Intended for healthcare professionals

Feature Maternal Health

Abortion round the world

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39393.491968.94 (Published 15 November 2007) Cite this as: BMJ 2007;335:1018

Can abortion laws in India prevent sex-selective foeticide?

Infanticide practices have been documented in India since 19th
century. British policy makers in India first addressed these issues in
1870 by passing ‘Infanticide Act’. Again in 1961 Government of India
passed ‘Female Infanticide Act’ to prevent killing of female infants.

Widespread illegal abortion prompted the introduction of ‘The Medical
Termination of Pregnancy Act 1971’ (MTP) which was passed in 1973 to
legalise the abortion. It was widely acknowledged that this would
significantly reduce morbidity and mortality relating to illegal
abortions. The act covered wide range of indications for termination
including mental illness arising due to continuation of the pregnancy.
The act stipulated various requirements to perform the procedure.
Unfortunately vast majority of terminations were performed by untrained
persons and in poor hygienic conditions.

Easy accessibility to newer technologies such as ultrasound scans,
amniocentesis and chorionic villi biopsy as led to early determination of
foetal sex. Epidemiological studies have shown low male-female sex
ratio(1,2). ‘The Prenatal Diagnostic Techniques Regulation and
Prevention of Misuse Act 1994’ was passed to prevent abuse of these
diagnostic tests. The act clearly stated misuse of test to identify the
sex of the foetus would be punishable offence including imprisonment and
fine.

In spite of above legislations the incidence of the sex selective
abortion continued to rise. Further the MPT Act 1971 was amended to
‘Medical Termination of Pregnancy Regulations 2003’. This act imposed
regularisation of centres which conducted the procedures. All centres had
to maintain a register and obtain a written consent prior to the
procedure. There are clear guidelines on storage of this information and
provision for accessing the data for inspection by the state health
authorities. Any misconduct would lead to revoking the license of the
centre and disciplinary action would be imposed on the professionals
involved.

Social issues predominate more than ethical considerations in India
compared to developed countries. Often people live in joint families or
nuclear families where the decisions for abortion are made by family
members rather than the women. Poverty and poor educational status of
girls has compounded the problem.

Although the abortion laws have been in existence for a long time
they have never achieved the desired objectives. Female infanticide is tip
of an iceberg; it reflects social inequalities in society and the
financial burden attached to female child. Until these wider issues are
addressed, amendments in abortion laws alone will be very futile.

References
1. Jha P, Kumar R, Vasa P, Dhingra N, Thiruchelvam D, Moineddin R. Male-to
-female sex ratio of children born in India: national survey of 1•1
million households. Lancet 2006; 367: 211-218
2. Varghese J, Aruldas V, Jeemon P. Analysis of trends in sex ratio at
birth of hospitalised deliveries in the state of Delhi. Christian Medical
Association of India. July, 2005

Competing interests:
None declared

Competing interests: No competing interests

22 November 2007
Sudheer Lankappa
Clinical Lecturer
Rani Prajwala
The Longley Centre, Norwood Grange Drive, Sheffield, S5 7JT