergo pre-natal diagnostic
tests if she can be brought into the
acceptable categories defined in Sec
tion 4. On finding of a female foetus
she can easily have her pregnancy ter
minated legally by the twentieth week
of the pregnancy under the MTP Act.
Stranger still is the existence of the
MTP Act which merrily allows foeti
cide as a method of contraception
since the Rules under the MTP Act
are not stringent. Doctors do not re
cord the exact age of the foetus at
the time of abortion, the method of
contraception used and reasons for
its failure, whether the abortion is be
ing asked for as the pregnant woman
apprehends genetic abnormalities be
cause of the family history, or because
the couple have already found out the
sex of the foetus and are aborting it
because it is fernale.
37
i
ahari”. C-46, East of
630091
.1 New Delhi-65
y-:
»
''
PRESS-CLIPPING SERVICE
“Harl Bhari", C-46, East of Kailash-I, New Delhi-110065
Name of the Paper
:
national herald
Published by
l
NEW PELHI
^4 SEP 1990
Dated
SicheckBemale
:Ahe"Gpi!emmint:. towards Mhe
increasing female foeticide- and J
7 urged it to take welfare measures -JI
«&She spolcTof.the.wiSfga^
■-between the;tmale-female..;ratio3
Srid said that in .1981 there werel
-. 934 females to 1000 males #Wt1l
• tiles Ministry had a proposal to }
dispose of- land belonging to^.
National Textile Corporation.
Mills. •
Mr Sunil Basu Ray. CPI-M,
-called for reviulising the Cycle
' Corporation of India in AsansoL
■
' • Mr S.P. Malaviya. Janata Dal,
called for immediate implement
tation of the Gujral committee
report on Urda He was suppor
ted by Mr Khaleelur Rehmaa'
Telegu Desam, who felt that the
Cabinet should t immediately«
accept the report as it was all 4
complete setting up the expert >
committee to review the findings ■
would only lead #to delay, no
added.
,
Mr* Chandresh P. iThakur, i
Congress, said the Government
should assure that the students
would not lose an academic year
due to the anti-reservation stir.
Mr Ajit PX JogL Congress,
said that lakhs of tnbals had not
been disbursed profits earned on
the sale of tendu leaves tn
Madhya Pradesh.
Dr Ratnakar Pandey. Con
gress. called for a probe of a Rs
‘ 12 000 crore excise scandal
involving steel manufacturers.
(City Edition)
"t
_______
HEALTH O- FTTTJESS
s
IF
t
. t r.
I
I
N official bill seeking •
to ban the misuse of
medical techniques like
amniocentesis for sex
prediction and. subsequently for
female foeticide was introduced on 8
April 1988 in the Maharashtra legisla
Doctors admit that
tive council. The bill also intends to
regulate the use of these techniques
most couples
and analysis of samples obtained
seeking
from them solely for prenatal diagno
sex-detection
tests
sis of genetic deformities, to genetic
counselling centres and genetic
want to get rid of
laboratories specifically licensed for
female foetuses
this purpose. If the bill is finally
passed. Maharashtra would probably *
become the first state in the world to
enact such a law.
However, the distinction is du
Pre-selection are notable exceptions.
bious, because nowhere in the world
So,
in the absence of any self
are these techniques being misused
regulating mechanism within the
on such a large scale by the medical
medical profession, a legal regulation
profession, for a purpose not listed in
is inevitable.
any medical texts. And no other state
The utility of legislative means in
has such a roaring 'sex prediction'
curbing social evils like 'female foeti
business as Maharashtra. Most dis
cide’ is often questioned. No doubt
tricts and small towns in Maharashtra
the final solution of the problem lies
have 'sex prediction centres', run by
with the creation of an egalitarian
doctors,
usually
gynaecologists,
society, in changing the values and
often without scientific training in the
attitudes of the people. Hence the role
use of amniocentesis and most often
of education and awareness creation
without the provision of ultrasonic
cannot be belittled. However, one
cover. According to a study commis
cannot simply wait for social reform
sioned by the Government of Mahar
to take its course, because the sex
ashtra and carried out by Dr. Sanjeev
ratio in India is adverse to females
Kulkarni, of the Foundation of Re
search in Community Health, Bom- • and it has been continuously declin
ing in the last eight decades. (1901:
bay, 85 per cent of the gynaecologists
972, 1981: 935 females per 1,000
in Bombay are involved in the sex
males). Further, proliferation of sex
prediction business, leading to appro
prediction technology might precipi
ximately 40,000-50,000 such tests
tate further demographic imbalances,
being conducted every year, in Bom
leading to grave social problems.
bay alone.-Doctors admit that most
Progressive legislation can at least
cappies seeking the test intend to get
curb female foeticide. Moreover, doc
rid of female foetuses.
tors being extremely concerned ab- ■
The bill is a response to the twoout their professional reputations
year-old campaign launched by the
would, by.and large, obey the law.
Forum Against Sex Determination
Hence,
progressive
legislation,
and Sex Pre-selection, Bombay. It is
although not sufficient, is indispens
widely ‘supported by the press and
able. Under the proposed Maharash
people from £11 walks of life. It is sad
tra Regulation of Use of Pre-natal
but true that the large scale violation
Diagnostic Techniques Act, 1988, pre
of medical ethics has continued
natal , diagnostic procedures like
almospunchallenged by members of
amniocentesis will be permitted in
the medical profession. Some senior
Maharashtra only for the detection of
members have even defended this
genetic or metabolic disorders, chro
misuse of medical technology. Mem
mosomal aonormalities or sex-linked
bers of the Organization of Doctors
disorders '• in specially registered
Against Sox Determination and Sex
4®,
R.P. RAVINDRA
64
2C;t.MAY19SS
genetic centres, laboratories, clinics
and hospitals.
This bill puts the onus of proof for
the offence of the selective abortion i
of female foetuses, not on the woman |
but on her husband and members of I
his family. Offenders face rigorous
imprisonment from one to three
years and a fine varying from Rs.
1,000 to Rs. 3,000. If in a particular
case, a woman is proved guilty a fine
of Rs. 50 on her as abettor to the
offence has been provided.
This is because the woman under
going a sex prediction test is a victim
of the system and not the real perpe
trator of the crime. Undergoing the
test is not her independent choice but
an act compelled by pressures and
threats. So such a woman should not '
be punished by law.
According to the bill, medical gene
ticists, gynaecologists, registered
medical practitioners or anyone own
ing centres, laboratories or clinics, or
employees of one, who perform an
abortion with the specific knowledge
that it is the abortion of a female
foetus, are also punishable with one
to three years of rigorous imprison
ment and Rs. 1,000 to 3,000 as a fine.
Institutions permitted to carry out
such tests will be registered with the
State Appropriate Authority. This
body will consist of six official mem
bers, including two representatives of
voluntary organizations and two exofficio representatives. The authority
which will have some powers of a
civil court, will examine, grant, and
renew applications for registration.
Centres, laboratories and clinics are
specifically prohibited from advertis
ing any facility or test available for
predicting the sex of the foetus.
To prevent abuse or misuse of tech-1
niques for sex prediction, an even (
more stringent penalty has been soe- i
cified—the suspension or cancellat’cn :
of the licence of the concerned meux- •
al practitioner.
However, to ensure ihat the b’ll •$ |
not misused, adequate representation •
from voluntary organizations may be
needed to monitor the functioning of
genetic laboratories, even at district
levels.
' ,
_ ____ '
joumal of Pointes <x busmj
P-
Published at
I BOMBAY
WK’
Dated
I.
• - ti
'A
fens’
OUR ardent,
feminists
are racing
to another
Pyrrhic
victory. The
monsoon
session -of
parliament
will outlaw
| prenatal tests to reveal the sex of
I
an
unborn
child,
because, if
•*".
I such tests show that the child
will be a girl, they are nearly
always followed by an abortion.
Undeterred by the spectacular discretion to tell or not’, she said.
failure of the ban Maharashtra
When told that the family did
imposed in unseemly haste'in
not have any history of genetic
. 1988. Taradevi.Siddhartha, the abnormality’ she sai<£ ‘the
union health minister, has patient will have to write
decided to thrust a similar whatever history of abnormality
prohibition on the entire
I will write'. When asked
country.
whether this would not lead to
Our governments and our problems, she said, ‘There are
legislators have a touching faith
so many patients who come
in new laws. They enact a law
here, it can be anybody. How can
and at once imagine they have
they check?’ She charges Rs
licked the problem. So it was
3500 for the genetic analysis’.
with the drink evil and
You may find this hard to
prohibition: so it has been with
believe, but Dr Purandare had
the dowry ban; so will it be with
been
on
a
government
Taradevi Siddhartha’s
fiat
committee that unanirMusly
against sex
determination
supported the ban before it was
testing. Having pushed the bill
legislated. You see now what
on to the statute book and made
might have prompted her
testing a crime, our rulers will
support The act must have
sit back with the feminists in
reinforced her devotion to Hie
smug satisfaction.
Sixteen
ban, for live government
months after Maharashtra
thereafter appointed her to an
enacted its law. The Times of- implementing committee. The
India reported that the act
appointment
understandably
remained on paper, gathering
roused the wrath of the Forum
dust.
Against Sex Determinatic-n. as
Have w e asked ourselves who
The Times of India reported in
will benefit from a sex
January 1989. Meanwhile, the
determination test ban? Not the
prices for undercover sex
parents of an unwelcome child.
determination
testing had
Surely not Lhe unfortunate child
soared. So had the profits cf the
herseif. Before her lies a grim
likes of Dr Purandare, of whom
prospect, a life that promises
the press discovered large
little more than misery. You
numbers in and around Bombay.
think of Aldonza's cri de coeur to
In the end, though, such
Don Quixote: 'You know the
flourishing practices may not
worst crime of ail? Being bom.
deserve the blind censure that
For that you get punished your
the press reports have implied
w hoie life’. Thai is Lhe future we
(even if you might regre*. the
offer millions of our women.
boost the Maharashtra law pre
But yes. there will be
them). What future lay before
beneficiaries of Lhe new law. a
those foetuses had they not been
whole
lot
of
grateful
aborted? What does our society
beneficiaries. Here is a story a
effer its unwelcome girls? Look
Bombay eveninger published
at what we do to them.
six months after Maharashtra
.Near my home in Bombay a
imposed its ban: "Dr Hema
couple of girl babies were found
Purandare. who runs a clinic in
in a garbage dump two years
Bandra (V.’est) [a Bombav
ago. abandoned by their
suburb], when approached by
parents, and dead. Babies are
this correspondent, who said
similarly abandoned all over the
her sister wished m go in for the
country, nearly ail of them girls.
test,
said
though
sex
Tn most parts of the country', a
determination
tests
were news magazine reported three
banned, ‘an overall genetic, years ago, ‘a woman is st3 an
analysis couid be d ine. We will
appendage... Her birth— is
communicate L'.e sex of the
greeted with silence, even
child orally to the family doctor
sorrow. A bov arrives to the
(who had recommended Dr sound of joyous conch shells.
Purandare) and it is her Discrimination begins at birth.
takes a lot 6f effort to persuade
the police to act in such cases.
Male-dominated as they are.the
police tend to look the cdter
way, at most to treat a hide
murder as an accident cr a
suicide. One of these happened
in a civil servants’ colony near
myhomeinApril 1989. Ituxian
aggressive intervention by the
local feminists to* rouse the
police belatedly from their
apathy.
With this trend toward
barbarity rising inexcratiy,
dubious
and
irrelevant does it make sense to insist that
advantages as a pale skin may parents must have children of a
reduce the price demanded.
sex they do not want and c-hen
The 1984 legislation against cannot afford? The Forum
dowry
has
made
little Against Sex Determinadco is
difference, even at levels of sure that it does. It is cochoent
society from which education that our society can tackle me
should have banished this dowry issue, a confidence few
repulsive practice. A 1987 report will share.
by a set of lecturers at the IAS
Happily for the unborn chad,
training school at Mussoorie sex determination testing ■vj]
revealed the shameful fact that scon move beyond the reach of
the majority of male IAS recruits the laws our feminist reafcis
demanded dowries ranging want Female foeticide, which
from 15 to 50 lakhs of rupees. offends their susceptibuhies,
These are the men who are may become unnecessary.
going to implement our laws, Amniocentesis, which reemres
including the Dowry Act.
..-U1UUH.- W1
the Uinsertion
of ua needle M
to
Dowry demands don’t, of withdraw from a prexxant
course, end on a bride's wedding uterus about a cubic inch of ±e
day. They may continue for amniotic Quid that envekees
years after, reinforced by the foetus, may. regain As
*!1 •
ill-treatment
of. the bride and original function of warr-h-r a
... - ----------- w
physical violence. Again, it is not mother about deformities ± ~e
j
L...i
i_ who she
carrying. Sex
just uneducated
husbands
beat their wives. An IAS joint determination is becocmg
secretary to the Maharashtra possible without puncture or
government had to be arrested tears.
in 1989 for torturing his wife.
In essence, lhe new techmme j
Quite a few wives must count involves
a
centnh-gai
themselves lucky if they are separation of male-prcdacmg i
merely beaten. On the union Y-chromosomes
frrra
home
minister's
own female-producing
admission, dowry deaths rose to X-chromosomes; the chosen
4.006 in 1989. from 1,912 two combination is then implamed
years ago, an increase of 110 per into the mother artificialiy. Dr
cent
Ronald Ericcson, a reprodixxwe . •
Here are a few mile* ones in physiologist, has already setup a ’I
this ghastly story of oppression:
clinic appropriately equipped at <
August 1937. A Bihar farmer Chami Road. Bombay. Sex ;
hacked
his
three
minor def erminalion before concezam
daughters to death to escape destroys one of the pro-Sfe
their dowry requirements.
lobby’s
most
powerial
February 1988. Three sisters, arguments.
between 18 and 23 years old.
But until such technkmes
hung themselves in Kanpur become widely available, new
because their middle class laws will have worked urrSd ;
parents could not afford the mischief. They will have urwen
dowry demanded for their sex testing into the' hands of 1
marriage.
quacks,
whose
covert
November
1988.
Four operations will wreak haw.
daughters of a Kerala policeman whose profits will soar ai-eez
ended their lives for a similar with those of lhe Purandares a'
reason.
our country, the relatively ;=w
Christmas 1988. Three sisters qualified physicians who defy
in Jeypore, Orissa, killed
the law with impunity.
themselves to relieve their
We should deplore the :
parents of the dowry dilemma.
attitudes that prevail in tor ,
Less
spectacular.
less society, the attitudes that shrizi ;
newsworthy sacrifices to the from female offspring and j
pernicious dowry system occur persecute women. It is stumd
all the time, and it generally ignore those attitudes.
It is foolish to enact laws banning sex determination tests while
ignoring the attitudes which persecute women, writes J B D’Souza
AVINASH GODBOLE
Girl babies are breast-fed less
frequently, and for a shorter
duration than boy babies... 71
per cent of females suffered
from severe malnutrition, as
acainst 28 per cent of the
males... Boys are taken to
hospitals for treatment of
common diseases in twice the
number as girls. Boys do not fail
ill more frequently than girls,
they are merely provided with
more health care by parents,
who value sons more than
daughters’.
The
bias
against girls
continues with equal vigour
when those who survive their
infant
miseries
reach
school-going age. In primary
schools, to every ten boys that
enrol, there are only seven girls.
Secondary education is still'less
even: pris number only a third
o; the enrolment. .No wonder
then that of the 424 million
women in India no less than 500
million are illiterate. For men,
the illiteracy figure is 183 out of
456 million, or 42 per cent
0 who cares if Indian girls
^^remain
illiterate
and
uneducated? Theirs not to
reason why. theirs but to do and
die. And that is precisely their lot
when they reach nubility. Then
—often much earlier—starts thefrantic effort to marry them off.
Mostly, the success of that effort
depends on their prospective
husbands’ intangible assets—a
green card for stay in the L’S. a
government job. a medical
degree—and only minimally on
the girl's qualities, where such
IT
4
MID-1
‘ Name of the Paper
ii:.' published by
aT"’
Dated.
’0HHA
ecial Report
amHypTonning or murder?
J
■ri
. middle-aged .woman,
But coming back to the con
L
H
—5-‘- the
—
by a gynaecologist couple in Am- , though they might not state mis troversial amniocentesis tests
anonymous,
twists
ritsar The‘miracle tests”, as they openly. Even in post- Cultural another
---------- method
, used is the CV
pallav of her sari before replying.
Revolution China, nearly 45.000 biopsy which is more expensive,
began to be known, became ex female
*T don’t know... my husband
foetuses and newly-born costing between Rs. 1,200 to Rs
tremely popular -and spread all
’brought me here to carry out
X
killed—
evepr
over,B,the^co^V
the country by rword-ofword-of- giri
yjM babies were ------/ ' year , 1t500, involves tests torsonog
some test to find out whether I m
mouth and sexist advertisements. There, abortion is not only legal- rap
hy, chromosomal and bio
raphy,
carrying a boy or a girl. My in
One such ad was captioned: b’ut officially condoned as .an ef- chemicaJ disorders.
a
laws want me to bear a boy so
“Spend Rs. 500 now to save ”
Rs. fective instrument of birth control higher success rate of 98% Unthat he can carry on the name of
5 lakhs later”, thereby implying and the policy of one-chiid-per like the amniocentesis tests which
the khandaan. I already have two
the
enormous dowry given to a family is rigorously enforced. Its are conducted only in an yd
daughters and I don’t think we
daughter
on her marriage could an uphill task in India since the vanced stage of pregnancy, the
lean afford another one. After all,
be saved. Naturally, keeping In society has preconceived ideas VCB is done when toe foetus is
girls are liabilities, aren't they?”
view the socio-sexlst bia_s in our about women being interior to only between eight to eleven
Her husband, sitting beside her in
men.”
weeks old. Ultrasonography was
country,
people began flocking to
toe waiting room of the clinical lab
• also being misused. The Enkson
toe clinic, gradually, several such
.
in West Patel Nagar. tactfully
I
• clinics opened in major cities and
Qn the other hand, there is a Method, which entails toe separa
shuts her up before she can say
j
tion
of
toe
chromosome
and
artifi
sex determination of foetuses and strong lobby of doctors who see
'anything more.
their subsequent abortion became the sex-determination tests and cial insemination-, was also
- being
■’Another time, another place,
---“
subsequent abortions as an effec- practised by hatf-a-dozen ooctors
aracket.
\
j This time it’s Bombay’s Andheri
in °
Bombay
before a ban was im—
What exactly is an amniocen live method of family planning, iI colony, where another woman exoosed.
■
Says Dr. Dana Pai, director of posed.
tesis test?
abplains why she’s there. ‘Arre
Pearl Centre Clinic of Bombay,
ffiphai, it's so simple. After toe docit
is
interesting
to
note
thai the
In the 16th or 18th week of
which conducted such tests till sex ratio in India has been going
’ tor sahib finds out whether the
pregnancy, a needle is inserted
recently: ‘If one cannot afford to down against women ovec the
| child inside me is a ladki or a
into the womb and the amniotic
child in a decent ue^s. |n the 1981 census it was
: baba, we shall .make up our
fluid, about 15 cc, is withdrawn bring up another
it is better not to have
wqjpen: 1,000 men. V/rth
•1 minds. We are from a middle- • from the sac. Subsequent lab way? then u
class family and find it difficult to
tests conclusively (success rate toe child at all. There are 200 mil- selective abortion becoming com
i make both ends meet. After all,
97%) determine the sex of toe un- 1|on orphans in our country whose mon and instances of female in
■ who doesn't want a boy? He
born child. At this advanced stage parents are either too poor or fanticide, particularly in nwal
j brings in dowry and supports his
of pregnancy, abortion becomes lackaidascal to provide them with areas, the ratio could come down
j parents in their old age. On the
as 900 wornen: 1,000
risky since the foetus is too big to the basic amenties. Unwanted to
: other hand, a ladki is paVaya
babies must be aborted. The con men by the turn of toe century. As
be taken out by the suction
cept of two and no more’ needs a result of to® practise, of female
from lhe
.u l’m0 she
t .u is method. Consequently, the risk of
to be populari&ed. I am a strong infanticide, to® Bhati community
poor methor
mother and
and father
father infection is also greater and there
^^rfsaving for her marriage."
have been several cases of sep- protagonist of sex determination jn jaisalmer has, wha! is probably
the lowest sex ratio, anywhere in
I
Discrimination against women,
sis forming in the reproductive tests".
I thus,, beglhs
begihs in the womb itself. It
tract causinq permanent damage
However, what is alarmng is the world at 550 women: 1,000
js
is now
to predict with al
al- to the reproductive organs.
that this kind of selective abortion men. it has been reported that
<
_’x
'• t. r\c>r.t __ _____ _ .
most
Sfeit-pi^ntaccuracy
the
is being publicised as an effective tfea^y 50 newborn girls were
Recently, Maharashtra banned
.sex
,sex of an uflBofh child. The
in the family of an MIA of
method of family planning even
all pre-natal diagnostic techniques
process is called amniocentesis
for the past swaraj
by some government agencies. Bharatpur
'
used solely to determine the sex
by Which
which the sex of the foetus can
The average Indian woman on generations. Female infanticids Is
of the foetus. Under the new law,
be established, and if so desired,
undergoing”the cyde of concep- also common in Gujjar farrifias to
procedures such as amnjocem
abortion carried out. These tests
tion-abortion-conception, till she is Rajasthan and in the Kallar comtesis will be permitted only to
. w,ere initially done to detect
detect cenain foetal
abnor not ‘blessed" with a son, be- munity of Madurai district in Tamfl
enetic disorders but are, today,
comes a physical and mental Nadu.
eing blatantly misused by un-. malities, and all dinics or hospi wreck. The misconception that
Until attitudes change, the situa
tals which conduct such tests
•crupulous doctors to make a
girls are the “weaker sex“ has tion will become even worse.
must be registered with the state
quick buck and who are cashing
been exploded in Kerala which is despite the undeniable fact that
government. However, the ban
, "In one the fact that male offspring
has only pushed such tests un the only state where the sex ratio whatever a boy can do, a gid can
;’are favoured in our society.
is in favour of women - 1,032: also do — sometimes better. Anderground and given a free hand
j It is estimated that between
1,000 men. It also has the highest cient prejudices against women
to quacks. Says Vibhuti Patel, ac
’(1978 and 1982, nearly 80,000
literacy rate among women at persist inspite of the much touted
tivist of the Forum Against Pre73.4%, the country’s lowest birth slogan: “lakda ho yaladki, ghar
female foetuses were aborted fol Natal Sex Determination and
pre-selection Techniques: ‘In a ’rate at 24.9 per 1,000, and the mein do hi achche/’(boy or girt,
lowing sex determination tests
lowest infant mortality rate at 37 two is the best). — AK Features/
predominantly patriarchial society,
which showed them to be of an
I
A
■ ’M ", _
-
a a •a
1
#I
"Harl Shari'*, C-46, East of Kallash-I, Now Delhl-1100®5
Ndmo'of the Paper t THE TIMES OF INDIA
I--
K
Published at
tj NEW DELHI
Dated
J
• •i'r;*-
14 APR
APfl I8$$
I9S|
-(
Haryana’s unborn convicts
. J , ..••
............... -
,
•_
in Haryana has an ^^hx^the
abysmally appalling
^wjex ratio.
| rpHtg/iwngiiai’cannot hide' her .. ' Rohtak district ih
1
U'
PREMA VISWANATHAN discovers why: the appalling
pp "8
rate of'female jfoeticide.
I tattoo on her belly, swelling for
raw ujj
11•
k
landed peasantry who hsyc ■
SSe^ child'1, since inheritance
junnises that the practice
f ^siXTn ^rlt^ejs^ow headed Dcm0&rapher Ashis Bose feels one explanation for this, the rise
"^^'^^^utr^hai
for the magic machme
machine whick
which she
foeticide."
kow natalj sex- determination sre ning carn^as m
£ ff" considerable
nsiderabte con- in female foeticide
•‘
hopes. Will not tefrav her as the h«« «
f
responsible One heartening feature bow- natal rex
gods did. But what if it tells her
neithcr outmigration ever, is the high degree oi - . -/e
.
,rab . bolds
boM!. ,«
r,e,o„or
’
her womb
yet »«!.«
“podrej o^
f females
nor rh^o^f
the migration of ness among doctors, women s
„ disclose5
j35v,-anL, a
daughter? Will she have tbc heart males into ihe
the dislnct
distort. That rights
pghts activists
activtsts and ^emmen
sovcnimcnt m<;^bcf. of lhc Manch, “one of
to snuff out her hfe. Her eyes f 11 lcaves
ie foeticide
fcmak
hersc|f
leaves only
only fcrna
female
foeticide as
as aa officials
officials about^e
about the n«d
need w
to curb
cur
at the very thought
.
..|t is nol entirely this practice Dr Kapwal htmrell
for
ullrasound and While it would be unfair to
unpredieuble, since ibc Jats are spared.
nbened rbe form, on My .< ro iinde out Dr Kambhoj for crit>asm, in that be is not the only
doctor indulging >n this
to pass a Lav.' banrepressive practice in Rohuk. it
has to be conceded that oilier
torwab said so. We an always
clinics (there are about five of
decide later what to do with the
them) in the town are less wpha’.
child.’’
,■
in their modus operandc The
Somewhat reassured, she walks
Narulas’ X-ray and ultrasound
' on, towards the ambulance which
clime, for instance, had earlier
holds the wonder eadget that wall r
put up a board outside eonounctell her whether the child in her
ing - l^dka ho ya ladhi. janch
womb is a boy or a girl. “It s just
Imro" (find out whether it is a ^rl
like an X-ray," the receptionist in
tor a boy), but following de
the clinic had assured her when
monstration’, by the y‘8>'?n
she had come in for registration.
Manch and the Janwadi Mahda
There would be no needle punc
Samili, it was withdrawn and
turing her abdomen, she’d been
now occupies pride of place in
the wailing room, the prefix
And the doctor is as good as his
■ywowA' (healthy) having been
word. The test is over in minutes,
added for legitimacy.
and the ultrasound delivers its
verdict: it’s a girl. The couple is
So effective is Dr Kambhoj s
in a quandary. The woman turns
publicity network (he employs
to her husband, a silent appeal tn
both printed pamphlets as well as
her eyes. He runs nervous fingers
word of mouth, asd unlike other
over his turban, undecided what
doctors, claims 100 per cent ac
The ultrasound delivers its verdict:
to do. "Suppose we decide to
curacy in diagnosis) that he has
•
keep the child, what will our
it's
a
girt
The
woman
turns
to
her
bus
now extended his area of opera
parents say?” is his dilemma. The
tions well beyond Haryana, to
b ' receptionist turns to him tn cx- ; band, a silent appeal in her eyes-,"Supinclude Meerut and even Deiht.
h
asperation: “If you were so unA pamphlet handed out to vis
. pose we decide to keep the child- hat'
itors to the clinic unabashedly
I
■ .; ........
v.
_
4c
1,!c
.-iilemma
will
our
parents
say?
”
is
his
dilemma,
proclaims him to be the ace ultra
■T
“J will convince her to get nd of
**
................... ..........
................................
" ’
wauiHmiim
u.;■round expert, "jinht shayad
I ' the’ child," he responds, almost
Bharat me is tai hi sahi report
1 tex-selection
| i aMiSon^accomplished, they
g- i - Mission accompnsneu,
was lowest among this commum mn,
pre
n-^likhne
ka sab —
re Ai^da thaju'ba
C!U
---------_
.
many'aa 100 doctors, inclu.
i./„ pow
,--ibty Iras more
Maneb expect air-lhinz bcHer from the hein" (who
experience
in
this
field than anyhour 5 anvc
- - in
sUlc of HaryBD8 „ and the Janwao
■ ■
j the ‘dies chief > hut it is that one day in a> one elre io the country).
'.s.&s'
2
■saais e « ss
.••■£-s asa
--
hi
Liases «««■-gSSrlS
SgHa
Unfortunately, Haryana’s
r women have allowed themselves
I to be decimated to an alarming
the°
femily •
our esm
d~ -• -• despite their rthu.u.K*ira, urc
“rr
qnnrw^ vtc'/..
-.-/ICC to C. ■ - ? the aeeds of degree
welfare officer,
•
•.■,.25 pstn-'.- on vt average measurable capacity for hard
to the
of (local residents put the Sgum «»I work
ww.k and
c--'. contribution
jjkespate
Hissar,
which sparked
need^mtt
But changinr/ '^be t.attitudes
—-~ .
•- of —lie.
Se
of rex-relcction
centres them beiplws. "The
Die donors
doming
30-401, mc-Jl of them i-uraMased. economic prospenty
in ’Haryana, Rohtak has now bebc«"g
^t^F
I* ScSowfed •«u “b;.: /_ ____ _- This >■
But,
as
Dr
UUnlur
variance
But.
s»
toHary^Roh^feno*^
—— T
the teaching
frateniity.
the claim mads by ?xxne of the Vicyan
Visyan W
Msnch
assem,
»n^robabili-- KxnwS. Dr Kalra points out that* even in> the
t^"" fct
. -ny.
in r.n tT-buiit t -.ristarr-: u> - rri-rists of . Hnryzna V’jyaa “Tbere; is
« ao need to wallow . in
'dotnCbuildin^,.in ^.^of ’
■SSecxn.tiotatbe^jneMf
tbe<'overaU rex-rauo in ffie coun-
teP dn>p ufc.
fu
of
/ .
an3nd ^mvtrrity,
Univtraty, Rohufc, with predict of sex pre-sctecuo® u an
Phil proposal on fcm.il d? it uE Struck dotented "
tv squares up moce; with. 1'r.
I; .-jawaTs theory that ids
the eviL’
sasSSk. sssacsss asg*
--■> •
as a
■A
...a
c- .•
•I
-'•s: uv
;'!?.FD3
:
"'HE TIUJt'NE
. Pcbli
:
CHA.XDIGAJII
...
.
.
.,
•.
■
.. J
Dateu
(City Edition,/
Pimjab to outlaw sex
determination tests
by P.P.S. Gill
Tribune News Service
CHANDIGARH, June 13 - Ban on
sex determination tests and repeal of
the Lepers Act, 1898, were two im
portant decisions taken by the Gov
ernor-in-Council here recently.
Of late, women activists, political
parties and even individuals had re
peatedly represented to the Punjab
Government to ban the misuse of sex
determination tests allegedly carried
out by private doctors. As a consequ
ence of these tests, the natural corol
lary was medical termination of pre
gnancy or female infanticide to be
precise.
Now the government proposes to
enact legislation to make sex deter
mination tests an offence. Though,
Punjab would eventually adopt the
central legislation, to begin with,
keeping in view the urgency and
importance of the issue, it would
follow the Maharashtra Parental Di
agnostic Techniques Act. 1988.
According to the Health Secretary,
Mr A.K. Kundra. what really made
the government sit up was the low
sex ratio reported in the 1991 census,
which showed there were just 888
females per 1.000 males in Punjab.
Admittedly, there was preference for
a male child in society yet the govern
ment was keen to educate the people
and mobilise opinion for the equality
of sexes. For this, besides the legisla
tion which is on the anvil, there was
need for intensive education, he
added.’
The ante-natal sex determination
tests in government hospitals were
done in exceptional cases for "re
search" and "diagnostic" purposes to
determine sexually-linked genetic
disorders. One of the reasons behind
the ban on tests was to end abortion
of female foetus to ensure equality of
sexes.
In May 1988, the central council of
health at its meeting in Delhi had
reached a consensus that sex deter
mination for "scientific purposes"
should be done only at government
hospitals or at approved centres run
by voluntary organisations. This was
solely for "genetic link diseases ’ or
for research purposes without,
however, disclosing the sex of the
foetus. However. Punjab showed con
cern at the scientific tool being mis
used.
Mr Kundra said the entire scheme
of things was aimed as a bifitting
gesture for promoting equality ot
sexes by preventing female infanti
1
cide through such tests.
Talking about the Lepers Act, Mr
Kundra said this was applicable to ]
Amritsar district alone since June
1953. But over a period of time, as
medical research advanced, it was
found that leprosy was curable and i
there was no need for segregation of 1
patients, who could get treatment at
home. First came Dapsone tablets in
the 50s and Rimpicine capsules in the
80s.
Thus, the multi-drug treatment
had the desired effect. All along
leprosy carried a social stigma. Since
the centre repealed the Act in ques
tion in 1984, it asked the states to
follow suit. Punjab was doing so now.
Under the Lepers Act, 1898. lepers
in Amritsar were prohibited from
preparing for sale or selling articles
of food, drink, drugs or clothes, bathe
or draw waler from public wells and
tanks and private carriers plying for
hire other than railways.
Medical science has now made it
possible to prevent physical deformi
ties arising out of this disease and
even correcting the same through
surgery.
Enquiries with the health director.
Dr Bachittar Singh, and the zonal
leprosy officer. Dr Jujhar Singh, re
vealed that at present the state had
about 3,500 leprosy patients. These
were mostly confined to 30-odd col
onies in different district undergoing 1
"regular treatment” with the depart
ment providing free medicines.
The incidence was more in Patiala,
Ludhiana, Jalandhar and Amritsar..
Both, Dr Bachittar Singh and Dr
Jujhar Singh, warned that any person
who finds "patches of discolourisa- •
lion” on the skin insensitive to pain •
should report to check whether there
are symptoms of leprosy. These
however, remain dormant for long
periods. People could now undergo
immunity tests to find whether there
is leprosy bacteria. Loss of sensation
on hands and feet should also ring a
bell!
Most of the patients tn Punjab
hospitals are from outside the state.
Bihar. UP and MP are considered to
be highly endemic to the disease.
Punjab now has district TB and lep
rosy officers in all districts
It. nevertheless, remains to be seen
how soon the two decisions are im
plemented and how effectively
r
*0
.1
§I
II
°o
o
5
I
cL >
r
L
’ *k 5 f'
) a tad
At 4
i
- b
7
■
U'
•
1'
.
■ ' J - BOYORG1RLG---<
/ A DANGEROUS TREND' '
Apre-hatalkiller;
female babieslS
... , - Skilled
Al a rmin g fis e in
Kr < fe hi ale i o e ti ci cl e.
| <- Female foeticide
Sig^igi
a; family planning?
:
,t
1
L*
.^xTu
•• • Maggie's shoes
.
.— Stepping’ into
*l; ;
■
I-
I
One can always «oc pregnant women in the clinics of gj nuccoliigUt*
walling lor (he results.of the sex of their unborn hahlcs. If It Is a’fcmalc,
they have it aborted; If It Is a male, they keep II. Z(D7t 7.0! I KA probit Into
flu* nourishing Mix dctemilnailoii racket and flic mi.suM* al (he coni rut it.
*lal (»•>(.
•
-tnhhy’nf doctors who see the sc.x- higher success'rate of 98rf. Unlike
determlnatlnn jests «3nd subsctiuftnl the amniocentesis tests which arc '
abortions
an effegtlyc method oT conducted only In an advanced stage
• family planrdng3>&ys Dr miEisjni
Pa Ha PalT)
- ~ of pregnancy the VCB is dor.c vW ?n
"cnrector of Pearl Centre Clinic of the foetus Is only between eight to
Bombay,"which db~rrgirCi'gd~ya?7) ICSTS' -eleven weeks old. U!f.-asono.7r-'.pn/
till recently: nlf one caririo('a!!driT7Un -was also being misused. The L. !<5on i
bring up anotheFchilfl fh 3 dut'urn Method, which entails the separation
way, then It Is better not 'to haveTIie" of the chromosome and artificial
Child
all There-are OTtBuiini
mill Irin" Insemination, was also being prac
orphans tn our conntry whose par- tised by half-a-dozen doctors In Bom
ents are either ton
or Inrk-Ttd-as- I bay before a ban was Imposed.
tnent t<? prcuHHg
u/l?h the hnclr | It, is Interesting to note that the sox
- amenities. Unwanted babies must he-l jatlo in India has been going down
it s
^3
rBY ZOYA ZOIIRA
/.•V-viV
i
«
ex: Determination Test
'•—
•
•
.
•
■*
‘.
A middle-aged woman, who pref oned: "Spend Rs. 500 now to save ks. |aborted. The concept of ‘two arid no against women over the years. In
tn bTFlWUUlJilAed. 1 em 1901, it v/as 933 women: 1.000 men.
5 lakhs later", thereby implying the [more' needs
rEi£irnb~M»ni»j
ers to remain anonymous, twists the
■
pallav of her sari before replying.
enormous down' given to a daughter |a strong protagonist of sex determl- “but In the last 1981 census It was 913
——— women: 1,000 men. With selective
.'T don't know... my husband brought
on her marriage could be saved. Nat Ina (ton tests.1"
me.here to cany out some test to
urally,- keeping in view the soclo: 3 However, what is alarming is that abortion becoming common and
<lnd out whether I'm carrying a' boy
sexist bias in our country,: people this kind of selective abortion is instances of female Infanticide, par
a girl. My in-laws want me to
began flocking to the clinic. Gradu being publicised as an effective ticularly In rural areas, the ratio
%ear a boy so that he can carry on’ ally, several such clinics opened in method of family planning even by could come down to as low as 900
, Jhe name of the khandaan. I already
major cities and sex determination some government agencies. The women: 1.000 men by the turn of the
' - have two daughters and I don't think of . foetuses and . their subsequent average Indian woman on undergo century. As a result of the practice of
.Eve can afford another one. After all,
abortion became a racket." : .
ing the cycle of conception • female Infanticide, the Bhati com
fgirls are liabilities, are’nt they?”
What exactly Is an amniocentesis abortion- conception, till she is not munity in Jaisalmcr has. what Is
fl Her husband, sitting beside her in
test?
•‘blessed" with a son. becomes a probably the lowest sex ratio, any
t the waiting room of the Loomba Clin- b Jn the 16th or 18th week of prog- physical and montn I wreck. The mis whore in the world at 550 women;
[Ileal Lab in Delhi’s West Patel I HrTncv. a noodle
Is Inserted Into trie conception - that girls are the 1000 men. It has been reported ehat
.irjamnjarfrTnfll
| Nagar, tactfully shuts her up before I womb and (he amniotic fluid, about' ?‘wcaker sex" has been exploded in nearly 50 newborn girls were killed
fl she can say anything more.
fl5’ cc,-l.$ withdrawn from the sac\
Kerala which Is the only state where in the family of an MLA of Bharat, - Another time, another place. This ilSubsequenr lab tests conr
the sex ratio is in favour of women— pur for the past several generations.
||(
success
rate
97G)
determine
the
sex
time it's the Goel Hospital in Bom
1.032.: 1.000 men. It also has the Female infanticide is also common
bay's Andheri colony, where another ^o^The
H^IU
H»M d itUill
r»i z\t this advanced
unbdrn
child,
highest literacy rate among women In Gujjacfamllies in Rajasthan and
? woman explains why she's there. ‘stage of pregnancy, -abortion at 73.4S the country’s lowest birth in the Kaiiar community of Madurai
t1 "Arre bhaJ, it’s so simple. After the becomes risky since the foetus Is too rate at 24.9 per 1.COO and the lowest district in Tamil Nadu.
i
doctor sahib; finds out whether the
Until attitudes change. th$ situa
big to be taken out by the suction Infant mortality rate at 37 per 1.000
Child Inside
inside me is a ladW
ladki or a baba,
j Childtion will become even worse, despite
method.. Consequently, the risk of blrths.‘ri-, j we shail make up our minds. We are
Infection is also-greater and there ’> But coming back to the controver- the undeniable fact that whatever a
■'i from a middle-class family'and
family and’fTnd.
find. have been, several cases cf^sepsisx • sial amniocentesis tests, another’) boy can do. a girl can also do— someit difficult to make both ends meet.
forming.' in • the reproductlvej tract. ' method used Is the CV biopsy which times better. Ancient prejudices
After all, who doesn't want a boy?
causing permanent damage to the Is more expensive, costing between against women persist inspitc of the ,
I He brings a dowry and suppons his
reproductive organs. 1
Y Rs. 1JICX1 to Rs. 1,500. Involves tests much touted slogan: “iadka ho ya j
• parents in their old age. On the other
Recently, Maharashtra banned all for sonograpHy, chromosomal and ladki, ghar mel« do hi achchcy” ■
hand, a ladki Is paraya dhan and
!/
pre-natal diagnostic techniques used bio-chemical disorders, but feas a (boy or girl, two Is the best).
from.the time-she is born, the poor solely to determine the sex of. the
~A K. FEATURES £_
f mother and father start saving for- foetus.'. Under the new law proce
I
her marriage.";; •;..y.
dures such as amnoicentesls will be
‘'v '
| ■ • Discrimination against
’omen,'
--- ------ ; A--------- ’ permitted only to detect certain foethus, begins in the womb itself. It is tai abnormalities,’ and all clinics or
< now possible to predict with
...ou almost;
.1----- - hospItab which’conduct such tests
cent-percent accuracy the sex of an-. must.-be Registered with
w.u. u.e
the »uM«r
state
^e^'^ver, the tan has
, <onlv pushed3uch;fests.underground
;
|
y t <*
frvziO-4 »-t
# In a
I**aI/
Ya
1
J AU)
------------------ rPre-natal SeX Deter
.detectfigenetict disorders? but' are/ •mination
—
~
>andlvPre-Selectlon
Tech
blatantly misused by niques .- '‘"In a' predominantly patriunscrupulous- doctors • to ■ make a archirJ society,-ours
vu*a is »a uuuvuh
difficult
■ quick buck and who are cashing in on Job.- EViry mother and.father wants
the.fact that.male offsprings are a sor although they might not state
favoured' In our socletv. It is estf- this openly. Even/.in post-Cultu.-al
mated that between 1978 and 1982,
Revolution ^Chlna?-, nearly 45.000
, nearly* 80,000 female foetuses were fem.de foetuses and ncwlv lxjrn girl
^aborted following sex determination
bab e.'.y were _• killed . every year.
Ftests which showed them to be an There, abortion Is’not only legalJiuf
"inferior.and unwanted sex."
off cially: condoned as un effective
Such tests began. ton years ngo bv •in.’trdmont of birth control and the
a gynaecologist couple in Amritsar,
pefje y jot- ;one<hlld pcr famllv is
rhe "miracle tests , as they began rl jcrously;enforced. It’s an uphill
to be known, became extremely pop Us), in India since the soclotv has
ular and spread all over the country p.'e.'onceived * ideas about women
by.word-of-mouth and sexist adver telig (nfertonto men."
tisements. One such ad was capti- '
(Mho other handsthere is a strong |
• ’■clMi (XaJLl)
-
>
O<It^hAAAA>ajH'!>'x.
!
.0
“?.............
This is especially applicable^
when things go so drastically
.
wrong with the process of gene- !
ration, that the foetus'lacks, ?
from the beginning, the funda- :
menial bi-' heal prerequisites, ;
for hi!-.'
uevelopmcnL For t
exan •
in
anencephaly, '■
where < ■- rain has not formed ’.
properly and as a result the baby
is incapable of living outside the
womb for more than a brief
period.
’
Similarly, where there is a,"
choice between the mother’s
life and the child’s, the obstetri- ■
cian’s decision to abort the child
L
Vs
is acceptable. But there are:
cases, especially relevant to|
India, where women who:
tmknowingly undergo routine I
.. X-rays during pregnancy are
advised that the risk is less than!
1 percent but that ihereis a defi-1
nite chance of congerdtal ano-1
niaiies. If the woman sc desires, ?
the pregnancy is terminated:
even before prenatal tests are ■
carried out. These are cases
measure to let defective people
wldch
require
critical j
Attention is often drawn to the
*iThe bodily person I am now,
contaminate the healthy oaes.”
!
financial benefits of preventing
began as one ceiL Ifthis original’ examination. ’
There is no denying that pre disabled children from being
The British medical bulletin :
ceil was capable of developing
natal diagnosis is a vital aid in born. The British Medicnl Jour
ruw
wild! ap
2a«» did
ma h
J.atP5 in.lhe context cf prenatal i
into uir,
me. what
capacities
it
monitoring pregnancy with a nal in 1976 estimated the net
have then? The ceveionment of u:a>^°sis, tnat because anew to safe deliveries. The income benefits of a screening
Dcrsnnal shilitS^*
nni come mother m.cht Uive JHlOritV to j
persona!
abilities does not
main purpose of prenatal dia- progranimeforpregnantwoniindependently cf our organic w:’.atsheconsidershcrbestir.te- (
gnosis is to promote the health en in terms of institutional care,
rests, the obstetrician has a spe
development. Teey a; e not add
and well-being of the unbcm less economic production by
cial obligation to prelect the
ed (by miracle?). If r e are to
childandtliemoiher-Forinsuin- parents of aJTected children and
interests
ofthe unborn child.
make sense cf our existence
ce, hydrocephalus, excess Quid the less-than-average‘ output of now, we must nimit thd: the
A leading obstetrician, who
Ln tlie brain cavities, can
—be
v.dia
J:_ such individuals.
capacities we here now, de; elo prefers anonymity, agrees that
gnosed by ultrasound. Needle
the best way to do this Is to
A contradictory view in 77ie ped from whatwe were from the
aspiration of excess fluid before Economics .
inform the mother cf the full
- •
of f. Prenatal •beginning."
dchvety- hdps to facilitate the Screening, however, points v
«*
implications
of such diagnosis
out
: Moreover, on Lockean lines,
birth of the child, thus prevent- that the underlying rationale of if (he eariy embryo does not pos and to discuss lhe status and
mg a Caesarean or preterm selective
’ ”
'
abortion
could well
sess a rational mfure, then nei interests of inc unborn child.
delivery.
undermine the position of the
ther does the comatose indivi The mother’s decision then, is .
’. Prenatal diagnosis males disabled and promote au
her own responsibility ■
dual or the ne'W»m baby.
sense w hen itis treatment orien increased aversion towards
By offering her advice heFrom the earnest time, the
ted. But when it is undertaken them. Further,
, the insinuation- ----.... has adopted uan
„ unvvmgive the foetus a belter
church
uncom
with a view to avoiding genetic , that the disabled person isoflespromising stana
on this issue.
c“aR
in the-----------face of<-prevailing
stand
«
3U
c.
. ce
----------- o
.«
.
O ? •»f»• ri •• f—
J J?«.* .
v
" * t
malformations by means of ser value,
....
devalues humanity The authoritative
document,
alljtudes.
In addition,
he might
selective abortion, it does noth itself. It regards a person in Donum ruae (13S7) reaffirms: spare
lhe
mother
lhe
agony of"
'na”'
ing lo promote the well-beingof material terms, his value depen
“The destruction of so-called regretting an abortion, for it
the patient most concerned, ding on the amount he gives in
‘We witliout value’ cannot in must not be taken for granted
namely, the unborn chili
return. One would then also be any way
..^j be
... jusdfied. From
, iy,,, the that every woman would rather
It is frequently pointed out justified in killing the old and time that the or.-m is fertilised, ba' i?11 ab°rtIoD than give birth
that Um daily care ofa handicap infirm.
- .
a life is begun which is neither to a disabled child.
.
.
ped child involves enormous
.Another argument is that the' that of lhe fatber nor of the
Abnormal foetuses that are
sacrifice on the part
of its par- -----------embryo, in the early stages after mother, but a fife of a humani aborted are often said to have
cuts. Il IS menially and physical- fertilisation, is not yet a rational
being with its o-ra CTowlh... Pre- been spared lives of poor j
ly exhausting, and finanriaily human being and therefore has natal diagnosis
is r
permissible
„---------_---- ---------iff quality. But what is frequentljr 4
taxing. Leading obstetricians no human rights. Dr A McLaren the
method safezuards
Lhe method
safizuards the
the life
life overlooked, is that even such ;
feel that abortion of abnormal in her book Humart Embryxi of the embryo azd the molher. ■ li'es may have their pleasures. ?
ffoetuses
•
.
2
is advantageous in that Research: Yes or No states that
But a diagnosis-which shows the A life which a healthy person j '
it spyes the child a life cf poor until the primitive;! streak existence of a malformation may view as pointless and • -i
quality.
This compyson, appears, the embryo is not a muai
must uut
not ue
be eequivalent lo a frustrating, could be viewed
however, Js solely dkected functional whole.
whole, v
: ;-. death
/. very
verydifTerentlv
differentlyhv
bythe.
thenrrson
person
*ath sentence.
spntAnrv..-’' _,
aius U5C
towards
the parents and does
As for rationality, according • The Hipprx-radc code explici- whose life it is. . v iv
no1 citcnd £1’ unborn chili to J Locke, in his work Essays ty states that lhe physician has a , This issue is juct
tb.i
y'-"
-?
iustthetipbfthe.
This discrepancy
discreaancr can
can be
be attriatlriThis
Concemmg
Human professional
, responsibility
rtsp
. to
.. iceberg. It points to the many
butcd -‘0
■r2«‘lhat the ibetus Lndeittending, the embryo is promote the padent
existina MT?
MT?.;.:
fuaent’s interest loopholes in the
Lhe existing
kjPin.2
i ’ notyetapcrsonas,inordertobe and to do no hor=. However, the Act. In our attempts to curb lhe «
rational, it is necessary to pos- Handbook
t/nr;th,.nt- of HtdiccJ
-^.7 Ei.hia
r.L.-i_ population growth, abortion ■
wcing n maj nc._be new-d as
sess exercisable abilities associ also states that ~ae (the doctor) has taken precedence over con•
ated with self-consciousness. has a moral duty to continue to traception at the cost of. the ] /
declare his own ethical position moralstatusofliie foetiii.Wliat-7
An apt counter-argument put and is entitled to persuade ever one's ethical stasd, abor--;
otiiers that it is the most lions cannot be put on a par with /j'. :--;
• of Medical El'ucs states that.
tooth extractions.
<1 r
©
J he case for aborting abnormal foetuses is that it spares a child a life
of poor quality. Ranaaz Vazifdar questions the right of the mother
and physician to decide the fate of the unborn child
...
» ’1 ’
I
• -
I1!' ti /J
’/z ?
■'
oilier, on Ine assumption that .h of
ooening the
the pregnancy may be terminal- - doors foranalx^vm*
ed if the foetus is found to be
hi this age Wcre-alaldiamto
nfreetei by any serious d*sor- 5is
omnip-Xent right of the
cer. Piceuniig an aborUon for . wo^an and me r-h^eian to
eugcn.cntasonstsnotveryduTj- dr.cide on
mlity of
of lh
the
<;>i!l in India, especially with a . unborn
. .. . chLM
. , mest L. ,
be questionlibera! Medic al Termination of «J. The Rovr.7 College
. ...reorPhysiciof PhysidPregnancy (MTP) Act in fo<w. ans. in its 1989 report on GeneThe act saru.'licns abortions ia t‘cScreening, recommends that
cases where pregnancy cuufc* the
Ute scape
scope of prenatsi
pre.n.'i'ai diagnosis.(ii.ngnosi.*.be iniuriptis lu the m'Xhars .»iih a view io a-ejecthe aher;l:h rhp.tl’h being
h/'in.? vir-wed
i
v^ed
can be prevented and preven
tion is uol Fusible before preh? r5 e°nIy
means cf detecting disorders >s
^'^?,”nrIn
scrr":,S ,iU
1,nnS
pregnancy.
India?
where
prenatal determination offoeial
ser
sex h«
has been hn...^:
banned .b.^eh
thioegh
fe.
v pretiatd
diagnosis of.congenital defects
; • T:-.•.•2? Or are we
moving lo'.s&rds an acc";'1"
of Hitler's view:.-it is a
assess
■
-t
:' GURGAON ’
e it
«
(New Delhi Bdkion)
©
U 0
os e-/>dent in New Delhi,
’arliarrrent and the very
dra Shekhar Government
■ems inconceivable that
be co-cerned about the
; country. Yet perhaps as
-omnaicy can sometimes
■naos. the Central
meed its intention to
current sess.cn cf
me use cf sex
egres.
been finalised by the Law
sed cn the
ccrr.m.’ttee set up two
heavily on tne experience
v in Msnaras'xa.
entra! taw to regulate the
an tec'ncloc es. raises
•lions that arose wren the
ormulateo. Tne base
wretrer the law can ever
am.
Technc'-ogies that were
ry ago to detect genetic
<. and whicr. incidentally
ex cf tha foetus, have
oantiy misused m Ind-a for
n of tne female child. Tne
attention when Dr
□vertised h s ante-natal
c in 197s Subsecuertty.
jay nctcea a prcfiieraton
oeniy advertised the
ie ma n techroiogy being
is. which involves
i from tre pregnant
of preg-ancy. The test
abnormality as we'l as tre
.iscove-.-g tnat the foetus
n was conducted.
spital in Bombay, the
was one of the early
4 cf pnrtzrg errors.
» of its prenatal sex
augurated in July 1977. h
r,e and cenefical test’ but
necessary, will not be
itaf.
provided the sex
abortion under the same
> runs such a centre which
determination tests, holds
i performing a
Nobody has a right to
noor and miserable
plam.es women, and the
hat has contributed to the
•e birth to a son. ’Wnen I
e good c d days, not a
the test u-'ess she had
states.
;t the misuse of
t sex dete^m.rF-ation tests
j...
-•p ...
in Bcm w«.
bay.. the Fcram
•on andSex^r^ection'
practice continued
•lously affect an already
vuw. The
.. v forum
ix .ratio.
inch prox ed that scores
mbay. a-d in smal'er
•ere openly advert.-sing
ihermore. a liberal
Pregnancy Act CMTP)
contraceptive failure as.
-ganabc<cn c •rev c d
another c d
Jtr^ltc'
e
e
is
a . sai»—jre^
could ba challenged under Artcie '9 cr He
Ccratcjoor.
Tre cuesticr. cf punishmen’ was aiso ceoated
Shou-o He woman be held liable at al: C' sr:u!c
one take .t for granted that sr.e had rescr-ed to
sex ceterrr.«nation because of direct prassure
frem
family or because of the md.rect
qj society? Here aca n He
aetvsts
and
HeS^XSdSeredwSIhe
foier
hektrne
•rxrrrsc-* .“."’•'•rr
•____ _
chat be -wcma.n should not be punished arc re
latter nstePng that some light punshme-t sno- d
be crvai to the woman. The Mansras'Ta '-aw
jrposes a fine cf Rs SC on He woman.
SuOCorariG this prov:s.on. M' D T. ucsecr. new
Uraan Dev-etooment Secrete-y to be
Goverrmert of Maharashtra and era z: re
achitects cr the law when he ne'e tra post z‘
the SAA or the valance committees being
const t-ted h took tne State. Government more
than seven months to start moving cr. the lay/.
When it finally took some steps, it d.d not
demorsrete sufftuter.t alertness or urgency. For
instance, soon after the constitution of the state
vigilance cornmirtee. activists discc-.erad that re
Gover-rrent had acoolnted a Gynecologist
v/>c '■ad oeen perfcrrr.ing tex determination
tests 'c.lov/mg the-r protests, she was asked to
step sown.
S roe d-ren. the -irpementation or the law has
bee-r practically non-existent The state vigilance
com.'r.ctee received two compiamts in 1S39.
about two private hospitals which
;
gove'fsmg sex-ceterminatxjn facilities. The
comcamants
cornea
—-ants sent pfcoxgraphic
phoxgraphic proof of this.
T--e co'-irrvttee did net move with any a’acrity.
—:z. .t horded C'-e' ^e t’s1* o' investigation
„ an
„.. oBicial
cricta! cf the Bc.rn.ba.
Bemba. Municipal
to
Coracration. and by tne tme the team went to
trese "cso.ta's. the boards bad bear removed.
=ve- z~<e SAA has no: been effective Despite
S usk
i
i i iimurwn
SUNDAY. JANUARY 6. 1991.
Weekly Edition —2
E
I
-------------------------- s !
India's National Newspaper
Pr-ctad st MsAss. Co^bstore. as^axre. *voe»ao*S. Vaav-fc Gurjao* trC
la
'Jirann,
Before finalising its legislation to control sex determination t ?sts. which
in this country is being misused for killing female foetuses. u;e Central
Government should learn from the shortcomings in the Maharashtra law
and its implementation, argues KALPANA SHARMA
by the Maharashtra Government which had
--------- -------- --------------------- ------------------begun
cons-denng
the feasibility
of a law to
femae
o(f 50
check fema
e foeticide, found that 42 out a
doctors questxx-.ed. that is 84 per cent
performed sex determination tests. The study, by
Dr. Sanjeev KJkami. calculated that these
doctors averaged 270 sex determination tests a
month W th mere than i.OOj gynaecologists
7
' “3 in re city of Bc-cay. the extent ;f
practising
the problem, could well be m^gmec The
majority of He doctors a‘so believed that the-/
were penorm^g a humane service for wemewho
net want daughters, in ether words, trey
felt no guilt -cr d-d they cc/sider tr.® art veg al
act. although re technology «as te-rc ciea-y
used for a p-oracse other tnan re one for wr. pn
it
* had
u''1 -beer,
------- ir-.er.ted.
------The impact cr the cc-r.vnted misuse of
sex-deterrr.ir.apcr was also e/ident from the
stat utes carerec by three ^cc-c'cg sts cf_h-c
villages in E/ae D stnct. Urar Pradesh, i -ey
* 'd
c;'
-:c- -’s'"''
■i’-t—'3 —>lei
state average cf ESS whicn s substantially lower
than me na’ioGa' s.erage tr 935 Sex
determination c'r cs had teen operating in the
c str et for severa- .eara ~cx io tr« survey.
It was a comb.rat.cn cf o.rage and such facts
that red to the ca- ra gn cerara.'g fcr a ban or.
sex cetermlnaho" •.ecrrac.g es.
__
Trie discussions cn d'e -e.v wr. cn were
•n.-t axe by the he? th mirery o' Manarashtra
are rs'e -ant teday w H. re Cerae cc-ns'dering a
-ibcralaw The c-est ora ras-x: ?en have yet
to oe fully anszerac
~ .rat would r. be - gr.t io ra-. a technology just
teca-s-e «t <5 be-ra —susec'’ -~e' a’l.
a'r-Tccer.tes s or c-cr.cn • . ' b cp-iy. another
such test s a v.te c-e w' -cr rar akin parents
about gera-c c aenrr-ai-ty r re foetus, thereby
giving them He ct tn ci -escra-g ?c an
abcra c*. .-f they z-: rc: w-v to oe c-zdened with
- abrerma!
.
ar.
cr -c
$
Secondly, co-, -z a ew c-e ra a p-.ici.ce that
rc
-c
tu'
sc
ft
c*
"e
rtf
ali
u? i .. >t _ . wt. __ u Tte*.
e- w«.n„
irani even
.u g-ve
u.- s
..uum
r&'ucta.'it
even to
gve u-i-i
b-rth 7?
a gr.f
cr7 Y.
’ouJd
•e*y pre. ertrg oeoo’e from cscc-.-er ng the
sex ^5
of the chtid step r«e praxes? WoUd it not
p-sh it unde'crounc enc raise re p.ce?
The very natu’e cf re test -ace ts cectroi
exren-ely c-rcutt A-rr.ocerass sees net
reccire scp-'-st-cated eo-r.omr- a e-ja .fed
cy-.aecc’ogst can reroe re a-rcoc
whxh can tren t« tested in cry peroccy
’eberatcry by a genet-cst Hc-«* ocud e’e catch
a doctor if. tr-e act cr oordact-c e sex
determination test7
The setvsts. who v/tre assocatec wtn the
formulation
rs.stsd. that
--------------- c-: re l.taharashts
the only way to check toe g-ewrg -suse cf the
technology was to
P'litete cractccrera
from ccnouct.ng-4^Trey help rar. f re test was
restricted to- gc/errmersmecca .-s-.-bers. its
rr-s_-se ccu'c oe cbec^eo e-e- f -ct cemp'etely
eliminated.
Heath Secretary, says. ’ The pfesumotior sreud
be ixs-t cto tr« law that wf eneve a v/cr-er
reserts to sex determination, she nas beer.
pus.'ed r~o domg it by others '
On the Question of banning sex-determnaccn
tests from private dimes. Mr Joseph fees such
a crcvs-cr. would be too drastic He suggests
that they should be allowed to use the
tecf.noocy. after being granted a soecia' -terse
•j-<Jer ire law. but that within five years ne
Gcvemmera should review the situation to
cocsxby hew the licensed institutions are
fmctxxtng and whether a review in the poxty s
needed•
The Maharashtra Regulation
aof Use
of
Prenatal DagrxjsbcTechniques Act *983. w-cr.
came into erect on May 10 of that year, was the
product sf many months cf intense d-scusscrs
bstween government bureaucrats, activists,
ooctors. tke Dr Pai who opposed the law. and
lawyers. Athcxjgh at the outset the law was
weiecmed as Maharashtra became one a re
first states to take such a step, subsequerry t
has beer, endersed both for the obvious
Jocchcies that exist in it and its lackadaisca
tfroiemeraatxcn by the Government
Tne act regulates ihe use of sex determracon
tecr.nok>ges txrt dees not ban Hem Ita'sc
the
aspect
of sex prase ecccn
does net touch on t
-----’
schnok>c*es. which the Fonxn felt srcuic Mve
been part of the law.
The act rxovides for a State Apprcpnata
Autherty SAA? which is enjoined to register
insctAcrs conducting these tests and state and
regioral vig fonce committees which are
suopcsed to keep an eve on these instiaitons
arc fqllc-w uo complaints.
h also fojS down that sexdetermmat’On
tecr.ndog >es can only be used on weme- ever
35 years w.tr- either a history of two or rrora
aixrtiocs. cr wno has teen exposed to
tera-egerx:
terategerx: drugs,
drugs, radiation,
radiation, mjectons
injections cr
cr
hy-^dr. .-; chemicals or with a family history c<
mental
—----- 1 —
rate'daSon cr r4*.«:r*a1
physical ri»Fnrm^iP«;
deformities. 1Ucoer
Sneer
no eyexmsosnees is the dcctor permitted to
re.-eal the se x cf the foetus.
The Act e'-so prohibits advensemers abcut
crerata-' se>. oetenmnation tests.
ass
by
S
-a
ref fie
? I* vi
n;
r.
4k_
r?. _,.sl.
e..
£
knowing that Here are literally thousa-ics of
private nursing homes sod clinics in- the state
with iacmt>es to cor.duct sexdetermii'at'cn teste,
the SAA received only 11 applications fo
rec straton. from the Bombay circle, wnica
consists of Bombay. Trane. Raigad. Raag n and
S'oauC-rc drstnets Of these nine have been
rec stereo To date some iGciin cs r
Menarasnra have been granted pcnr.ssicn to
use He teohneiogy for Detecting genetc
aooermaoes.
Dr S. R. Salur.khe. ont director of health
sconces, admits that there is no way in which the
d.ntcs mat have not applied to the SAA fcr
reg steraoon can be forced to do so. Nor does
the Government have the machinery to check
whether jTregtstered nursing
J hemes ae
are
conductr»g these
conductrc
tnese less
tests or net In fact
Gcverrment officials privately admit Hat
checking tne misuse of ammocentes«s is a
relatively tow priority area when there are far
more pressing preb’ems m die area of health
care.
Given ths attitude, it is net surprising that even
a law considered inadequate, has rema:ned on
paoer.ln foot. ever, the Health Departrrert’s plea
that Bcmcey- required a separate >. tg.iance
committee because of the large number of
private I'scTutocs conducting sexdetermination
tests :n re City, wss only acknowledged last
ccmmitiee has only jjst begun. The otner
regional vratlance ccmrr.mees are non-existent
Mr. Joseph, however, holds that despite the
ine^ic’ent ■mc-lamentaixyi of the !aw. it Fas had
an effect Cimics cannot openly advertise their
services, e.rar if they are carrying them cut
oovertiy. The more law-abiding ct the medical
fraternity has stooped domg the tests. Even if.
their numbers are few. ths should not be
dteccurted. Dr. Pai. for instance, says fear of
Gcd arc hs er.em>es' has persuaded him to step
dome the teste.
Dr. Pntam Phatnanu a medico-legal expert
howe.-e-^. says that the law has net curbed the
pract ce at a>. Instead of conducting the teste in
He rura rkg homes, doctors a*e row se-d^g the
same’es of ~e amniobc fluid jus: across tne .
(
J
•
;
.
,
J
j
I
dst@rnnmot;^n« _■
|
■ .. i ,1 j
.
■
or .extermj
: 5 ; '• v ■? 7- - *.-. < ®ut health officials given the t
.
‘ SSO
tf
hr
^®se= siss.si~ ^=~s-?
',' -.......
^n‘on Govef'
/ nieans a male foet^^^a avOurabie'- ^hich ' povXS t<^?JI?Ch'ne'y t0 check chn.cs and
the Cenuai ia,
iw. the
■ KKS“g!=S~4'K
?J■"
■
^'al they can fui^i the
c^f?ced to en^*,e
5S?eSB- •
■
.<■ l^“xof^aboned^u^J^tb>'^no/flo^rX^dtime,i‘‘sev'den'-fhata
y ^«^9esuthat^ ^l“"^la?/’ed.He7b«a^ ^’c^^
the l*„ is uJh^X^5 0',he ««*«''°
'■'
And nS* ■
.
° “pP'^-nt U^^.!°^essure “* S^e”
f; -ftSSRX«“• *»• «.-•■»toSSI?
as^-sss^.
.ybllshed at
' NE'iD3 JAN 1^'
ill
I-
(City
, «.
.r'
rion)
I Limiting the licence to .kill
AY Rs. 70 now, save
Rs 70,000 later": The
.
poster, pasted on a
I peeling wall in a remote village
| m northern UP, says it all. JuxI lapose this with a staggering set
of statistics: 78,000 female
I foetuses aborted in the space of
| five years (1978-1983) after deI termining their gender.
|
And it’s not just your average
I unlettered village woman who
I wends her way to the clinic to
check out if her* womb holds an
heir-apparent. According to a re
cent Delhi university M.Phil
thesis titled "The Silent Deaths:
A Study on Female Foeticide in
Delhi”, many of the women opt
ing for sex- selection are gradu
ates and post-graduates.
The draft bill for the preven
tion of misuse of pre-natal
diagnostic techniques, circulated
in Parliament last week, then, has not come a day too soon, r
pass but for the initative taken
They got rid of their unborn child
because of one abnormality:
if was a girl
most crucial to the successful
implementation of this Act.
“Both the Maharashtra Act as
well as the draft bill prepared by
the expert committee have ad
vocated the formation cf such
committees, comprising govern
ment officials, medical expav
and members of vchinury •
ganisations. Instead, th;
bill vests all authority in ,j
;
government official.”
An equally significant lacuna
is the granting of licences to
private hospitals and clinics. Ac
cording to Ali, only select ,?,o emment hospitals should be
authorised to conduct these tests
in cases of suspected genetic ab
normalities. Karat agrees 4 Once I
the private sector is allowed to !
get in, vested interests will hold
sway. And the whole law will be
reduced to a travesty.”
A point of view which finds
Yet another women-oriented law is on .favour with Swami Agnivesh,
the anvil which treats the victim as oofr thJ
?1
the Arya Samaj, had conoffender. PREMA VISWANATHAN on the ducted several ^demonstrations
by women’s groups in Bombay.
Organisations such as the Forum
in the capital calling for a ban on
Against Oppression of Women
amniocentesis. But he points out
and The Women’s Centre, along
with activists of the People’s of her own free will, whereas implemented." In the absence of that the issue of female foeticide
Science Movement, set up the research reveals that this is not such a committed approach,
approach. cannot , be. viewed as a purely
Forum Against Sex-determina- the case at all, even among the lacunae tend to creep in, making . w2men s ’^sue. I would say it isj
t.on and Preselection in March educated.
■
'
» na human n.h,
rights ......
issue. aAfter .n
all ..it
the whole
exercise
counterThis is a point that has been productive. “Which is what has is a practice which makes a
.1986. It was the Forum which
'entually pressured the state highlighted by Subhashini Ali, happened in the case of this draft mockery of Indian culture and
kvernment to bring the law into CPM MP, who has submitted a law. The lessons of the civilisation, lowering the stan
jfce in early 1988.
memorandum to the minister Maharashtra experience have dards of social life. It is nothing
I With all its - flaws, the for health, Shakeelur Rehman, not been taken into account at but another form of sati. This is
■harashtra Act had a positive seeking a review of the draft. all. Why else would there be this the point wt! must pul across to
lout. Using it as a precedent, The letter, counter-signed by obnoxious clause, which views the people, using all means of
pmen’s organisations and Ravindra R.P., member of the the woman seeking sex-selection propaganda, especially the elec
Iman rights activists have been government-instituted expert as a potential offender. Why tronic media."
■Tying on a sustained cam- committee andJ of
-r the Forum can’t they recognise that it is - Indian tradition can come to
_______ the aid of such a campaign, he
Sign for imposing a coun- Against Sex-determination and social and familial pressures
I wide ban on these tests which Pre-selection in Bombay, has ap- which force a woman to opt for contends. “The Vedas and Up:t female foeticide. The Rajiv . parently met with a favourable female foeticide?"
’ ’ * contain several referen
'
anishads
Igime drafted a law but it never response. The minister has
Pramila Dandavate of the ces to the elevated status of
w the light of day. After him, promised to invite represen- Mahila Dakshata Samiti concurs women, their importance in the
P.Singh extended an assurance tatives of women’s organisations with Karat’s criticism. "This is life- sustaining process. We
i Parliament that his govern- to discuss the fine- tuning of the exactly like the sati legislation. should highlight this to counter
Jient
The woman is seen as the culprit the regressive aspects of latterI
ent would pass the legislation, draft sometime‘ before the
■ his also proved abortive. And budget session,,
:
*«:
----- * of the victim!*discloses- Ali.
instead
day religion which pull down the
low, the Chandra Shekhar govBrinda Karat of the All India
She admits, however, that position of women.” Unless a
Imment has finally presented a Democratic Women’s Organisa- there is divergence
of opinion
on
-----------------» cultural
campaign is hunched
Jraft bill to Parliament.
lion, however, does not place too this clause among women’s cutting across gender and class
I. But while women’s organisa- much importance on these as- rights activists. “Kapila barriers, the law by itself will
“I prefer to go by rere Hingorani of the Indian FederaJons have welcomed the govern- surances. "I
Federa have no effect, he cautions.
Rent’s move, they are perturbed sults.
suits. Our experience with past tion of Women Lawyers, for
Karat concurs. “I think it is !
the fact that the draft has governments, especially the instance,
lime we stopped treating this
i nstance, supports this
1'
{Tjrtually replicated the Congress government, has been provision. But we in the Mahila issue as women-specific. That is
their ‘professed’’ concon Dakshata Samiti feel that the too simplistican approach. After
r’aharashtra legislation, in- that despite their
■SOrporating all its. loopholes, ccrr.
---- u’—
•«- - their issue cannot ....
cern for wo
women
s rights,
be viewed in purely all, we’ve had a lot of support
JOne of the most objectionable approach
,, > not isserious. It’s
legal terms. The social context is from men in our campaigns for
'■
» Divisions is that a woman who more in the nature of tokenism. equally important if the law is tc women’s rights. Moreover, it
8°es in for a sex-determination When laws arc passed, for in oenefit women.”
robs the movement of .a human
< lc$t shall be punished with im- stance, the provisions are not
i
Yet another loophole
which perspective."
Pnsonmcni and a fin«zl This examined ^minutely and in the has been enuqued by Ali is the
Which, in these times of
presupposcs that the woman has context of the social environ exclusion of the very concept ol discord, is the only perspective
°r ‘d to abort her female foetus ment in which they are to be vigilance committees which is that promises sanity.
- ’■
'■ ■ draft amniocentesis bill
------------
df&se sex of child
By A.LrCbon^ule
BOMBAY, May 19
NY abortion based on sex of the
foetus is a cognisable offence
under the Indian Penal Code.
In Maharashtra there-is an addt-,
tional act called the Maharashtra Reg
ulation of Pre-natal Diagnostic
Techniques Act^1988, pmed by the
slate assembly in April 1988 to .curb
this practice. However,, despite the
act, sex determination (SD) tests sad
abortion .of female foetuses is ram
pant.
While defiant gynaecologists offer
SD tests openly in sheer violation of
the law, many doctors are more cauti
ous about their unethical and criminal
practice, informs Dr. Inamdar who is
*in the forefront of the campaign
against selective female foeticide.
Says he? “There are no written re
cords. All that the doctors do is ex
tract the amniotic fluid and send it to
the lab to ascertain the sex of the Techs. Obviously it ihatten
shatters the myth even doctors wanting it banned. •;
foetus. Patients are conveyed the re that education brings about attitudi- Those who speak io its favour iirgue j
sults orally, and then abortions are nal changes.
that amniocentesis is a useful family
carried out under the Medical Termi
The reason for the act being totally planning device. However, the fact
nation of Pregnancy Act, 1971.”
ineffective is the lack of political wih they have overlooked, say campaig- i
According to another leading )to implement it. Such is the apathy of nerc opposed -to the lest, is that by j
gynaecologist, there are 1,000 the state government that even after taking recourse to amniocentesis the I
gynaecologists in Bombay and it can the
( act came into force, according to woman does not undergo sterilisation I
be safely assumed that more than 50 the forum’s activists, it took more ^,but me rely aborts female foetuses till '
per cent arc carping out the tests pri than eight month* for the government such lime that she does not conceive
vately. According to a survey of 50 to appoint the Slate Appropriate Au a male child,
doctors conducted by Dr. Sanjeev thority (SAA) ~ the supreme ad- .* Though through amniocentesis j
Kulkami of the Foundation for Re ministrative body to regulate.the use .over 70 genetic diseases can be desearch in Community Health, a year of pre-natal techniques:— and the { tccted, its misuse has made it quite
after the act was passed, over 64 per .. State Vigilance Committee (SVC), popular And its misuse could be one
cent of the city doctors said that they And local vigilance committees were * of the reasons that has affected the
used amniocentesis solely to deter non-existent for the first two yean. : male-febrile sex ratio. The 1991 cenmine the sex of the child.
.Gaping flaws in the act have re* sus reveals that .the sex ratio has deAnother fallout of the act, says Dr. ndered it ineffective. The act does not dined to 929 females per 1,000 males
Vibhuti Patel, member of the Forum j prescribe any mtnamum number of from 935 females per 1,000 males in I
Against Sex Determination and Sex meetings for the SVC in a year’ 1981. The campaigners and protestors q
Pre-selection and 'reader in SNDT whereas the SAA-is supposed io meet bad demanded that private clinics I
University, is the sudden increase in only twice.
should not be allowed to offer, the .
cost. Before the ban, an amniocen
In fact, the existence of these com* tests as the occurcoce of genetic disor- >
tesis test. cost about Rs. 500 to 1.2C0,
.
mittees is cloaked in anonymity be- dera is one in one lakh foetuses an4 '
government hospi- ;
government has not there are enough govermnent
and the equipment ...
used. Today .tit ^jijjQunced the names of the commit- tab to cope with the problem. Instead :
does not cost less than Rs. 2,000. tee members in the papers. Neither the government thought it best to reg- .
Some of the leading gynaecologists is the lay public aware of the proce- . ulate the misuse of the pre natal diag*.
charge as much as Rs. 8,000.
dores and regulations the comminees nostic techniques by issuing ticenges '
Amniocentesis has become a have adopted to book the culprits.
to private clinics and bureaucratic J
booming business in small towns like
The forum members feel though it control, thus increasing the scope for’,
Dahahu, Jalgaoti, Amravati and provides for the SAA to issue IkenoES corruption,
Dhule. In fact, according to Vibhuti, to clinics for carrying out amniocen
What is more surprising is that a
after Bombay, Dahanu is a major tesis and biher scientific tests for the toothless act like this is a model for '
centre today for SD tests.
purpose of detecting genetic abnor the Central draft bill which was intro
Sex determination tests are equally malities, ibe process of booking the duced in the winter session of the reor . more popular inrs the
, .states
•. of offending doctors is a task in itself, cently dissolved Lok Sabhi. The
Gujarat, Madhya Pradesh, Utter pOf.
a complaint Central bill does aot provide for vigPradcsh, Punjab, Haryana, Delhi,
approach the court flioce committees and all the MitborTamil Nadu and Orissa. And after the against unscrupulous doctors. The by is vested wi|h s angle govennoeal i
ban came imp force in Maharashtra complaint has to be lodged with SAA offid*!. And what « worse is that the
three years ago. SD test has caught whj<:b
uke
—L' Central bill, like the Maharashtra act,
on in Goa too. • ■ .
ex.
Ever since while on the one hand punisher women who seek such tests
, Last year alone, according to statis the popularity of tbe/test caught on
.it h a knoun (act that most
tics revealed in Parliament, one lakh like wildfire, on the .other hand tt^Womea who undergo such tests do
' female foetu^ycre aborted after »s- triggerd off a national debate which
pressure from their husbaw3
h 3$ now taken an ideological turn widr'^or. families.
______ J?______ _________ __
aI____ —________
f
The Ericsson technique.
|
<Vv
r. ■
to X'
women?
‘rrSrehilv in India id propagate"a new sex selection technique he has
inv^nleii^MANISH^GUPTE and RAVI DUGGAL, who spoke >o
iiny^
’ hini^disc^s the ethical questions this controversial technique raises
hiM
■ •fZ«
' af^k
•&..<pensive ultraso•
■
ESF5WB':
\w
...™ ^n.1 demandsBV peno-
•
'Such a proce-
dure would cost, at a modest estihe
Invented-Jon whtch is ant.thetieal to the. mate, Rs 2,000. The entire procedure may have to be repeated three
m CalifofniiJhCTeby the father's,. fernintst stance a»CTtmg (hat the
or four times to ensure pregnancy^
Once the woman gets pregnant,
there is still the lurking 25 per cent
chance that she may have conceived
a child of the “wrong” sex ie female
* if she had hoped for a male or vice
1
'
■:
j
,<
’-
? ■:
ila<x a halo,; biopsy
or amniooeotesB andjn‘he .
^Vsu^a
tnbtahe.wouMhavo •
ifie 'sDenrS^^ivuii.-;faste? than thowYwant is tQ^n |
;
sperms ran. ^colljcted, at
IWlll
fx-iin'r/that exists
p^^a? chniis’afl? oveh the
LU
f be then c
J natei?*wii
f would Jia'
v?S««SSfe-
and at exhorbitant financial cost as
-■ "“te.r'S Sste ■
■ -*■ The consequences of shch a tech-> '•
/ nique would be horrifying Firstly;‘ A j. \
' and ‘ most' evidently, \ it would .. •
fr^S .Gimetrfcs; US.
female sex Selection is,■ however;^,
o^>« onN Mter aeq J
tndryet
^elope^g^^ •^’’from- the nearest Ericsson
r
?As&
'wfe'.Xz” XJ
■ c
craving” so obvious in India, couP^v.ouJd
Ian™* thdr families” but would, /
definitely not have even a single
female child if they could help it.
The argument that the status of
women would rise if their numbers
decreased has been scientifically disproven. There are numerous sur
veys to prove that, in fact, an
adverse sex ratio increases rape,
purdah, polyandr/as well as other
violence on and oppression ot
women The status of Indian women
is pitiful enough when they arc born
as unavoidable evils" but it wall be
much worse when they are bom .
despite a planned conspiracy to ex■terminate them. In Punjab, a gir is
endearingly and indulgently
’ Sfuee" (literally meaning “dead ),
indicating the secret death wish that
even natal family members place on
their female progeny; so, the un
masked hostility towards a female,
born as an "accident", after the
procedure of sex selection, can be
well imagined.—--------- —- -
^AVVY SPOTLIGHT
■'l J <|'
■ i*ST3
• by Raka Sinha
Rohtak Rampage
Alarming Female Foeticid
“Just yesterday,
a bitch was seen
candying a fourn
I J, foetus
in its mouth.”
ux
«-t»S
I
Must (in)famous of them
all ■ Dr Kambhoj's Sex
Determination Centre
Family pressure drives
Saintri, a mother of two
daughters > to determine the
sex of her unborn child
ongested, crumbling and callous, is a desi one. She gives personal pi
Haryana’s Rohtak town and its sur- efficacy: “I myself ate the me
rounding district have the dubious dis- month and then gave bii
.
! .
tinction of possessing the lowest sex-ratio in mother, (who is currently ill and at home) has
the country: an alarming 866 females t > 1000 been trained as a nurse-daf, Savitri Devi s.
males. What is even more alarming is that and she also does abortions, “but only th
while the all-India sex-ratio has dropped from which are two-month-old, and by the D & <
934 to 929 females, a drop of 6 points, the method.” I see a small, dingy and dirty
Rohtak figure has slid as many as 13 points, at the back of the shop where a amshac
from 879 to 866. There has been a correspond- wooden platfrom has been set up. No si
ing drop in the population growth rate in the of any kind of medical equipment — 1
district — it now stands at 17% against the Rama Devi does the D & C operations remain .
State average of 28%, in spite of a not-too-suc- to be imagined.
cessful family planning programme in the
Over to an elderly couple, the Sabharwals,
'area. ‘Rampant female foeticide’ is the verdict
who have obtained their medical diplomas
of most medical and social observers.
When I, eight months pregnant myself, from Lahore, before partition. Yes, they do
went to Rohtak to investigate, my first en abortions “using the D & C method” and also
counter with the horrors there took plnce in use a cream or an injection at times. They
the city police station, where the inspector refuse to tell me the name of the cream or
complacently told me, “Just yesterday a case injection .
was reported to us where a bitch was seen
At Dr Chitkara’s Nursing Home, Dr (Mrs)
carrying a four-month-old foetus in its mouth. Chitkara reveals, “There are almost 80 out
It was spotted by a tea-shop owner, but it lets in Rohtak where abortions can be done.
would be difficult for us to trace where it Some are done by. trained dais or even nurses,
came from.” He could not tell me whether the and of course lady doctors like myself.”
foetus was male or female.
Though the dais use Fetex cream (which is
My next stop is at the clinic of Dr Mahindra cheap but extremely hazardous), Dr Chitkara
Kambhoji, one of the most (in)famous doctors says she uses an imported injection w’hich
in Rohtak. He owns four sex-determination costs Rs 380 to Rs 475. It has a few side
suddenly her husband
centres at Meerut, Delhi, Hissar and Rohtak, effects...
----------- ~
;------ calls her
and local residents put his clientele figures at aside and whispers something... she► comes
she is not prearound 1,000 a month. His charges range from back
1 ' and tells
" me sternly
’
, that
’
Rs 200 to Rs 400 to Rs 1000 per test (depend- pared to answer any more of my questions.
ing on the kind of scanning done). Dr KamDr Vinay Gour is ready to do so, however.
bhoj, however,very politely insisted, “Few A pleasant-looking woman she admits, “Many
women come to me to determine the sex of women from the surrounding villages come
the foetus.” The pregnant women sitting out to me for abortions; they are quite aware that
side in his clinic tell a different story. Sax ii ri
the sex of a foetus can be determined early
who has already had two daughters.confessc
on. We do about ten such abortions in a
“I have come to find out the sex of my child. month. The cost ranges from Rs 500 to Rs
If it is female, I might abort her." Santosh 1,000.’” Dr Gour justifies her practice: “In
admits, “I have three daughters and want to Haryana, if a woman gives birth only to
find out the sex of this unborn child. If vt
female babies, the husband will either get
female, I will have to discuss the matter with marrjed again or he, along with her in-laws,
my family members and decide whether t o
totally neglect her and. the girls. That, is
go in for an abortion.” Neelam, a housewife, why I am in favour of these abortions.”
whose husband works in a college, rev'-als
How many times before have we heard this
that she has one daughter, wants to find out kind of reasoning? The same old excuses, the
if the next baby will be a female... the imp
same white-washing of guilt. Tri? societal
cations of her statement hang heavily on her
changes don’t take place overnight, but till
Opposite Dr Kambhoj’s clinic is a small shop then, the government, women’s rganisations, politicians, women’s publications, you,
with a hoarding which says We .mpp'
medicines for ensuring the birth of a son’ The me, all of us, have to work towaids creating
name-plate
reads, ‘R D Hospital’. Inside, greater awareness as the first step towards
_ ....
Savitri Devi, the lady at the counter says her curbing this shameful practice of murder of
mother Rama Devi makes the medicine whi<
the female of the species.
■
.
ris»w-l
W!
-??IS3*.5
WMl^U
jh ’“«j jil
-“H=is=r:
,:i-s
g
■ rw-M
s:t ■ = JS *» 5
o
QD
*3 3
■-«*
p4"*
ciasK^’s-s
b
'§*1 ■•
Sr’’.?£.o-s><-g
/Sii
.is
4g •8 ““■g^s'”
mwitf
-a'
’Ml 0*01-- *S
5 2's’;S = s«
I-*-4
« O(
'2es^ou"-j2 >:*!
’&!
zr
E?5
-
mi
^--. „ _ -.-t
©
iWK iM
£sip.3?
2^SS:?f?XeeX.S
:
!
=?
Filvi
.«s
<8S.3^S,'-5-=: =5
■li:P
MrF3
»iHtt
’
“
11
"t
li
i
i
=-!
‘
-i
bo
HM’ . = oZ1S*1|- 5 P£E
ifsh:
1
’^IK
~hll
s;._
11 c5x- *c.
-5
gls
-Wa
;b.i
£ OD phi; >H :H iR%
sS£81’I -I^ir |ici
.
.41!
i>
10
®
.2
-I5 °-1
© ^!
E - Sz'z'sl * pilililllR
.^■hw
Ph^5
I
fr-4 s
■>hshHHywMii*
-_■
;Me
r
li
!
£
u.
I -S «J;iiOih!
Hi WM
L ittKJiWii®
?*:5 o
«•
’ i*
rftiolW
- - °-.y.£ t^-i2sg5’»
® t» C
Mfll
:- ©
■g
f
I
o
B
eS X >vc S? S-S-5
C
— <)«
,
u
is
E " - " ? 5 •*:
-. ^tlh sMr; Ill |F|?F!i 1 hsufflta
sI'
"c
^efLls’l'lltii-ss-a 16 g-2i=iilaUi <= -' -2
j: p, —
►» *■ •^'<-*3* c 3
**
w£
= "“
■
-----------------------
Sc
;t------------------------------ - ----- r~" Even if the sex selection technT
^EVSiFthe argument that sex selection is
entirely non-invasive and non-yiolent is
it wui be used to select the male f
untrue and neither is it as modestly priced as ^hoio^^fcicveian?state vni-
/itismadeimttobe^^-^
7
_1 ^tha^^ger"^,.
'
SSnd’dass’^J’fo^men. as
:
s s SBKJWKriWK
i0 ‘he
Encsson technique has raised
io the US. Ttotgh>
J male may either I---- t-..— ■
concentrated semen, the probability . :
of
hts fathenng a male
slighUy
opposed on rHioimu
religious rounds.
grounds. In
In
iha
tn
everv
100
females.
India,
a
similar
resistance
not
^o maal“ct Sa^^aph?cany. ■ be put up becau^ aayaDymay
Indian
successful educationally and econo
mically than siblings born later.
Another clever game thai the
“sex selectors” play is to pass the
i wus ? wkzixsw . . ..w buck around. When asked about the
que then?* It raisc< questions r.0^ « .w w— - commodity of the social consequences of sex selection
other^than^tbc^F husband^her"uterus was the “gar-; they deny all responsibility and:say
hn chand owned and that while it ts the doctors duty jo
the frui^ of any
w _ ______
s to edu-.
the general public against dis- .
—1---- -*i. When asked \
refuse to
^“^“not
^conpie,
techni-
as? ttsesssssa
*?F
w1"-
ii “
Sn’imorove tHe’'quality of- tfef^ to bear a.“legitimate” heir to ha ques, they argue that since coupes
progeny”,-“qualit^implying thc^; throng The idea of the “busband’s .would anyway:resort .to
--—
_•— artificially msemientific and
binder naturally. In the- panF;^
own seed!’ being
insemi- . unsci
unscientific
and harmful
harmful methods
methods to
to
get ‘
ohlets8 issued by PC Ericsson;. one’V naled may not seem like a repug- produce male offspring and ge
S reeTelnte^t
defencesbuilt^
inantaeienGo
v<m«t nani »«« «
. < “cheated”, the benevolentJ^i^
benevolent medical .
ixpected^ .r^&ce^
DrMehU,
who^ruu
En~ profession
pnof^jcould
^xblarned £
Sp against z cxpSted:^
resistances^ Dr
Mehta, who
will run an Encscourt ootbeblamed
fot Thoutfi his' teSiquo; is . better':'?l>h chnic in Bombay, argues that performing.su<± t«U.
,
adapted
a the
by toth Dr
idapted to
to choote
choose the
the male
male sex,
sex, he
he$f
the cost
cost benefit
benefit is
is greater
greater when
when a ments’were
savs
says that the
the';; “‘‘tex
sex selection tony
forv,; couple uses sex. selection as
’< com- Kapoor of a hosptal m Bombay
femal«
parid: to
He says
w^wiU^n^
females is
is more
more complicated".
complicated”,; biltT
but* ' pared*,
to amniocentesis.
amniocentesis. He
says ,4>ere
that “methods of selecting -femalesfemales, that amnibcentesis only detects gengen-, and by Dr Mehta »*<>•?
are also being developed by Gamet->;
await
:
Gamet-> - \jer>
^ef.- The dangers of undergoing an the sex >elemM
ria
others”
52abortion,
that zcz
too ir
in *the
’"surmoun^e hurd^^aU
rics and
and others
”.. .Heargues
He argues that
that 52
abortion;.-, tLiC
u- secondper
have trimester of pregnancy are greater, those who, «sh
J’JS^adver- '
ner cent of the couples who have,
Sntactetrtim
wantsjd. female chU->
chil< >•
contactecf^him wanted
‘ j© is
b the;
the cost. However, the argu- sexist ^^tfbte" imSben of "
dren (he does not disclose the sex><.
sex£\ men
mentt b
is not very convincing. Sperm sancs are rc*P«ta
ratio of the chiWren'.ftL families;;;.*separation alone would cost around1
which wanted^ a jiri
SS sy~Erf-;
■ “s jusSSesrefts&xSs ■,
t
Sn-; >A • >
(Delhi)
feMAN
.=
fa EXPRESS
(Dolhi)
A/Will bill to ban sex test control
(^medical mercenaries
aph
y
’T
HUMAN RIGHTS
by Vsha Rai
FT"’! HE massacre of lhe female
r I
foetus after determining
H
the sex of lhe child by use
/-•- of the most lophistlcaled
pre-natal
diagnostic
techniques
sounds like a horror story. It is »
crime in which the medical profes
sion has colluded with parents who
do not want a girl child.
In this session of Parliament the
bill for prevention of misuse of
pre-natal diagnostic techniques is
likely to be discussed and passed.
A joint select committee of Par
liament has held a scries of meetings
Io incorporate the suggestions of
interested patties. But will the bill
really solve,the problem? Or will it
be just another ornament in the
cause of women's upllfimcnlf
Even as the joint select commit
tee was grappling with the amazing
mass of evidence for a cogent,
I meaningful bill, at Udaipur a doctor
held a crash course for two days to
-trtiin doctors in pre-natal testing.
I lc was charging u whoppmg l<»
.tf.UXJ for lhe course. The yming
doctors undergoing the irnining
were assured they would get back
their investment in no lime at a I
and then they would be on the high
road lo minting ilioncy.
Fifteen years ago when the alarm
was first sounded about the pre
natal testing, the amniotic fluid was
being extracted from the pregnant
woman's womb and the chiomosomc pattern tested to determine
the sex of the child. But now 95 per
cent of the sex determination tests
(SDTs) arc
arc try
by unra
ultra suunu
sound equip(SDTs)
ment which has innumerable other
(llblil
WIHVSi
••••* -
i. A
z~»
Between 1986-87 ab
out 50,000 female
foetuses were aborted
after sex test. A doctor
at Udaipur held a twoday* crash course
in
.ii
pre-natal testing. He
Bid there are fems that the ghiment may u*e it to achieve its; i so
^wn
immediate goal of bringing
one
the Net Reproductive Ra'.c
(that is a woman piuduces j / one
lemalr <luld.)
The bill seeks tu give lice- e to
anyone who wants to register as a
genetic counsellor oi those m .ning
clinics and laboraiof;
genetic clinics
A person
person v.
who has a degi c or
A
diploma in medical genetics .ii' l tsvo
. years
years cx|»cricnce
exoericnce has
has beta
hcvn lerncd a
t was charging 3 WhOp-
-----------
incdical
medical uses and has mushroomed
to small towns and even villages.
Banning the ultra sound is neither <•..
feasible or advisable. But its use 1 :
definitely needs control.
•—1
■ • i
•
'^According
given
According to evidence B
1*6" to
° ... ttion,
-on jseveral
Cverni sopmsnemeu
sophisticated tcchnithe select committee, be ween 197«
bon. se c
[..sdcc!ion
•——n are in19H2'78,000
quej,i^..i».v
and 198278.000 female foetuses
creasingly being dcvelofKd and
ilarised conimcrcinlly hmc toe
lion and between I9H6-87 30,(XXI to
mc(hod
50,000 were aborted.
Sex determination facilities have
Between 1982 to 1987 lhe number
emend to rural interiors like Hijnor
I of clinics for sex dctcrnmiaoon In
(UP) ; Dhulia, Satara ami Sangh in
creased from less than 10 to 248 in
Maharashtra and areas of Gujarat
where basic facilities like potable
Bombay city alone.
A 1986 government sponsorea
from the rural
water do not exist,
tstudy in Bombay revealed that 84
the amniotic fluid is sent for
areas t..v
per cent of the sample of doctors
testing to the cities in ice p.icks.
were performing anmiocenlisis lor
Doctors and oilier who siipix.rl
sex determination alone.
the SDTs point out Ih.ii in a country
Each of the doctors was doing an
where abortion has been legalised
average of 270 tests it mdnth.
'-----there should be no squeanushness
In 1987 the Garbh I’arkshan
about SDTs and the subsequent
Virodhi Manch reported that 24(X)
abortions.
cryrs were conducted in Baroda
Those seeking a ban point mil
Jhy and only three of 30 drrcldrs
that the impact of the SI H s can now
I interviewed were against sex deterbe felt al the demographic level and
ping Rs 35,000 for the
course.
.i fninoUun,
,
(•
In icvcn Delhi dimes
• SDTs were done between 1987-88,
’
While ultrasonography Is the
Hcommoner way of xex dctermlmi-
the falling ratio of women to men.
The bill is welcomed ns the first
nllcmpl to control medical technol
ogy and piivatc medical practice.
gene list’.
*•medical
n’
bill
It has been suggested lh:o
be amended to specify whr pre
I he
natal diagnostic (cst-sAcchniq
the
legislation proposes to. confr I
'flic purpose for which fl tests
are conducted should be
c I out
and there should be a ccnira
pervisory board fbr monitoring ncm.
Pre-natal testing should
■ li
mited to hospitals atlatl.' ' to
medical collet rct< , . -'I /
Medical C’uuncil o» ' ■'■■'a
d U
apex rcscanh nipms.. .
that
have facilities on par "f hiyi' than
teaching hospitals, if '■ s Ik
sug
gested.
An interesting suggestion ■ de to
al the
the select committee was
I 'lira Sound ei|iii|'nienl I|y I ought
rnents
under the D.inp
1 '!
icied
Ad - like g'H"
I uhra
firms should be >U A - ; ''
<1 subsound equi['mcn:
:• r
persequent sale slu 'dd O'’1
milled.
'The onus of rc|Mn'.:hH ■ for the
• die a I
crime should fall <.n
I ind
professionals and tin* h.i 1
I
other relatives for .mlii'i'
ling the crime.
But the women on .i1’ .ni he tests
i the
arc conducted are >> o,
cii'lnif, gender bins a' O o, ,i>l not
Ik: prosecuted.
-Mssuc *
---
CONFIDENTIAL
CB II NO. 378
S A B H A
LOK
THE PRE-NATAL DIAGNOSTIC TECHNIQUES
(REGULATION AND PREVENTION OF MISUSE)
1991
BILL,
REPORT
THE
OF
JOINT
COMMITTEE
(Presented on 22nd December,1992)
S
E
A
L
LOK
SABHA
SECRETARIAT
NEW DELHI
December,
Date: 11.1.93
J 992 / Agrahayana,
1914 (Saka)
CONTENTS
Page
1.
Composition of the Joiafc..Committee
(iii)
2.
Report of the Joint Committee
1-19
3.
Note of dissent
4.
Bill as reported by the Joint Committee
*
APPENDICES*
Appendix I
Motion in Lok Sabha for reference
of the Bill to- the Joint Committee.
Appendix II :
Motion in Rajya Sabha.
Appendix III s
List of Associations/Organisations,
individuals/ etc. from whom Memoranda
were received by the Joint Committee.
Appendix IV :
List of witnesses who tendered oral
evidence before the Joint Committee.
Appendix
V i
Minutes of the Joint Committee.
-(ii)-♦To be appended at the time of -printing.
♦
JOINT COMMITTEE ON THE PRE-NATAL DIAGNOSTIC
TECHNIQUES
(REGULATION AND PREVENTION OF
MISUSE) BILL/ 1991.
.
COMPOSITIGK OF THE COMJ'UTTEE
Smt o D.K. Tharadevi
iddhartha
Chairperson
- InEMBERS
LOK SABHA
02.
03.
04.
05.
Smt. Girija Devi
06.
Dr. Mahavirsinh Harisinhji Gohil
07.
Dr. Viswanatham Kanithi
Smt. Sumitra Mahajan
08.
09.
*10.
11.
12.
13.
14.
15.
Smt» Dil Kumari Bhandari
Smt. Malini Bhattacharya
Smt. Sapoj Dubey
Smt. Geeta Mukherjee
Dr. (Smt.) Padma
Dr. Kartikeswap patra
Dr. Vasant Niwrutti Pawar
Dr. (Smt.) K.S. Soundaram
Km. Uma Bharati
Km. Vimla Verma
RAJYA JSAEHA
16.
17.
18.
Smt. Chandrika Abhinandan Jain
Smt. Sarla Meheshwari
Shri Sarda Mohanty
19.
20.
Shri V. Narayanasamy
Smt. Satya Bahin
21.
**22.
Smt. Sushma Swaraj
I
*
Appointed w.e’.f.20.12.1991 vice Shri kZr.NarayaFSiTFSTi^d .
•k ★
Shri Bhaskar Annaji Masodkar ceased to be a member of
the Committee. w..e.< 4.7.1992 on the expiry
his term
ln
Sabha and the vacancy- was not filled up.
(ill)
SECRETARIAT
1.
2.
Shri S.C. Gupta
- Additional Secretary
- Joint Secretary
3.
4.
Shri R.K. Chatterjee
Shri T.D. Dhingra
- Deputy Secretary
- Under Secretary
Shri G.L. Batra
REPRESENTATIVES
OPTATIVES OF THE MINISTRY OF LAW,
JUSTICE AND COMPANY AFFAIRS (LEGISLATIVE
DEPARTMENT)
lo
Shri
Jayakar
- Joint Secretary and
Legislative Counsel.
2,
Shri N.K, Agrawel
Jeint Secretary and
Legislative Counsel
3.
Shri M.S. Sharma
- Additional Legislative
Counsel.
4O
Shri T.K. Vishwanathan
- Additional Legislative
Counsel.
0F
MiNiSTRY OF HEALTH
AND FAMILY WELFARE (DEPARTMENT OF FAMILY
WELFARE)o
le
Shrimati Usha Vohra
- Secretary
2.
Shri A.K. Mukherjee
- Acting D.G.H.S.
3e
Shri S.B. Mishra
- Joint Secretary
4o
Shri S.S. Kapur
- Director
<iv)
REPORT OF THE JOINT COMMITTEE ON PRE
NATAL DIAGNOSTIC TECHNIQUES(REGULATION
AND PREVENTION OF MISUSE) BILL, 1991..
♦
1.
The Chairperson of the Joint Committee to which the
Bill* viz. the Pre-Natal Diagnostic Techniques (Regulation
and Prevention of Misuse) Bill, 1991 was referred, having
been authorised to submit the Report on their behalf, present
this Report.
2.
The Bill was introduced in the Lok. Sabha on 12 Sept.
1991. The motion for reference of the Bill to a Joint Com
mittee of- both Houses of Parliament was moved•in Lok Sabha
by Shri M.L. Fotedar, Minister of Health and Family Welfare
on 16 September, 19'91 and was adopted (Appendix I).
The Rajya Sabha concurred in the said motion on
3.
17 September, 1991 (Appendix II).
4a
The message from Raj ya Sabha was published in Lok Sabha
Bulletin Part II on 19 September, 1991.
5.
The Committee held 18 sittings in all.
6.
The first sitting was held on 22 October, 1991. At this
fitting, the Committee considered their future programme of
work and decided to issue a press communique inviting
■>
*>
memoranda containing suggestions/comments on the Bill by
22 November, 1991 from the State Governments, Union Terri
tory Administrations, Bar Councils, Medical Associations
and other individuals.interested in the subject matter of
the Bill for their consideration. They also desired that
•>
*Published in the' Gazette of India Extra-ordinary Part II
Section II, dated 12’September, 1991,
3
1
I
1G
Clause 14
31.
This clause provides for disqualification for appointment
as members of the Central Sup rviso.ry Beard. The Committee
feel that those persons' who have been associated with the use
oir pjrca'kzcic*i of pjre—nr t?
.
p
-l-‘ ------- —canigues ror determina... ■
ticn of sex should be disqualified from being members of the
Supervisory Board. Accordingly, the Committee have decided’
to provide a new sub-clause (f) which provides that a person
should be disqualified from being appointed as a member if
he has, in the opinion of the Central Government, been associa
ted with the use or promotion of pre-natal diagnostic tech
niques for the determination of sex.
Clause 16
. jOn^gf^the functions of the Central Supervisory Board is
statute be to create public awareness against the practice
of female foeticide. The purpose of the Bill is to discourage
the practice of pre-natal sex-determination itself to prevent
its misuse.
Therefore, the Committee have modified the rele
vant provision to provide for creating public awareness not
just against the practice of female foeticide but basically
against the pre-natal sex-detr mination, whether or not it
leads to female foeticide. Therefore, the words "pre-natal
sex determination ’and" have b^n ^ded at the eoorooriate '
place.
■*x
Clause 17
33.
This clause provides for the appointment of Appropriate
Authorities for discharging the functions of granting registration enforcing standards
prescribed for such Centres,
Laboratories and Clinics,
suspension or cancellation, of a
Genetic Counselling Centre, Genetic laboratory or Genetic-
e
e
e
e
e
a
e
e
•
a
a (
•
a
a
a
a
a
e
a
a
a
a
a
e
(9
9
9
9
9
9
9
9
9
9
9
I
9
>
Clinic and to enforce standards prescribed for such Centres,
9
9
•
I
I
II III i iMllill n i^saai
■in i ii'Tii
J
•» t
Laboratories and Clinics.
It also provides for the appoint
ment of Advisory Committee to advise the Appropriate Authori
ties in the discharge of the'r functions.
Sub-clause (1) and (2)
In sub-clause (1) and sub-clause (2)/ the existing Bill
34.
provides that the Central Government or the State Government;
shall appoint one or more '’officers” as Appropriate Authorities
for each'of the Union Territories/States etc. The Committee
feel that the existing provision needs to be amplified inas
much as there could be one or more Appropriate Authorities
for the whole or part of the State or Union Territory for the
purposes of this Act keeping in view the intensity of the
problem of pre-natal sex determination leading to female
'foeticide. Therefore^ the Committee have amended these sub
clauses accordingly.
Sub-clause (3)j
35.
In this sub-clause the present provision states that the
Appropriate Authorities contemplated in sub-clauses(1) and (2)
shall be of or above the rank of Joint Director of Health and
Family Welfare of the State Government or a Union Territory,
as the case may be.
In this connection, uhe Committee appre
ciate, that at the district level officers of the rank of Joint
Director or above may not be available. Therefore, the
Committee have amended the clause to provide inter-alia for
officers ”of or above the rank of Joint Director of Health
and Family Welfare or such other rank of the State Government
or of the Union Territory, as the Central Government or the
State Government, as the case may be, may deem fit to appoint" «.
12
Sub-clause (4)
36.
While discussing this sub-clause, the Committee have
/
felt that while discharging the functions of Appropriate
Authority, it should be obligatory for the Z.uthcrity to seek
and consider the advice of the Advisory Committee, constituted
under sub-clause (5) of ciauoe 17 on matters relating tc_ grant
of registration, complaints or suspension or cancellation of
the registration etc. Accordingly, the Committee have added
a new sub-clause to this sub-clause ' to provide for it
Sub-clause 5
37.
The existing provisions in the Bill do not give adequate
representation to certain interests tc make the Advisory
Committee effective.
The Committee are of the opinion that
the Advisory Committee should include a paediatrician, a legal
expert as also an officer concerned with the information and
publicity of the concerned Department. The Committee feel
that since the Appropriate Authority is to be guided by this
Advisory Committee, the opinions emerging from the Advisory
Committee should be well considered from all angles, for
which these interests should be properly represented. The
Committee have also decided to include a provision that one of
the Members of the Advisory c mmittee should be appointed as
the Chai
rf
O'-mmittcc ?^y ocntpal Government ox the
State Government as the case may be., to guide the deliberations
and to discharge the various functions of the Committee. The
Committee also feel that only those persons should be represen
ted on this Committee who are in no way associated with the
use or promotion of the pre-natal diagnostic techniques for
determination of sex. This sub-clause has been amended
.accordingly.
The Committee have also come tc the conclusion
that the Advisory Committee should meet at reasonably fixed
intervals which could be provided in the rules so that the
Advisory Committee can render useful advise to the Appropriate
13
Authority at the appropriate times. The sub-clause has been
amended accordingly.
/ ■_
Clause 18
38.
This clause p./cvides for registration of all Genetic
Counselling Centres, Genetic Laboratories and Genetic Clinics
engaged in conducting pre-natal diagnostic techniques. The
Committee feel that in cpder to cover any loophole, it is
necessary to provide for registration of the Genetic Centre
Laboratory or Clinic functioning "either separately or
Jointly”. The Committee have amended sub-clauses (1), (3)
and (4) of this clause accordingly.
Clause 19
39.
Sub-clause (1) has been amended to, include the words
“Either separately.or jointly” as explained.in regard to
clause 18 above.
Clause 22
40. This clause bans advertisements by a Genetic Counselling.
Centref Laboratory or a Clinic relating to pre-natal diagno
stic techniques and also provides for the punishment for its
contravention.
The Committee have amended the sub-clause(1)
to provide that, even any agent on behalf of a Centre., Labora-.
by these provisions.
tory or a Clinic shall bo
V
‘
A -
.
41. The Committee'are of the opinion that even, those who
print such an advertisement should also be punishable.
Accordingly, the Committee have provided a new sub-dause(2)
to:, this clause.
r
Clause 23
42. This clause provides for offences and penalities * The
Committee feel that instead of all persons employed in a
Counselling Centre/ Laboratory or Clinic/ only those persons
- 14 who render professional or technical services should come -
within the purview of the penal clause of this Bill. The
clause has been amended accordingly.
Clause 24
uhar rhe
che court shall presume^
presume unless
43. Tms clause provides -char
the contrary is proved/ that the pregnant woman has been com
pelled by her husband or the relative to undergo pre-natal
diagnostic technique and such person shall be liable for
abetment of the offence under sub-section (3) of section 23.
44o The Committee deliberated on the question at length
whether the pregnant woman who undergoes such pre-natal
diagnostic techniques should be exempted from such punishment
considering
the social status and compulsions in which the’
Indian woman is placed today. However, the Committee felt
that providing for punishment for the pregnant woman herself
will go a long way in achieving cherished objectives of the
Bill, Therefore/ the Committee decided not to make any change
in the present clause and to retain it as it is.
Clause 28
45.
This .clause, provides that the court shall take cognizance
of an offence under the Act only on a complaint made by the
Appropriate Authority or any officer authorised by the Central
Govr*'*
Government or the Appropriate Authority
n*- by a person .who has given notice of not less than sixty
days to the Appropriate Authority of the alleged offence and
his intention tb make’' a complaint to the court.
46.
In clause (b) of sub-clause (1)/ the Committee have
decided to amplify the existing provision to provide that any
person “including a person representing any social organization” could give a notice of his intention to make a complaint
to the court.
I l._3illl II
IIWH1
15
47.
The Committea have also felt thau the existing
existing
provision of sixty days’ notice is too long for
approaching the court, The Committee, have, therefore,
decided to reduce it to thirty days. The Committee
have amended the clause accordingly.
48.
e
The Joint Committee recommended that the Bill,
as amended, be passed.
NEW DELHI;
16 December, 1992.
0
4
9
9
*
4
•
4
4
11.1.93:Pr/
SMT. D.K. THARADEVI SIDDHARTHA
CHAIRPERSON
Joint Committee on Pre-Natal
Diagnostic Techniques (Regulation
and Prevention of Misuse)Bill,1991.
nil WIIMBI
<S
€
I
t.
Bill No. 155 of 1991.
e
THE
pre-natal
-- TECHNIQUES (REGULATION
DIAGNOSTIC
OF MISUSE) BILL. 1991
and prevention ci
(AS REPORTED BY THE
*
Joint Committee)
.
WU» *• •iw'"*'"11,
or
[WcrrcU’ underlinedCommUKe.
.«««>>« i"d‘“‘e
the C,
b”
A
BILL
of <»«
to provide
the, repoioeum
for the for
purpose
'of ^-tzn^ge^c^nmmbohc^mde- - c ‘ =
sonujl
abnorwahties or certain
sorrel abnormalities
hx j
g
gf
techniques
>» -x-"' ”■ •'» r'-“w" "
India as follows: —
CHAPTER I
Preliminary
5
■ i
Diagnostic Techniques
1 (I) This Act may be called the Pre-natal
(Regulation and Prevention of Misuse) Act.
i—. 19^2.
the State of Jammu
whole of India except
(2) It shall extend t° 1116
and Kashmir.
(3) It shall come in tl» omcl.l C««ette. .ppn.nl
may, by i-----
Sluxt
title,
extent
uul coin
mencer 'ent.
2
DefmiUcna.
2. In this Act, unless the context otherwise requires,—
(a) “Appropriate Authority” means the Appropriate Aum^i. .
appointed under section 17;
(b) “Board” means the Central Supervisory Board cons!ituted
under section 7;
(c) Genetic Counselling Centrq” means an inslitiiicp li.jspiiap
nursing home or any place, by whatever name called, which provides
for genetic counselling to patients ***;
(d) “Genetic Clinic” means a clinic, institute, hospital nursing
home or any place, by whatever name called, which is used for con-t
)<•
ducting pre-natal diagnostic procedures;
(e) “Genetic Laboratory” means a laboratory and includes
a
place where facilities are provided for conducting analysis or tests
of samples received from
. Genetic
---------- Clinic
- ---- j fop prc-nata] diagnostic test;
(f) gynaecologist ’ means a person who possesses a post-gra
duate qualification in gynaecology and obstetrics;
(p) “medical geneticist” means a jperson who
’ possesses a degree
or diploma or certificate in medical genetics in the field1 of pre-natal
diagnostic techniques or has experience of not less than
two years
in such field after obtaining—
i5
29
(■>.) any one of the medical qualifications recognised under
the Indian Medical Council Act. 1956; or
10?.
195b.
yd .’cyr
Postgraduate degree in biological sciences;
(h) “paediatrician*' means a person who possesses a post-gra
duate qualification in paediatrics;
pre-natal diagnostic procedures’’ means all gynaecological or
25
r °r, meclical procedures such as ultrasonography foeto. *afirni£ or ’’emovmg samples of amniotic fluid chorionic villi •
fihl^hxT^ tlASUe'°f 3 prefir‘Qnt womaP {or being sent to a Genetic
hr Genetie Clinic for eonducting pr^njta! diaenostie Ust;- 30
■.Wj) ‘‘pre-natal diagnostic
techniques"
includes' all pre-natal
diagnostic 'pi-ocedurhs and-pre-natal diagnostic tests; ■
pre-natal diagnostic test” means ultrasonography or any •
test, or analysis of amniotic fluid. chorionicTflTTTl^i^T^’fissue
of a pregnant woman conducted to detect geneti,. or metabolic dis
35
orders or chromosomal abnormalities or congenital anomalies
nr
haemoglob-nopatbies or sex-linked disrates:
“pre-cribed" means prescribed
by rules made under this
?mj, “i •'isteriyi medical practitioner" means
Acf:
medical mactihv Hirai
tioner who f assesses any recognised medical <,,>.1.i
v
■
!11 r)
irl''i!liiush -(.,' iof Stection'of the Indian Medic:,! i mund Ac,' W-r' lu JU?:
11X.O
and whose i me has-begn entered in .-1 State Medical Register;
.J
3
‘‘i-^ul'Ations*’'means regulations' 'frameci, by the .Board under
this Act.
CHAPTER II
Regulation of Genetic Counselling Centres, Genetic Laboratories
tnt:’tn yvJi-and GenbTic Clinics...ro: 'H v. ■' ■ ■.•: •. > .<■ is. ..
■
••
3. On and from the commencement of this Act,
I
5
Ml
10
15
<
no Genetic Counselling Centre Genetic Laboratory or
Genetic Clinic unless registered under this Act, ‘ shall conduct or
associate with, or help in, conducting activities relating to pre-natal
diagnostic techniques;
Kcglll
tion .'f
Gone lie
Counsel
ling
Centres,
i.i
(2)|*no-Genetic Counselling Centre, Genetic Laboratory or Gene
tic Clinic shall employ or. cause to be employed any person who does
hot possess the prescribed qualifications;
Genetic
Labora
tories an. I
Genetic
Clinics.
(3) no medical geneticist, gynaecologist - paediatrician registered
medical practitioner or any other person shall conduct or cause to
be: conducted or aid in conducting by himself or through any other
person, any pre-natal diagnostic techniques at a place other than a
place registered under this . Act.
I
Chapter hi
20
...Regulation of pr^-natal diagnostic'techniques
4. On and from the commencement of this AS'
25
;-(l). no place including‘a registered Genetic Counselling
Centre
x
...
«
.. or- Gepetio -Laboratory or Genetic Clinic’shall be csed or caused to
f be used by any person’for conducting pre-natal 'diagn^tic techniques.
except for the purposes specified in clause (2) and arer satisfying
any of the conditions Specified in clause (3);
,(2) no pre-natal diagnostic techniques shall be conducted except
for .-the purposes of detection of any of the following abnormalities,
•
;
<
l-;'. namely;.—r
30
(i) chromosomal abnormalities;
’(ii) genetic metabolic diseases;
(iii) haemoglobinopathies;
(iv) sex-linked genetic diseases;
(v) congenital-anomalies;
35
(vi) any other abnormalities or diseases as may be specified
; 1 'by the Central Supervisory Board;
;•
(3) no pre-natal diagnostic technirjucs shall be used or conducted
unless the person qualified to do so is satisfied that any of the fol7
lowing conditions are fulfilled, namely:—
.T
40
(i) age of the pregnant woman-is above thirty-five years;
Regulation
of prenatal
diagnostic
techniques
(ii) the pregnant ,woman has undergone of two or nioro
spontaneous abortions or foetal’loss;
i) the pregnant woman had been exposed to potentially
teratogenic agents
such: as drugs, : radiation.
infection, o.
*
chemicals;.
•I’.hd
(iv) the pregnant woman;, has a family history of
retardation or physical deformities such as spasticity or any
other genetic disease;,
(v) any other condition as may be specified by
Super.yisoryy Board; ,
the Central
KJ
(4) no person, being a relative or the husband of the pregnant
woman shall seek or encourage the conduct of any pre-natal diathe purpose
specified
in
gnostic tecl uniques on her except for
clause ■ (2). .
Wrjtieu
consent of
pregnant
.woman and
prohibition
of commu
nicating the
sex of
foetus.
5, (1) No person referred to in clause (2) of section 3 shall conduct 1>
the pre-natal diagnostic procedures unless—
(a) he has explained all known side and after effects of such
procedures to the pregnant woman concerned;
(b) he has obtained in the prescribed form her written consent
undergo
such procedures in the language which she understands; ?.()
to
and
(c) a copy of her written consent obtained under clause (b) is
given to the pregnant woman.
(2) No person conducting pre-natal diagnostic procedures shall
communicate to the pregnant woman concerned or her relatives the sex 25
of the foetus by words, signs or in any other manner.
Dote; mi nation of
aex pro
hibited.
6. Un and from the commencement of this Act,—
(a) no Genetic Counselling Centre or Genetic Laboratory or
Genetic Clinic shall conduct or cause to be conducted in its Centre.
Laboratory or Clinic, pre-natal diagnostic techniques including ultra 30
sonography. for the purpose of determining the sex of a foetus;
(b) no person shall conduct or cause to be conducted any pre
natal diagnostic techniques including ultrasonography for the pur
pose of determining the sex of a foetus.
CHAPTER IV
Central Supervisory Board
Constitu
tion of
Central
Supervitury
7. (1) The Central Government shall cons’itutc a Board to be
known as the Central Supervisory Board to exercise the powers and
perforin the functions conferred on the Board under this Act.
(2) The Board shall consist of—
40
.!■ yiri!.
(a) the Minister in charge of the Ministry or Department of 5
Family Welfare, who shall be the Chairman. >?x' officio;
i
5
(b) the Secretary to the Government of India in ch.arge of the
department of Family Wtdfmc. who shall be the V ire-Chairnian,
ax‘ off'U: io
(c) two mejmbers to be appointed by the Central Government
to represent the Ministries of Central Government in
of
in charge
charge
woman and Child Development and of Law and Justice, e.v officii;
5
(d) tlie Director General of Health
Government, ex officio;
H
Services of the
(e) ten members to be appointed b y the Centra I
two each from amongst—
Central
Government,
(i) ejninent medical geneticists;
(m) eminent gynaecologists and obstetricians,;
(iii) eminent paediatricians;
(iv) eminent social scientists; and
i.5
(n) representatives <»t women welfare o'n'ini.-rHmns;
(J) three women members of Parliament, of v.-lu-m I v. o s vail h.elected by the House of the People and one by the Council of Slate-:;
20
(p) four members to be appointed by the Central Government
by rotation to represent the States and the Union territories, two in
the alphabetical order and two in the revc'T.e alphabetical order:
Provided that no appointment under this clause shall be made
except on the recommendation of the Suite Government or. as the
case may be, the Union territory;
23
(/?•) an officer, not below the rank of a Joint Secretary or
equivalent of the Central Government, in charge of Family Welfare,
who shall be the member-secretary, ex. officio.^
(1) The term of office of a member, oiher than an r.r oGcio member,
shall be,—
30
(a) in case of appointment under clause
sub-section (2) of ruction 7. three ycai’s; and
er
■.’iiiil'ei*.
clause (f) of
(b) in case of appointment under clause (g) of the said sub
section, one year.
(2) If a casual vacancy, occurs in the office of an- other members,
whether by reason of his death,
ion or inability to di'-chnrge his
' ~ to illness’ or other menmeify, such vacancy shah be filled
35 functions owing
by the Central Government by making n rrP<h appointment and the memher .so appointed shall hold office for the remainder of the term of nffici*
of the person in whose place ho is co appointed.
(3) Tlie Vice-Chairman shnP perform such functions as
^10 assigned to him by the Chairman fr6m time to time.
11 r rn r f
• ■Hi. r of
AV be
(I) The procedure to be followed b the members in Un? Jiscbar.}”'
of their functions shall be such as may be prescribed.
6
Meetings
of the
!». (1) The Board shall- meet at such time
and place, :,„d
.
observe such rules of procedure in ^ar.l t<, the transaction of J.m,
Board.
at its meetings (including the quorum ;,t such meetings) as . mav
provided, by regulations:
I rovided that the Board sliaj
meet at leasf once in six month
(^) The Chairman and in his absence
the Vice-Chai rm an shaji ,
side, at the meetings of the Board.
(3) If for any reason the Chairman
or tin* Vice-Chairman is unai/ic
attend any meeUng' of the Board,
any other member chosen by the inetiihers present at the meeting shall
preside at the meeting.
qUCst,ons which conie up before any meeting of the Board
shall be decided by a majority of the votes of the members present and
VO ing, and in the event of an equality of votes, tin/ Chairman or in h.
absence, the person presiding, shall have and exercise :l second or can
ing vote.
(5) Members other than e.r
t
ff ' members
\
officio
shalF receive such alio ,
.wanceSj if any, from the Board as may be prescribed.
Vacancies,
cfc., not to
invalidate
proceedings
Of the
Board.
10. No act or proceeding of the Board shall
ho inv.-'lid /Merely by
reason of—'
(a) any vacancy in, or any defect in the
constitution of, the 2()
Board; or
(b) any defect in the. appointment of a
member of the Board; or
person acting as a
(C) any irregularity in the procedure of the Board
not affecting
the merits- of the case.
Tempo
rary asso
ciation. of
persons
with lhe
Board ' for
particular
purposes.
?>
11- (1) The Board may associate with itself in such
manner and for
such purposes, as may be determined by regulations. • any person whose
f°r adViCe U mny desire in carr-vin« out any of the provisions
OI
vlllS
T1CI.
(2) A person associated with it by the Board under sub-section (1)
for any purpose shall have a right to take part in the discussions relevant 30
' Roa d
bUThaU nOt haVe 3 right t0 vote at
'^eeting of the
Board and shall not be a member for any other purpose.
Appoint
ment of
officers
and
other cmcmp/oyees of
.the Board,
12. (7)
...
U) For
hor the
the purpose of enabling it efficiently to discharge
. ..functions under this Act, the Board may, subject to such regulations ».fs
as 35
n'ade W, th'S beha,f’ aPP<>mt (whether on deputation '
or otherwise) such number of officers and other employees as it mav consider
necessary!
Provided that the appointment of such category
t* officers. ;>s m:<v
be,specified in such regulations, shall be* subject1 to tlw
nnprvval of the
Central Government.
(2) Every officer or. other employee appointed b
Board shall lie
subject to such-conditions of service and shnll be y
on1 ■ ■!| to such rcmnneration as maybe specified in the repul''■ ■
xi
Authvinica
13 All orders and decisions of the Board shall be authenticated by
13 All or
chairrnan .or any other member authorised by the lion of
by thc Board nliall onk'*’. -‘jid
the signature of the Chairman, or ,nyruments
other inBeard in this behalf,, and all other
J of the member-secretary' or any other sit unicjitn
be authenticated by the signature
of the
manner in this.behalf.
5 officer of the Board authorised in
i.. like
1
Board.
14. A person shall be disqualified for being appointed as a member
■
if,
10
15
(a) has been convicted and sentenced to h'lprisomnent,. for an
Central Government, involves
offence.which, in the opinion of the <---------moral turpitude; or
• (b)* is an undischarged insolvent; or
declared by a competent
(c) is of unsound mind and stands so
court; or
‘
i the service of the
dismissed from
•(d) has been removed or
controlled
by the Governowned or c —
Government or a Corporation
l)isqu;ilili
cations
for
appoint
me nt as
member.
ment; or
such
* ' L
Of the Central Government,
(e) has, in the opinion
is likely to affect pre;..L_ /; iin the Board as
financial or other interest
a member; or
discharge by him of his functions as
judicially the c—
1 Government, been asso• l of the Central
.
(f) has, in the opinion
21
of 1pre-natal diagnostic technique
elated with the use or promotion
1
i
for determination of sex.
be Eiigibiliiy
15. Subject to the other terms and
rc- of member
for represcribed, any person ceasing to be a member
appoint
25 appointment as such member.
ment.
16. The Board shall have the following functions, namely:
(i) to advise the Government on policy matters r
g
use
of pre-natal diagnostics techniques;
(ii) to review implementation of the Act and_1 the rules made
said Act and rules to the
thereunder and recommend changes in the a----------
30
Func
tions
of ih«
Board.
Cen^)TcZe public awareness against the practice of pre^
determination, of sex and female foeticide;
^TtTffiTdown
code of conduct to be observed y pe
.
Laboratories and
working at Genetic Counselling Centres, GeneUc ---------
35
Genetic Clinics;
. .
(v) any other functions as may be specified under t. e .
CHAPTER V
Appbop™ Authohtty ani, AovtsonY CoM^rr^
40
17
omali
'• l in the
(1) The Central Government shall appoint, by notification
for each of the
Aww.-. A.®-™. • ■
Union territories for the purposes of this A
Appro
priate
Autho
rity and
Advisory
Committee
8
(2) The State Government shall appoint, by notification in the Ofii< H
Gazette, one or more Appropriate Authorities for the whole or }pa 11 ( i
the State for the purposes of this Act having regard to the intense
of the problem of pre-natal sex determination
determination leading
female foeti<
foot. ■
‘
leading ttoo female
(5) The officers appointed
Appropriate Authorities under
section (1) or sub-section (2) shall be,—
I A
»•
M • .a«
A
. . J 1
• a ’
«
.'jhI
(a) when appointed for the whole of the State or
the Unit?territory, of or above the rank of the Joint Dirt
of I I (’.! I! 1) , | «
Family Welfare; and
5
(b) when appointed for any part of the St. te or
territory, of such other rank as the State Government or the Central Government, as the case may be, may deem fit.
(if) The Appropriate Authority shall
namely; —
have the following functions, *
.(a) to grant suspend or cancel registration of a Genetic Coun. .selling Centre, Genetic Laboratory, or Genetic Clinic;
i
(Vn/™ r° er’forrc\standalds prescribed for the Genetic Counselline
Centre, Genetic Laboratory and Genetic Clinic;
4
’Xf nr
inv®stisate complaints of breach of the provisions of this
>Act or the rules made thereune’er and take immediate action; and
and take nnmecliate
20
•■‘ (d) to seek and consider the iadvice
’
of the Advisory Committee,
, constituted under sub-section (5), on application for
anduon complaints for suspension’
'
reeistratiOn
i or cancellation of registration.
SI
nentra' Government OI
Government, as the case
or ine
the State Government,
Turk I
constitute an Advisory Committee for each Appropriate
of ite°funcHons
Appropria,e Authority in the discharge’
of its functions and shall appoint
one of
the members
of the Advisory
•appoint one
of the
members of
Committee to be its Chairman.
^ovisory
(6) The Adivsory Committee shall consist of—
.
(a) three medical experts from amongst gynaecologists obstnri
cans, paediatricians and medical genetcists; S'VnaeCOlOph,ts’ obsten-
30
(b) one legal expert;
(c) one officer to r
‘2° cle!;:,rlment dealing with information and publicity of the State Governm
------- -lent or the Union territory,
as the case may be;
.
a
--------------
(d) three eminent social workers of whom
u,an onp
not JUSS
less than
shall be from
amongst representatives of womens organisations.
State Goveroment^the
35
f6”*™1 Gcvern™nt or the
use
Id
• (8) The Advisory Committee may m-et as and
>
• , ,
on the request of the Appropriate Authority f"r considernt
application for remstration nr ™
consideration of any
tion of registration and to give advTc^hercon': ' SUSPCnSi°n or eancella-h"
9
|
Provided that the period intervening between any . ivo meetings shall
not exceed the prescribed period.
(.9) The terms and conditions subject to which a person may be
appointed to the Advisory Committee and the procedure to be followed
by such Committee in the discharge of its functions shall be such a.--;
may be prescribed.
CHAPTER VI
Registration of Genetic Counselling Centres, Genetic Laboratohies
and Genetic Clinics
JO
18. (1) No person shall open any Genetic Counselling Centre, Genetic
Laboratory or Genetic Clinic after the commencement of this Act unless
such Centre, Laboratory or Clinic is duly registered separately or jojntjy
—n—w nr.
under this Act.
(2) Every application for registration under sub-section (1), shall be
15 made to the Appropriate Authority in such form and in such manner and
shall be accompanied by such fees as may be prescribed.
(3) Every Genetic Counselling Centre, Genetic Laboratory or Genetic
Clinic engaged, either partly or exclusively, in counselling or conduct’•
'
Reghtrathw
of Genetic
Coirnsclling
Centres,
Genetic
Laboratories
fu
Genetic
Clinics.
mx ye**. >
ing pre-natal diagnostic techniques for any of the purposes mentioned in
2u section 4, immediately before the commencement of this Act, shall apply
for registration within sixty days from the date of such commencement.
(4) Subject to the provisions of section 6. every Genetic Counselling
Centre, Genetic Laboratory or Genetic Clinic engaged in counselling or
conducting pre-natal diagnostic techniques shall cease to conduct any
25 such counselling or technique on the expiry of six months from the date *
of commencement of this Act unless such Centre, Laboratory or Clinic
has applied for registration and is so registered separately or jointly or
till such application is disposed of, whichever is earlier.
(5) No Genetic Counselling Centre, Genetic Laboratory or Genetic
30 Clinic shall be registered under this Act unless the Appropriate Autho
rity is satisfied that such Centre, Laboratory or Clinic is in a position to
provide such facilities, maintain such equipment and standards as may be
prescribed.
19. (1) The Appropriate Authority shall, aftqr holding an inquiry
35 and after satisfying itself that the applicant has complied with all the
requirements of this Act and the rules made thereunder and having
regard to the advice of the Advisory Committee in this behalf, grant a
certificate of registration in the prescribed form jointly or separately to
the Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic,
40 as the case may be.
(2) If, after the inquiry and after giving an onaortunily of being heard
to the applicant and having regard to the advice of the Advisory
Committee, the Appropriate Authority is satisfied that the applicant has
not complied with the requirements of this
Act or the rules, it shall,
45 for reasons to be recorded in writing, reject the application for regis
tration.
(Certificate
of regis
tration.
(3) Every certificate of registration shall be renewed in such inannet
and after such period and on payment of such fees as may be proscribed
(4) The certificate, of registry lion shall be displayed by the registered
Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic in i
conspicuous place at its place of business.
Cancella
tion or sus
pension of
registration.
5
20. (1) The Appropriate Authority may suo nmln, or on complaiiil
issue a notice to the Genetic Counselling Centro, Genetic Laboratory >r
Genetic Clinic to show cause why its registration should not he sus
pended ar cancelled for the reasons mentioned in the notice.
(2) If, after giving a reasonable opportunity of being heard to the
Genetic Counselling Centre. Genetic Laboratory or Genetic Clinic and
10
having regard-to the advice of the Advisory Committee, the Appropriate
AtdliorTty’ is^satisfied’ that there has been a breach of the provisions of
this Act or the rules; it may, without prejudice Io ahy criminal action
that it may take against such Centre, Laboratory or Clinic, suspend its. i
registration for such period’as it may think fit or cancel its registration,
as the case may be.
(3) Notwithstanding' anything contained in sub sections" (I) and
(2), if the Appropriate Authority is of the opinion that it is necessary
or expedient go to do in the public interest, it may, for reasons to be 20
recorded in writing, suspend the registration of any Genetic Counselling
Centre, Genetic Laboratory or Genetie Clinic without issuing any such
notice referred to in sub-section (1) .
Appeal.
21. The Genetic Counselling Centre, Genetic Laboratory or Genetic
Clinic may, within thirty days from the date of receipt of the order of
suspension or cancellation of
registration passed by
the Appropriate
Authority under section 20, prefer an appeal against such order to
(i) the Central Government, where the appeal is against the
order of the Central Appropriate Authority; and
(ii) the State Government, where the appeal is against
order of the State Appropriate Authority,
th a 30
in the prescribed manner.
CHAPTER VII
Offences and penalties
Prohibition
of adver
tisement
relating (o
pre-natal
dclejmirialion of sex
and punish
ment for
contra ven
lion.
22. (1) No person, organisafon, Genetic Counselling Centre, Genetic 35
Laboratory or Genetic Clinic shall issue or cause to be issued any adver-l
tisement in any manner regarding facilities of pre-natal determination^
of sexnivailable at such Centre, Laboratory. Clinic or any other place.
(2) No person or organisation shall publish or distribute or cause to
be published or distributed any advertisvmerit in any manner regarding 40
facilities . of pre-natal dolcrminat’on
of sex available at any Genetic
Counselling Centre, Genetic Laboratory, Genetic Clinic or any other
place.
11
(3) Any person who contravenes the provisions of sub-section {I) or
sub-section (2) shall be punishable VdJh’ imprisonment .lor a term which
may extend to three years and with fine which may extend to ten thou
sand rupees.
1
t
5
i
Expiration.—For the purposes of 'this section, “advertisement inclu
des any notice, circular, label, wrapper or other document and also,
includes any visible representation made by .means of any light, soum:
smoke or gas.
.
.
•
23. (1) Any medical geneticist,.gypaecujogr-t, regislercd. medical prac----titioner
or any person who owns#a Genetie
’ Counselling Centre,, a Genetic
10
Centre, LaboraLaboratory or a Genetic Clinic or is employed in such a C_„l_
tory or Clinic and renders his professional or - technical services to or
(Ifftn. i
nn'ci
,
pcnahic1
A ' J .Xt’DT’tUI
at such Centre, Laboratory or Clinic, whether on an honorary-basis or
otherwise, and who contravenes any of the provisions of this Act or
a
rules made thereunder shall be punishable with imprisonment for
15
term which may extend io three years and with fine which may extend
to ten thousand rupees and .on any subsequent conviction, wih imprisonment which may extend to five years and with fine which may extend to
fifty thousand rupees.
I
20
25
(2) The name of the registered medical practitioner who has b^en
convicted by the court under sub-section (7),.shall be reported, by the
for
Appropriate Authority to the respective State Medical Council
from the
taking necessary action including the removal of his namcafrol
register of the Council for a period of two years for- the first offence
— and
permanently for the subsequent offence.
(5) Any person who seeks the aid of a Genetic Counselling Centre,
geneticist,
Genetic Laboratory or1 Genetic Clinic, or of n medical r
gynaecologist or registered medical. practitioner for conducting prewoman (including such
natal diagnostic techniques on any
i . pregnant
.
30 woman unless she was compelled to undergo-such fbnf'nostic techniques)
for purposes other than those specified in clause (2) of section 4, Shall,
be punishable with imprisonment for a' term whick may extend to three
years and with fine which may extend to ten thowsand rurwes and on any
subsequent conviction with .imprisonment which may
to • five
years and with fine which may extend to fifty thousand .rupees.
35
lof J«72.
•
24. Notwithstanding anything in the Indian Evidence Act, 1872. the
court shall presume unless the contrary is proved that the . pregnant
woman has b§en compelled by her husbancj or the relative to undergo
pre-natal diagnostic technique and such person shall be liable (or abet
ment
of offence under sub-section (.?) of section 23 and shall bo punish
40
able for the offence specified under that section.
?•
Pjouinbtion in the
case of
conduct of
pre-natal
diagnostic
lechqiqlucs.
25. Whoever contravenes any of the provisions of this Act or
any Penalty
rules made thereunder, for which no penalty has been elsewhere pro- for contra
vided in this Act, shall be punishable with imprisonment for a term vention of
* the pipvi45 which may extend to three mo'ilh.s or with fine, which m.iy OJ^nd to Mons of ihj.
one thousand rupees or with both and in the case* of continuing contra Act or rule,
vention with an additional finr which may extend to five hundred for Khkh
rupees for every day during which, such contravention- continues after np
punishrnenf
conviction, for the first such contravention:
’
>,*
is proviefaf
<•
i
f
12
Offences
by com
panies.
26. (1) Where any offence, punishable under this Act has been com
mitted by a company, every person who, at the time the offence was
committed was in charge of, and was responsible to. the company for
the conduct of the business of the company, as well as the company,
shall be deemed to be guilty of the offence and shall be liable to he
proceeded against and punished accordingly:
5
Provided that nothing contained in this sub-section shall render any
such person liable to any punishment, if he proves that the ollence was
committed without his knowledge or that he had exercised all due dili
iu
gence to prevent the commission of such offence.
(2) Notwithstanding anything contained in sub-section (1). where
any offence punishable under this Act has been committed by a company
and it is proved that the offence has been committed with the consent
or connivance of, or is attributable to any neglect on the part of, any
director, manager, secretary or other officer of the company, such
director, manager, secrelury or other officer shall also be deemed to be
• guilty of that offence and shall be liable to be proceeded against and
15
. punished accordingly.
Explanation.—For the purposes of this section,—
(a) “company’’ ineans any body corporate and includes a firm 20
other
association of individuals, and
or
(b) “director”, in relation to a firm, means a partner in the firm.
shall be cognizable, non-bailalbe
Offence id
be cogni
zable, nonbailablo
and noncompound
able.
27. Every offence under this Act
and non-compoundable.
Cognizance
of offences.
28. (1) No court shall take cognizance of an offence under this Act 25
except on a complaint made by—
(a) the Appropriate Authority concerned, or any officer autho
rised in this behalf by the Central Government or State Government,
as the case may be, or the Appropriate Authority; or
(b) a person who has given notice of not less than thirty days. 30
in the manner prescribed, to the Appropriate Authority, of the
alleged offence and of his intention to make a complaint to the court.
Explano-tion.—For the purpose of this clause, “person” includes a f
social organisation.
(2) No court other than that of a Metropolitan Magistrate or a Judicial Magistrate of the first class shall try any offence punishable under
this Act.
(5) Where a complaint has been made -under clause (b) of sub
section (I), the coq.rt may, on demand by such person, direct the Appro
priate Authority to make available copies of the relevant records in its 40
possession to such person.
- . -
13
CHAPTER Vill
Miscellaneous
Mainienup..'
for such period
prescribed:
J
criminal or other proceedings are instituted
Provided Genetic
that, if Counselling
any
Centre. Genetic Laboratory or Genetic
against any <---------documchts of such Centre., Laboratory
Clinic, the records and all other
final disposal of such proceedings.
10 or Clinic shall be preserved till the
such records shall, at all reasonable times, be ma^J»vailabJe
(2) AH Such
nprenn
for inspection to the
the Appropriate Authority or to any. o.her perso
authorised by the Appropriate Authority in this beha .
30 fl) If the Appropriate Authority has reason to belipve
15
Sd.' 1M. Act ta. !,«> „ « MH
that an
«
’ Counselling Centre, Genetic Lnborilory or Genetic Clmic. s»eb Aut. ority or any officer authorised thereof in this behalf may, subject to st.^
rules as may be prescribed, enter and search at a'l reasonable tunes wit
such assistance, if any, as such m horitv or ofiicer considers ncc'-^ ■ •
So such Genetic Counselling Centre, (Anetic Laboratory, pr C.iyietic dm.
°
..vaminp anv record, register, document, book, pamphlet, advertiseand examine any record, register,
ment or any other mater-al objr^- found Ibrrein and seize Ike same it
such Authority or officer has reason to believe that it may furnish
evidence of the commission of an offence punishable under this Act.
2 of 1974.
25
Power io
real ch and
seize rceoids,
etc. I
(2)
(2) The
The provisions
provisions of
of the
the uoae
Code of Criminal Procedure, 1973 relating
to searches and seizures shall, so far as may be, apply to every search
or seizure made under this Act.
31. No suit, prosecution or other legal proceeding shall lie against
the Central or the State Government or the Appropriate Authority or
State Government or by the
30 any officer authorised by the Central or
Authority foTanything which is in good faith done or intended to
he
Protcciion
Gt action
ktken in
jood faith.
'■ I
done in pursuance of the provisions of this Act.
32. (1) The Central Government may make rules for carrying out
the provisions
Aet.
35
(2) In particular, and without prejudice to the generality, of the foregoing power, such rules may provide for
a
(i) the minimum qualifications for persons
employed at
registered Genetic Counselling Centre, Genetic Laboratory or Genetic
Clinic under clause (1) of section 3;
(it) the form in which consent of a pregnant woman has to be
■
obtained under section 5;
(Hi) the procedure io be fodowed by the members of the Central
Supervisory Board in the discharge of their functions under sub-
section (4) of section 8;
Power io
maike ruks.
14
(iv) allowances for members other than
admissible under sub-section (5) of section 9;
ex officio member
(v) the period intervening between any two meetings of
t.iej
Advisory Committee under the proviso to sub-section (S) of section 17; j
(vi) the tarmS and conditions subject to which a person may .be-
app^nted to the Advisory Committee and the procedure to be
followed by such Committee under sub-section (9) of section 17;
(vii) the form and manner in which an application shall be mmc
foPTegistration and the fee payable thereof under sub-section (i’) of.
section 18;
1
(piii) the facilities to be provided, equipment and other standards
to be"maintained by the Genetic Counselling Centre, Genetic Labo
ratory or Genetic Clinic under sub-section (5) of section 18;
be
(to) the form in which a
certificate of registration shall
issuecPunder sub-section (1) of section 19,
(x) the manner in which and the period after which a certificate
I ■
of registration shall be renewed and the fee payable for such renewal
under sub-section (-?) of section 19;
(xi) the manner in which an
appeal may be preferred under
20
section 21;
'
(aSi) the period up to which records, charts, etc., shall be presetv-
ed under sub-section (1) of section 29;
(xiii) the manner in which the Jseizure of documents, records,
shall be made and the manner in which seizure list shall
objects, etc.,
*■
—-------—
be prepared anc} delivered to the personi from whose custody such 25
seized under sub-section (1) of
documents, records or objects were £——
section 30;
is required to be, or may be.
other matter that
(xiv) any
prescribed.
33 The Board may, with the previous sanction of the Central Gov- 30
’ Power to
not
eminent, by notification in the Official Gazette make regulations
make regu inconsistent with the provisions of this Act and the rules made therelations.
under to provide for—
I
(a) the time and place of the meetings of the Board and the
35
procedure to be followed for the transaction of business at sue i
meetings and (he number of members which shall form the quorum
under sub-section (1) of section 9;
(b) the manner in which a person may be temporarily assocnnlcd with the Board under sub-section. (I) of section 11;
and 4B
(c) the method of appointment, the conditions of service
the scales of pay and allowances of the officer and other employees
of the Board appointed under section 12;
(dY generally for the efficient conduct of the affairs
Board.
of
the
15
34. Every rule and every regulation made under this Act shall be Rules nml
rcgulaiions
laid, as soon as may be after it is made, before each -House of parliament, to be laid
while it is in session, for a total period of thirty days which may be- before Pai"
comprised in one session or in two or more successive‘sessions, and if,- ‘ liaqicai.
5 before the expiry of the session immediately following the session or the
successive sessions aforesaid, both Houses agree in making any modifica
tion in the rule or regulation or both Houses agree that the rule or regu
lation should not be made, the rule or regulation shall thereafter have
effect only in such modified form or be of no effect, as the case may be;
10 so, however, that any such modification or annulment shall be without
prejudice, to the validity of anything previously done under that rule or
regulation.
'T^his collection of essays on the state of India’s health is the first of its kind in
1 the country. Written in a lucid and cogent style and dramatically illustrated,
this volume looks at ‘Health’ from a broader perspective, concentrating primarily
on preventive rather than curative care. Avoiding the use of jargon to the extent
possible so as to reach its target audience - the layperson - this book takes one
through the entire gamut of issues relating to this wider concept of health
education, indigenous systems of medicine, health finance, family welfare,
information systems, disability, the condition of the aged and the mentally ill. and,
above all, the specific issues relating to women and health.
A valuable and timely collection of articles that attempts to assess the impact of
socio-economic developments on people’s health, the reach and effectiveness of
existing health services, and the role of the government and NGOs in the field.
This book will prove invaluable reading for all those interested in the health of
India’s population - not medical professionals alone, but social and political
activists, policy-makers and health planners, programme implementors, academ
ics, and, above all, the layperson
voluntary Health Association of India
Tong Swasthya Bhavan
40, Institutional Area, Near Qutab Hotel
New Delhi 110016, INDIA
Not viewed