Crackdown on female foeticide

The Haryana government is pulling out all stops to confront the scourge that the state had once gained notoriety for — gender-based sex-selection and female foeticide, the practice of terminating a pregnancy when it is determined that the foetus is female. The year 2024 ended with a drop of six points in Haryana’s sex ratio — 910 female births per 1,000 males. Alarmed by the dip and reports of use of pre-natal diagnostic technologies to determine the sex of the foetus despite the ban, a State Task Force (STF) was constituted in February this year, with Additional Chief Secretary (Health) Sudhir Rajpal in charge. The mandate was to monitor every facet of the skewed sex ratio and plug the holes in a state known for its patriarchal mores and preference for a boy.

The STF, which first met on February 7, decided to track pregnant women who had already given birth to a girl child and attach ‘Sahelis’ or health workers with them. It also tightened the noose around the medical termination of pregnancy (MTP).

The Medical Termination of Pregnancy Act 1971 (2021) allows abortions up to nine weeks using MTP kits, but only under the supervision of a registered gynaecologist in an approved centre. An MTP kit has Schedule-H drugs that cannot be sold without a prescription from a registered medical practitioner (RMP).

An illegally sold MTP kit is more often than not used only after a sex-determination test has ascertained that the pregnant woman is carrying a female foetus.

Tracking suppliers

The online sale of MTP kits is illegal. The Drugs Control Officers (DCOs) in Haryana have donned a new role and are playing decoy, taking on online suppliers of MTP kits; shops and nursing homes carrying out illegal MTPs; illegal clinics flourishing unnoticed and the drug peddlers coming from neighbouring states.

While more than 6,000 MTP kits have been seized, 30 cases of illegal sale of MTPs have been found. Twenty FIRs have been lodged, four sale licences cancelled and 12 persons arrested in the past three months.

It began with Gurugram when the DCO placed an online order for an MTP kit on February 11. The kit, ordered from a website which had its supplier based in Uttar Pradesh’s Badaun, was delivered at his office after which an FIR was registered and one accused was arrested.

Later, the health authorities zeroed in on a gynaecologist from Karnal who could not explain the mismatch in the number of MTP kits procured and used at her clinic.

The biggest haul came from Kaithal last week when the health authorities seized 5,800 MTP kits from a house.

“After getting a tip-off about drugs being stocked at a particular house in Kaithal, we took the help of the local police and monitored the movement of the accused for more than 10 days before arriving at his doorstep for a raid with a team of the state narcotics cell. While he had stocks of drugs without necessary permissions, we found more than 5,800 MTP kits. He disclosed that he had procured these from a supplier in Karnal, and we raided his premises the same night. The raid thus began at 11 am and ended the next morning at 5 am,” says Chetan Verma, the Kaithal DCO.

In yet another raid, the Food and Drugs Administration team got a tip-off of a Hyundai Aura car being used to deliver MTP kits and drugs to Faridabad. “He had 20 MTP kits and 35 types of allopathic drugs. An FIR was lodged and he was arrested,” says State Food and Drugs Controller Manmohan Taneja.

Modus operandi

While the kits cost anywhere between Rs 100 and Rs 200 per piece to the supplier, these are sold to the customers for nearly Rs 1,000 or more, given the risk involved. These are sold within a closed network and the outreach is through word of mouth. “Though the doctors are rarely involved in this nexus between the supplier and the consumers, the involvement of the staff cannot be ruled out. However, this, too, is limited to sharing information about suppliers to acquaintances,” health officials claim.

Most of these online suppliers operate from Tier-II cities and are based in non-descript villages of Bihar and Uttar Pradesh, two states which figure prominently in the list of suppliers based on the online orders placed and received. Some suppliers also operate from high-end areas and prominent cities in a bid to ward off suspicion.

Also, with 21 of the 22 districts in Haryana (other than Rohtak) sharing boundaries with other states, nabbing these suppliers becomes a big challenge. “While we are carrying on with identifying websites and registering FIRs against the suppliers, on the directions of the STF, the DCOs have fanned out across districts and are carrying out inspections at the 1,200 MTP centres as well. The more raids we are carrying out, the more information about the illegal sale of MTPs is flowing in. We are verifying whatever tip-off is coming our way,” explains Taneja, adding that no mismatch in records at these registered MTP centres is being overlooked.

New norms

The government is trying to put a check on the sale of MTP kits by enforcing stricter norms. “While the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994, mandates the consent of two gynaecologists for an MTP after 12 weeks, the Health Department has recommended to the Centre to amend the legislation in a way that it becomes mandatory that the consent also comes from a government hospital even if it is being carried out at a private recognised centre,” says Dr Simmi, a member of the STF.

She adds that the Health Department, in a letter to all Civil Surgeons, has said an MTP of a woman with two girl children should be monitored. Further, the department has ordered that no wholesaler will give supplies to a retailer; this will only be given to the 1,200 approved MTP centres. “The DCOs will carry out inspections at the centres for details of the MTP kits procured and put to use,” Taneja explains.

When the STF was set up, Chief Minister Nayab Singh Saini had assured of strict action against the conduct of sex-determination tests.

ACS (Health) Sudhir Rajpal says meetings of the STF are being held regularly to monitor the sex ratio at the micro level. Every birth is being tracked through the health workers, and the impact of the actions against illegal operators is being gauged.

“We are putting in place a multi-pronged strategy to ensure that the sex ratio shows a marked improvement. We have written to the Police Department for a dedicated team for raids. We have also involved the Women and Child Development Department in our rural outreach programme for pregnant women, and sought a status report of pregnant women from health workers,” says Rajpal.

Directions have also been issued for looking into the sale of illegal MTP kits over the past two months for comparison with the termination of pregnancies before and after 12 weeks during the period.

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