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Poverty. Riches. The world's largest democracy. An ancient caste system. Bollywood. India is a land of contrasts, a booming new power that remains baffling to outsiders and insiders alike. The Shiva Rules is a year-long GlobalPost series that decodes the many mysteries of India's uneven rise in the 21st century.
Up to 12 million abortions have occurred in India as a result of sex selection. What is India doing about it?
In an attempt to prevent sex-selective abortions, India has banned doctors from using ultrasounds or other technology to tell women the sex of their fetus, and gynecologists are not allowed to perform abortions for the purpose of sex selection. Abortion is only legal in India up to week 12, with the exception of extreme cases, and a fetus must be at least 14 weeks before an ultrasound can detect its sex.
There have been a string of other government efforts to crack down on this practice, particularly after the release of the 2011 census data triggered countless reports in the local media on sex selection. The national and state governments have suggested requiring the registration of ultrasounds, monitoring doctors, making abortions subject to checks, and providing incentives to families to have girls.
Maharashtra’s state public health minister, Suresh Shetty, proposed using spy-cams to catch doctors.
However, like most issues in India, the law is not the problem — enforcement is. Few violators of the law have been prosecuted, and regulation of private clinics is limited.
“Actually, you can have an abortion whenever you want,” said public health activist Sabu George, who has been working on the issue of sex selection for 25 years. “There’s no regulation.”
George says the law has not been enforced because of a lack of political and social will. Furthermore, most people are not ashamed of breaking the law, and corruption enables many doctors to avoid getting caught or facing penalties.
From India: Corruption chaos
“Doctors are highly organized, and they are doing everything to spread the promotion of the practice,” he said. “What you are seeing is organized medical crime.”
In April, after the discouraging census figures, the health ministry drafted new personnel for the central supervisory board tasked with ensuring that the laws against using ultrasounds for sex selection were strictly implemented. Though the board is supposed to meet every six months, the previous members had not met since 2007.
Parliamentarian Mabel Rebello, one of the new members, is not convinced that this time will be all that much different. "For a short while [the country will focus on this], after that they will forget," she said in an interview with GlobalPost.
"Our rules are not strict enough to punish them. If we have to punish a few doctors and put them behind bars, they would be scared," Rebello said.
"In all the district hospitals, the government should tell all the 28 state governments and seven union territories that they should oversee things very strictly, and all the 600 district collectors should be instructed, and wherever there is a skewed sex ratio, the collectors should be punished," she added.
However, the limitations of federalism prevent that kind of strong action.
"The central government can only start schemes and give money," Rebello said. "Implementation has to be done by the respective state governments."
Civil-society groups, seeing what they consider a lax effort on behalf of the government, have also stepped in to help enforce the law and change mindsets.
A lawyer and women’s-rights activist in Maharashtra, Varsha Deshpande, has organized dozens of sting operations on clinics to try to catch doctors who tell women the sex of their fetus.
From India: Crackdown on sex-selective abortions
Deshpande and activists like her enlist a pregnant woman to collaborate and then send her into a clinic to ask for information on the sex of her fetus. Once the doctor tells the pregnant woman the sex — either outright or by using a trick like pointing to something blue or pink — the group announces the sting and catches the doctor.
Deshpande says the sting operations are widely publicized and serve to scare other doctors in the community. But they have only had limited success, since some activists say they do little more than advertise to the community the doctors who provide gender information.
Waiting for the transition
Demographers like Guilmoto say that India will reach a transition point in which the child sex ratio begins to stabilize and then work its way back to equilibrium. The question is how long that will take, and how badly society will be affected in the meantime.
He says that the census data and birth registrations have shown that while states with large populations, like Bihar and Uttar Pradesh, have seen an increase in the child sex ratio, smaller and more prosperous states — like Delhi, Punjab and Haryana — have begun to show signs of improvement. The sex ratios continue to be distorted in these states, but they are not getting worse.
He said families in states showing slight improvements still have a strong preference for sons, and face the pressure of wanting a smaller family, but they might have also realized that such uneven sex ratios are unsustainable.
“Probably these are people who have realized they are going to get themselves into a serious mess by overproducing sons,” Guilmoto said.
Another reason could be that a slow but gradual process of greater gender equality has had an effect on people’s attitudes and views. Such a transition will come to the rest of India when families in other states likewise realize that a distorted sex ratio is unsustainable, and as more women delay marriage, become better educated, have more bargaining power and take up more space in society.
“These women are the forerunners for what’s in store for India,” Guilmoto said. “How long it will take, we don’t know.”
He says the government should monitor this issue more closely and conduct annual surveys, rather than waiting for the census.
“Once in a while we have census data, and once in a while we start worrying and say, ‘Oh my god, look what happened,’” he said. “It would be like if you checked your team report every 10 years.”
Accelerating the process
In order to more quickly bring back a sex-ratio equilibrium, public health and women’s activists say there needs to be a change in mentality about the role of women in society.
The state must also strengthen the monitoring of doctors and regulation of technology. And a social-security system should be created so elderly parents need not rely on sons for support.
“Let’s hope that there is political leadership. Let’s hope that there is civil society [pressure]. Let’s hope that people will wake up,” George said. “It will happen. The question is, will it happen in the next 10 years? Will it happen in my lifetime? I don’t know.”
Jason Overdorf contributed to this report from New Delhi. This story was done in collaboration with Round Earth Media, which is a news source that partners with early-career journalists to cover important issues from overlooked parts of the world.
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