The Pre-conception and Pre-natal

Diagnostic Techniques (Prohibition of

Sex Selection) Act 2003

Dr Urman Dhruv MD LLB

Director, Department of Internal Medicine & Diabetes,
HCG Hospitals, Ahmedabad
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Need for a legal initiative?

National Sex Ratio –

933/1000(2001 CENSUS)
940/1000 (2011CENSUS)

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Dismal Picture
20 09 1994

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 Is Sex selection a health Issue?
Yes, It is as much a health issue, as it
is a social issue.
•Repeated abortions for a SON adversely affect the
sexual and reproductive health of women.

•It also adversely impacts mental health of women as they

are normally blamed for their inability to produce a son.

•Sex selection is also an ethical issue and needs to be

viewed in the light of medical ethics.

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 The Pre-conception and Pre-natal Diagnostic
Techniques (Prohibition of
Sex Selection) Act 2003
To provide for the prohibition of sex selection, before or after
conception
For regulation of pre-natal diagnostic techniques for the
purposes of detecting abnormalities or metabolic
disorders or chromosomal abnormalities or certain
congenital malformations or sex-linked disorders
The prevention of their misuse for sex determination
leading to female foeticide and for matters connected
therewith or incidental thereto

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◾ PROCEDURES(TECHNIQUE)
◾ PLACES
◾ PERSONS

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◾ Ultrasonography
◾ Foetoscopy
◾ Amniotic fluid
◾ Chorionic villi
◾ Blood
◾ Any tissue/Fluid

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◾ GENETIC COUNSELLING CENTRE

◾ GENETIC CLINIC – CONDUCT PND procedures –

includes USG imaging machine carried in a vehicle

◾ GENETIC LABORATORY- CONDUCT

ANALYSIS - PLACE

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◾ Gynaecologist
◾ Medical Geneticist
◾ Paediatrician
◾ Registered Medical Practitioner
◾ Laboratory technician
◾ Radiologist
◾ Sonologist or Imaging Specialist -
◾ Sonologist, Imaging Specialist, Radiologist or
Registered Medical Practitioner having Post Graduate
degree or diploma or six months training or one year
experience in sonography or image scanning.

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 Major Prohibitions
• The major prohibitions under the PC-P.N.D.T Act are-
 Prohibition of sex selection ,before and after
conception(section 3A of the act)
 Prohibition of advertisement of any technique for sex
selection as well as sex determination (Sec 22 of the Act)
 Prohibition on sale of ultrasound machines to
persons not registered under this Act (Rule 3A)

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 Pre-natal diagnostic procedures
All gynaecological or obstetrical or medical procedures
such as:
• Ultrasonography;
• Foetoscopy;
• Taking or removing samples of amniotic fluid, chorionic
villi, blood, any tissue, fluid of a man or a woman
before or after conception for being sent to a Genetic
Laboratory or Genetic Clinic for conducting any type of
analysis or pre-natal diagnostic tests for selection of sex
before or after conception.

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 Pre-natal diagnostic tests
• Ultrasonography
• Test or analysis of Amniotic fluid, Chorionic villi,
Blood, Any tissue, Fluid of any pregnant woman or
conceptus conducted to detect:

– Genetic disorders

– Metabolic disorders

– Chromosomal abnormalities
•
– Congenital anomalies

Haemoglobinopathies
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 Salient Features Of The ACT
• Use of PNDT only allowed on medical grounds & not for
determination of sex

• PNDT can be conducted only by clinics registered under the Act

• No person conducting prenatal diagnostic procedure shall

communicate to pregnant women or her relatives, the sex of
the foetus by words or signs or any other method

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 Salient Features Of The ACT
• Clinics involved in advertisement (conducting sex
determination) are liable for punishment

• Declaration on each report that he/she has neither

detected nor disclosed the sex of foetus to pregnant
woman or to any body

• Offence under PNDT are cognizable, non-bailable and non

compoundable

• Clients and their relatives asking for sex determination are

also punishable

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 Registration is Mandatory
• All bodies under the PC &PNDT Act namely Genetic
Counselling Centre, Genetic Laboratory or Genetic Clinic
cannot function unless registered

• The requirement of registration is mandatory whether the

body is government, private, voluntary, honorary, part-
time, contractual or consultative

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 Procedure for Registration
Every application for registration shall be made:

To the Chief Medical Officer of the district or any other

medical officer constituted as an Appropriate Authority

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Who is Appropriate Authority under
the Act?

• State Level: Additional Director (Family Welfare)

• District Level: Civil Surgeon/Medical Officer of Health
• Taluka Level: Medical Superintendent

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 It is mandatory for everybody
registered under this Act to
display the certificate of
registration at a conspicuous
place in such centre, laboratory
or clinic.

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•REGISTER 3 MONTHS IN ADVANCE
• DUPLICATE IN FORM A
• AFFIDAVIT

• ACKNOWLEDGEMENT SLIP

• APPLICATION FEE IN THE FORM OF A DD

• 25,000 SINCE 2012 FORGCC/GC/GL & ULTRASOUND CLINIC
• 35,000 SINCE 2012 FOR ANY PLACE PROVIDING
A COMBINATIONTHEREOF

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◾ VALID FOR A PERIOD OF FIVEYEARS SINCE ITS ISSUANCE.
◾ Non-transferable
◾ Change of ownership – Old certificate is surrendered
◾ New owner- apply for fresh application.
◾One center can have multiple USG machines, but the
manufacturer’s name and the makes and models of the machines
should be noted in the PC-PNDT registration
◾Certificate (all ultrasound machines available at that center should
be registered on the certificate or on a separate attached sheet).
◾ No doctor other than the one registered in that particular center
may use the machine installed there.
◾Any changes in the center (e.g., change in machine or place of
use) should be intimated to the AA 30 days in advance.
◾ Any change of the doctor operating the machine should be
intimated to the AA within 30 days.
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 Maintenance of records by USG
centers
• Declaration on each report that he/she has neither detected
nor disclosed the sex of foetus.
• Declaration of pregnant woman that she does not want to
know sex of the foetus.
• Records to be made available to appropriate authority
for inspection.
• All records to be preserved for two years.

• Report to be sent by 5th of every month to appropriate

authority.
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 Functions of Appropriate Authority
• To grant, suspend or cancel registration

• To enforce standard prescribed and to supervise

• To investigate complaints and take actions

•To create public awareness

•• To seek & consider advise of advisory Committee

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 Powers Of Appropriate Authority
• Registration/Renewal of registration of Institutions

• Search

• Seal and Seize: if the center is unrecognized.

• Cancellation or Suspension of Registration

• Summoning
• Cognizance of offence – Court shall take cognizance of an offence
on complaint made by Appropriate Authority or authorized
person

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 Who Can Make A Complaint?
• The Appropriate Authority concerned

• Any officer authorized in this behalf by the Central

Government or State Government or the Appropriate
Authority

• A person who has given notice of at least 15 days to the

Appropriate Authority of the alleged offence and of his
intention to make a complaint in the court i.e. if the
Appropriate Authority fails to take action on the complaint
made by a person, on the lapse of 15 days, that person can
directly approach the court

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 Who Can Make A Complaint?
• Every public spirited person can activate the PC&PNDT law
for the violation of the same and he/she can seek the
assistance of a lawyer or an NGO. Even a group of persons
can file a complaint together

• The offence under the Act shall be tried only in a court of

the Metropolitan Magistrate or a Judicial Magistrate of the
First Class

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 1 1 1 0 0 0
0 1
0 0 0
0 4 3
1 2 1
COURT-
CASE
30 13
2 4 0
SEALED
11

4
4
2 1
SHOW CAUSE 48 4
NOTICE

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 Penalties for the offences
Non-availability of copy of the
PNDT Act in the registered centre Case may be launched in the
court of JMIC u/s 25 of the Act
Non- Display of registration Show cause notice u/s 20(1),(2)
certificate in the centre. for temporary suspension of
registration.
Non-Display of Board in the
premises in English and Local
Language

Advertisement relating to pre-

U/s 22(3) of the PNDT
conception and pre-natal
Amendment Act, Case is to be
detection of sex
launched in the court u/s 238 of
the Act

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 Equipment to be sealed &
seized by the Appropriate
Authority concerned.
Unregistered Launch the case in the court u/s
Centers/Machine 28 of the Act.
Registration granted after
Penalty & affidavit
Record Keeping Irregularities in Contravention (a major offence)
record keeping as per revised of provision of section 5 and 6 of
form ‘F’ are a major offence the Act and punishable U/s 23(1)
of the PNDT Act.

Sex Selection Violation of section 5 and 6 of

the Act and punishable u/s 23 of
the Act.
4
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• Imprisonment for a term which may extend to 3 years & with
a fine which may extend to 10,000 rupees.
• Subsequent conviction, with imprisonment which may extend
to 5 years and with fine which may extend to 50,000 rupees.
• Suspension of the registration if charges are framed by the
court and till the case is disposed.
• Removal of name from the register of the council on
conviction for the period of
• 5 years for the first offence.
• PERMANENTLY for the subsequent offence.
• HONORARY/ NAMESAKE basis to a ultrasound clinic, he is
equally responsible.
• ADVERTISEMENT of any sort is banned and is punishable
under
• the Act with a fine of up to Rs.1 Lakh and/or imprisonment
for 5 years.
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Gujarat H igh Court in “Suo Motu
Vs State Of Gujarat - on 30 September,
2008”

Any improper maintenance of record in itself is equivalent to

violation of the provisions of sections 5 and 6 (sub-section (3) of
section 4 of the act.

Cases where the form F is not filled at all, or where the vital details
are lacking, such that the woman who has undergone the
ultrasound cannot be identified, than this lapse cannot be passed
over as a procedural lapse, and has to be in all seriousness tried in a
court of law.
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 Centre For Enquiry Into Health And Allied Themes
(C.E.H.A.T) & Ors V. Union Of India & Ors [2003]
 Directed the appropriate authorities to take prompt action
against all bodies who are operating without a valid certificate of
registration under the act.

 The centers which are unregistered are required to be prosecuted

by the authorities under provisions of the act and there is no
question of issue of warning and to permit them to continue
their illegal activities.

 Appropriate authorities or any officer of the central or the state

government authorized in this behalf is required to file complaint
under section 28 of the act for prosecuting the offenders.
6

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◾ Portable machines are prohibited – except
 Used within premises it is registered for providing
services to indoor patients.
 As a part of mobile medical unit which provides a
bouquet of other health and medical services.
 Centres with portable machines – fix it by using wall
mounting/tables

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◾ E-advertisement relating to preconception and prenatal
sex determination.
◾ Punishable with 3 years imprisonment with fine upto
10,000/-

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◾ Centre registered – if new CT and MRI are introduced –
submit details of the new equipment to the appropriate
authority – no need to apply for fresh registration/fees.
◾ Exclusively CT and MRI – NOT registered – NEED to
apply for fresh registration.
◾ CT, MRI or B scan – WILL REQUIRE to fill FORM F –
when investigation is done on pregnant woman – FOR
ABDOMEN SCAN ONLY

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◾ Centre registered – if new echocardiography are
introduced – submit details of the new equipment to the
appropriate authority – no need to apply for fresh
registration/fees.
◾ Exclusively Echocardiography– NOT registered –
NEED to apply for fresh registration.
◾ Echocardiography–WILL REQUIRE to fill FORM F –
when investigation is done on pregnant woman – FOR
ABDOMEN SCAN ONLY aka Fetal ECHO.

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 Doctors’ Dillemma
• Onus of proving not-guilty is on
radiologist/sonologist and NOT on the authorities.
This is similar to dowry or rape case where accused
has to prove that he is not guilty. In other criminal
cases the prosecution has to prove that the accused
is guilty.

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 Doctors’ Dillemma
• Even if a radiologist is attached on HONORARY/
NAMESAKE basis to a ultrasound clinic, he is equally
responsible for any contraventions of provisions of
PCPNDT law done in the center and thus is equally
liable for punishment like imprisonment and fine.

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 Doctors’ Dillemma
• Radiologist is at par with Registered Medical
Practitioner having six months training or one year
experience in sonography or image scanning,

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 Doctors’ Dillemma
• Change in equipment and radiologist we do report,
however change in other employees, like say an
attendant or nurse, do we need to report?

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 Doctors’ Dillemma
As a medical professional, I am not duty bound to
talk on social issues?

Response:

Are we not part of society, and are affected by good or bad

practices of society?

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 Common Arguments
It is choice of individual clients, what is
wrong if couple choose to have a son?
Response:

Strong desire to have a son, puts tremendous psychological

pressure on women.
Obsession for boys can lead to domestic violence, with
women bearing the brunt for her inability to produce a
male child.
This can also lead to desertion and/or bigamy.

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 Common Arguments
By Sex selection and elimination of Girls, I would only be
increasing their value and position in society?

• Response:

• With declining sex ratio, practices like polyandry, selling

of brides, violence against women, denial of their basic
rights, trafficking of girls, will increase.
• Declining Sex Ratio in other states have not led to
women’s empowerment, on the other hand, instances of
violence and crime against women are steadily increasing.

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 Common Arguments
Only couples with two or more daughters go for sex
selection, therefore it does not affect overall sex ratio?

• Response:

• This is misleading.
• Had this been true, sex ratio of girls would not have
gone down drastically.

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 Common Arguments
It is more humane to eliminate a female foetus rather
than subjugate her to life of discrimination?

Response:

By this logic, it would be justifiable to eliminate poor &

handicapped people.

The girl child is not a problem, the practice of sex

selection is a problem.

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 How can you impact sex selection?
• Be vigilant towards misuse of technology and morally
pressurize doctors indulging in Sex selection
• Take initiatives to break silence around this issue
• Stop sympathizing with perpetrators
• Counsel vulnerable couples & link with local NGO for
community support
• Value and celebrate the girl child’s life in your family and
community
• Advocate to promote positive image of girl child
• Strictly Abide by the PCPNDT Act

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 Recommendaions
• The implementing authorities should be made
accountable for sex ratios of their districts.
• Awareness should be increased in the general masses regarding
the rules of Act.
• The P.C-P.N.D.T act must be included in the syllabus of medical
and related disciplines.
• The media should be involved in all raids, so that no complaint
can be swept under the carpet by the implementing authorities.

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 Recommendations
• The National Inspection and Monitoring Committee should have a
regulatory role over the legal actions being initiated against the
clinics/establishments raided by them.
• All the actions taken by the implementing authorities should be
accessible to the civil society
• All cases of P.C-P.N.D.T should be immediately transferred to fast track
court.
• The loopholes in the act should be plugged , which allow the
offenders to get away with lighter sentences.

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◾ HOW MANY CHAPTERS DOESTHE PNDT ACT HAVE?
ANS – SEVEN (VII)

◾ HOW MANY ANNEXURES DOESTHE PNDT ACT HAVE?

ANS – NINE (IX)

◾ HOW MANY APPENDICES DOESTHE PNDT ACT

HAVE? ANS – FIVE (V)

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◾ WHICH SECTION INTHE APPENDIX HAS ALLTHE FORMS?
ANS- 2

◾ WHAT IS AN ACT?
 Act is a legal document (in written form) passed by a
legislator to regulate certain area of social behavior.
 LAW is generally a system of rules of behavior covering
all sources of law (including acts).

◾ Do MRI & CT machines need to be registered?

◾ Yes, they need to be registered and all changes to be

notified to the AA

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 Conclusion
• The Act is legislated in a manner that it should be a
deterrent for those indulging in sex determination.
• The Act penalizes all the errants, either involved in sex
determination or non-maintenance of records.
• Remedies are also provided—like filing an appeal before the
appellate authority and getting the machine released from
the court of law, but all these remedial measures are time-
consuming and bring the career of an individual to a
standstill.
• It would not be out of place to therefore state that the most effective
precautionary measures are to maintain records scrupulously, fill the
Form-F as provided in the Act, accurately and correctly, submit the
records to the appropriate authority within the stipulated time; then
there will be nothing to worry

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