Sex-Selective Abortion in India: Gender, Society and New Reproductive Technologies

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Edited by: Tulsi Patel

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    Dedication

    For Kaki and Kakosa, my parents-in-law (Smt. Jamuna and Shri Amrit Lal Patel)

    List of Tables

    List of Abbreviations

    ANMAuxiliary Nurse Midwife
    ARIAcute Respiratory Infections
    BEEBlock Extension Educator
    BIMARUDemographically speaking, the sick states of Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh
    CASSACampaign Against Sex-selective Abortion
    CBRCrude Birth Rate
    CEDAWConvention on the Elimination of All Forms of Discrimination Against Women
    CEHATCentre for the Enquiry of Health and Allied Themes
    CHCCommunity Health Centers
    CNAACommunity Need Assessment Approach
    CPRCouple Protection Rate, for contraception purposes
    CSRChild Sex Ratio
    CSSMChild Survival and Safe Motherhood Programme
    CVARACoordinating Voluntary Adoption Resource Agency
    CWDSCentre for Women's Development Studies
    DCCWDelhi Council of Child Welfare
    DEMARUDaughter Eliminating Male Aspiring Rage for Ultrasound
    DFPODistrict Family Planning Officer
    EPIExpanded Program on Immunisation
    FASDSPForum Against Sex Determination and Sex Pre-Selection
    FGDsFocus Group Discussions
    FMRFemale Male Ratio
    FPPFamily Planning Programme
    FWPFamily Welfare Programme
    GEIGender Equality Index
    GWAGuardians and Wards Act, 1890
    HAMAHindu Adoptions and Maintenance Act, 1956
    ICDSIntegrated Child Development Scheme
    ICPDInternational Conference on Population Development
    IECInformation, Education & Communication Activities
    IMRInfant Mortality Rate
    IUDIntra Uterine Device
    JNUJawaharlal Nehru University
    KAPKnowledge, Attitude and Practice (surveys)
    MASUMMahila Sarvangeen Utkarsh Mandal
    MCHMaternal & Child Health
    MPWMultipurpose Health Worker
    MSSMahila Swasthya Sangh
    MSSManuscript Sources
    MTPMedical Termination of Pregnancy
    NFHNational Family Health Survey
    NRINon-Resident Indian
    NRTNew Reproductive Technologies
    NSSONational Sample Survey Organisation
    ORTOral Rehydration Therapy
    PBEFPre-Birth Elimination of Female
    PHCPrimary Health Centre
    PILPublic Interest Litigation
    PNDTPre-natal Diagnostic Techniques (Regulation and Prevention of Misuse, Act of 1994)
    PPParliamentary Papers
    RCHReproductive and Child Health Project
    SCSub-centres
    SCHSubsidiary Health Centres
    SDTSex determination test
    SMPSafe Motherhood Programme
    SPSex Pre-selection
    SRBGSelections from Records of Bombay Government
    SRGSelections from Records of Government
    TFATarget Free Approach
    TFRTotal Fertility Rate
    UCIUniversal Child Immunisation
    UIPUniversal Immunisation Programme
    VCAVoluntary Coordinating Agency
    VHAIVoluntary Health Association of India
    VHWVillage Health Worker
    VVIPVery very important person

    Foreword

    No one can doubt the great importance of the subject that is addressed by this book—namely the decision by prospective parents to have a test conducted in order to determine the sex of a foetus, and the subsequent action to abort the foetus if the outcome points to the birth of a baby girl.

    The results of the 2001 census of India have underscored just how big this problem has become in the country. The deficit of young girls—compared to young boys—is extremely pronounced in the states of Punjab, Haryana, and in western areas of Uttar Pradesh. However, it is severe as well in north-eastern Rajasthan, in western areas of Maharashtra, and throughout most of Gujarat. Census data for other parts of north India (for example, some districts in Bihar) also show incipient evidence of the practice of female specific abortion. And while in 2001 most districts in the country's south and east showed little sign of an abnormal deficit of young girls, this was not always the case. For example, data from the last four censuses reveal first for Salem district in Tamil Nadu, and later for adjacent districts, a disturbing trend towards an emerging deficit of young girls compared to young boys. The outward spread of the phenomenon from Salem resembles nothing less than the growth of a malignancy. It seems likely that this trend too partly reflects a rise in the practice of sex-selective abortion.

    Of course, as many of the contributions to this volume attest, especially in areas of north India the modern practice of female specific abortion has been overlain on pre-existing discriminatory practices that have extremely deep historical roots. Thus in the 19th century and before, female infanticide was common in some sections of society, and as a result there were markedly fewer girls and women than would otherwise have been the case. While the overt practice of female infanticide diminished greatly during the 20th century, there remained very strong biases in patterns of childcare between the sexes. In particular, boys were much more likely to receive attention—medical and other—if they fell ill. Of course, such differences in childcare practices between boys and girls persist. And they mean that even today the death rates for young girls, especially in north India, are markedly higher than those for boys (a disparity that persists well into the reproductive years).

    In sum, the fairly recent appearance of female specific abortion—reflecting the coming of new technologies—is occurring on top of deeply embedded practices that discriminate greatly against girls and women. Female infanticide, discrimination against girls, and sex-selective abortion—they all reflect the consequences of underlying social structures, especially in relation to fundamental concerns of marriage and inheritance.

    The discriminatory practices against females—both before and after birth—that prevail in some parts of India are extreme by any standards. Yet it is important to remember that they do have echoes in other societies. For example, excess female child mortality was not unknown in parts of Europe in past times. And in Asia—especially East Asia—female infanticide and severely discriminatory treatment against girls and women were, and still are, very common. Of course, one upshot of this has been that the same new technologies that now make female specific abortion possible in India have also been taken up widely in countries like China and South Korea. It is worth remarking that—despite many other problems—a strong preference for boys over girls seems never to have characterized societies in sub-Saharan Africa. In part, this may ultimately have reflected greater land abundance in that region during previous millennia, compared to the constraints that were faced by the developing agricultural civilisations of Eurasia.

    Returning to India, one wonders just where this invidious practice of female specific abortion is going. That is, what is likely to happen in the future? Clearly, for a country that is so vast and varied, there can be no simple answer to this question. However, in the end the matter will depend upon how people come to value the lives of girls and women relative to those of boys and men. And in this context there are both positive (i.e. encouraging) and negative (i.e. destructive) forces at work.

    On the positive side, the fact of fertility decline raises the prospect that the lives of many Indian women will become increasingly freed from the concerns of the domestic domain, in particular childbearing and childcare. Largely as a consequence, the institution of marriage may itself come under increasing strain—something that would probably work to the benefit of women in the longer run. It is also possible that such beneficial developments could be strengthened by labour market changes that provide increasing opportunities for women compared to men (at least in some parts of society). And, of course, the state and sections of civil society will continue with efforts to improve the situation—although both the strength of such efforts and their impact are likely to be modest, at best. Perhaps a stronger positive force will come through the influence of the media on Indian society—reflecting the values and behaviour of the wider world which generally holds girls and women in appreciably higher regard. Also, one should not underestimate the potentially beneficial impact of visits to India by women of South Asian ancestry who have been brought up in the very different cultural milieu of North America, Europe and elsewhere.

    Some commentators may doubt whether such positive forces will have much impact on the circumstances of Indian women—and therefore the extent to which practices like female specific abortion are resorted to. However, several of the developments noted above—perhaps especially the fact of low fertility, and the influence of new role-models for women's lives—could well have a transformative impact on the behaviour of urban middle class society over the next two or three decades. It should be recalled that social scientists have a rather indifferent record in foreseeing the speed at which such changes can occur. In this context it is noteworthy that the institution of marriage is being rapidly altered—nay, eroded—throughout much of Asia. Large parts of Indian society, especially the better off, will be no less influenced by these developments.

    However, regarding the incidence of female specific abortion among the bulk of the country's population, the future looks rather dire. Particularly—but not only—operating through the marriage system, the pressures that work against the birth of a female appear to have the upper hand. Thus in common with many other societies, India is becoming more, not less, socio-economically differentiated as it develops economically. Therefore the pressures to marry off daughters and make a good match are increasing, not falling. In addition, as is noted by several of the contributors here, physical and economic access to the technology that makes sex-selective abortion possible will almost certainly rise in the coming years. When one looks at a map of district-level child sex ratios as revealed by the 2001 census, what strikes one are the huge areas of the country—especially in the south and east—where this invidious practice can yet spread, conditioned by essentially imported norms and patterns of behaviour. Alas, there is vast potential for these various negative processes to play out.

    Of course, there are those who argue that the operation of the marriage market's ‘hidden hand’ will work to raise the value of the girl child in India in the long run, as shortages of potential brides emerge. There are several countries in Asia where shortages of women in the marriage market are being addressed partly through increased international migration. However migration of this sort certainly cannot have an appreciable influence on the dynamics of India's marriage market, and the same is likely to apply to internal migration. Those who have faith in the eventual operation of some beneficial ‘hidden hand’ neglect the distinct possibility that negative processes could become re-enforcing and self-sustaining in much of society. There are many examples in which the actions of individuals work against the collective interests of society as a whole. For example: who can doubt that India would be better in every way if men and women were held in equal regard? And in relation to the practice of female specific abortion, it is quite possible to envisage a future downward spiral in which this practice increases, making marriage more difficult, while at the same time marriage itself becomes an increasingly undervalued state.

    Some thirty years ago, Ashok Mitra suggested that understanding the position of women in society was probably the single most important element in comprehending India's population. And despite all the changes that have occurred in the meantime, that observation surely retains its force.

    So, to reiterate, this is a hugely important and challenging subject. The editor is to be commended greatly in making this volume possible, and the contributors are to be thanked for the insight that their writings contain. If there is any hope of influencing events so that the practice of female specific abortion disappears, then it must be based on increased understanding of the kind that is provided for us here.

    TimDyson

    Preface

    My interest in the relationship between missing girls and female foeticide germinated on the margins of another study. This happened while I was doing a study for OXFAM, Lucknow, on domestic violence. The plan for the study took shape in 2002. The 2001 census of India, soon after the preliminary census results were out, had officially accepted the numerical female deficit in the child sex ratio figures as a serious cause for concern. It was in my meetings with NGO workers during the visits to Jhansi and other districts of Bundlekhand for the study that the processes operating toward the phenomenon of missing girls were gradually unravelled. By then the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994, commonly called (PNDT), initiated by women's groups and civil society organisations, had been a few years old and the service providers were all aware of the Act if not all the service seekers. Taking off from there, as I was persuaded by my personal interest, I explored more about the problem. And also reverted to a few stray cases I had fleetingly come across in towns in Rajasthan to gather more details. Subsequently, scholars and activists who had been working on this problem and fighting against its persistence participated in a workshop. The essays in this book are newer incarnations of those originally presented at the workshop I organised in the Department of Sociology, University of Delhi, at the end of October 2003. They mark out the various disciplinary orientations and vantage points from which the serious problem of missing girls in India is addressed. At that point, one was still hoping that the menace of sex-selective abortion, also called female foeticide, would subside and the tide would turn. I had not imagined that the problem will reach the steep level that it has today.

    There was a great deal of social concern among social scientists and the media after the 2001 census reiterated its findings at various forums. In the public sphere, citizen's groups mobilisation had influenced the state apparatuses to revise the 1994 PNDT Act. It was an achievement that two amendments to the Act, those of 2002 and 2003 were passed. The theme of one of the three sections in this book, deals with the various layers and levels of interaction between the state and the society. It brings out the view that participation in, and defiance of different but intersecting systems of authority is, in itself a political phenomenon. Mobilisation of and by civil society groups in the public sphere regarding intimate, private and yet politically charged matters brings to light the conflict of ethics and interests. The life of the citizen as a person, revolves primarily around elements and mechanisms of the affective community. And the life of a person as a citizen is intertwined in multiple ways with the organs of the state at one level and those of the society and their representations at another.

    The theme that sets out the book is the puzzle of positive indicators of development in modern India going gender-awry, especially as the society seems to turn against the female baby and foetus. Social inequities have been pegged on strata based on biological categories, such as age and sex in human society for long. But its traces persist in some societies, such as South and South-east Asia, while they are wiped out in others. This poses a serious challenge to social anthropology to study practices and processes that are not limited to small scale societies.

    The political economy of emotions constitutes the theme running through most of the essays. It is on the micro-politics around socially shared consciousness regarding reproduction, progeny and parenting at several interrelated levels—the individual, the family and the society in everyday life. The meanings people assign to actions and consequences thereof are private and intimate political matters, but at the same time, they also are social and political matters for those very people. This reiterates the idea of personal as political. The subjectivity of people and the meanings they imbue to their and others’ actions concretise politics at the private, individual as well as the social level, having micro- and macro level consequences. Politics as maternal agency, and passivity within and outside the family, is a complex play of individual and social groups’ emotions and interests, of will and deed, and means and ends. The practice of sex-selective abortions is not uniform even within India. Certain high castes in India had had a tradition of female infanticide. Tradition in this book is not taken as a historical baggage or as a synonym for culture. It is a state of the mind, a state that provides meaning, embedded predispositions in thought and action to the present, in the light of mythology and a selective retrieval of the past in this specific context. The politics and economics of micro-power games are intertwined with the notions of prestige and esteem, which regularly nurse and draw upon the ‘partially othering’ ethos towards the daughter in North India. The daughter is for safekeeping in parental custody only for a time period; and this view is an important constituent for what it means to be a daughter's parents. Selective dislike for daughters, especially for the second and subsequent ones emerges in the essays, as they explore, the mindset along with other issues. They ask if an underlying layer of tradition is retrieved in a modern avtaar with its attendant structural considerations and meanings.

    Acknowledgements

    The book is an outcome of the efforts not only of the contributors and the editor. It also represents the contributions of the very many people who took part in the workshop of which this book is an incarnation, and who discussed the publication of this volume after the workshop. To the colleagues in the Department of Sociology whose questions I benefited from and to all those people therefore I would like to take this opportunity of expressing my thanks. Special mention may be made here for Janaki Abraham, Mahua Bandyopadhayay and Sudakshina Malik among others, who managed the organising of the workshop.

    In preparing this volume, I have received much cordial support from colleagues in the Department of Anthropology, South Asia Institute, University of Heidelberg, Germany, where a great deal of editorial work for the volume was done. As Chair in India Studies for a semester, Professor William Sax willingly provided the requisite social and academic inputs. Dr Roland Hardenberg not only worked as a sounding board but also provided valuable inputs. Dr Gabriele Alex stood by her South Indian Vaghris who loved their daughters. Dr Elisabeth Shombucher-Kursterer and Professor Gita Dharampal-Fricke (Department of History) gave their critical inputs. Ferdinand Okwara's comments on one of my papers were helpful. Professor Ursula Sharma read two of my essays. I value her comments. Professor A.M. Shah's inputs have been of special importance at different junctures in the preparation of this volume. Dr Arima Mishra's comments on one of the essays were perceptive. I am grateful to all these people for cheerfully sharing what it takes to do such a task. For the forbearance they have shown at all times in the making of this volume, I take this opportunity to mention Radheshyam Patel, my husband who has been as usual the rock behind me, and Savita, my daughter whose inputs and experience have taught me many a lesson in the fruition of this volume's life.

    All the contributors to this volume, unfortunately a couple of them could not find time to contribute their revised versions, I thank for their cheerful disposition, and for other support I needed from them, working across the continent. To Ms. Anamika Mukharji and Ms. Swati Sahi of Sage goes my admiration for prompt and careful handling of the publication. I am thankful to the anonymous reviewer for comments on the manuscript.

    The production of this book has arisen out of the labour and interest of many researchers and concerned social scientists. The book has come at an enormous cost. It has seen the light of the day in the midst of a pathology. It has come at the cost of millions of girls who were not fortunate enough to be born. This need not be confused with taking a pro-life position. It is the selective genocide with which this effort engages. As I offer this volume to lost lives of those unborn girls, I share with the contributors of this volume the hope that the devaluation of the female sex is stalled.

    Financial support through the University of Delhi was helpful in the participation of many scholars and students in the workshop in October, 2003. I am thankful to Delhi University for its support though it bears no responsibility for the views expressed here.

    TulsiPatel 30 April 2006
  • Appendix 1: Campaign Against Female Foeticide: Perspectives, Strategies and Experiences

    BijayalaxmiNanda

    The child sex ratio is calculated as the number of girls per 1,000 boys in the 0–6 year age group. The 2001 census of India reported a child sex ratio of 927 girls per 1,000 boys. Therefore, there are 73 ‘missing girls’ for every 1,000 boys in our country, and soon it may become very difficult to make up for them. The practice of eliminating female foetuses is believed to be one of the main reasons for the adverse child sex ratio. Millions of female foetuses were, and are still being terminated, creating a serious imbalance in the child sex ratio in the country. Female foeticide seems to be more prevalent in urban areas than in the rural areas, but the gap is fast decreasing because of the easy availability of sex determination tests now in rural areas. Some of the factors responsible for this can be categorised as:

    Socio-cultural
    • preference for a son by family and society (as he carries forward the name of the family, is considered a source of support during old age and he also performs the last rites at the time of cremation)
    • social and familial pressure on women to produce sons
    • lower status of women in the society
    • inheritance system where a girl child has no right to her father's property
    • social evil of dowry
    Economic
    • child rearing cost vis-à-vis benefits that may accrue when the child becomes an adult
    • cost related to marriage, especially in the form of dowry
    • most women lack financial independence
    Political
    • the issue does not attract the attention of political parties
    • weak enforcement of existing policies and laws aimed at curbing the practice
    • little political interest in bringing innovative policies to deal with the problem

    The practice of eliminating unwanted girls and selecting desirable boys has been aided and facilitated by the misuse of medical technologies or reproductive technologies. Commercial minded and unethical doctors have been abusing these advanced scientific techniques for selective elimination of female foetuses through sex determination. Some of the common methods of sex determination, before birth as well as before conception are:

    • Amniocentesis (Amnion: membrane, Kentesis: pricking)—in this technique, amniotic fluid is drawn from the amniotic sac surrounding the foetus in the uterus through a long needle inserted into the abdomen. Foetal cells present in the fluid help in determining the sex of the foetus. It is normally performed after 15–17 weeks of pregnancy.
    • Chorionic villi biopsy—this refers to the removal of elongated cells (called villi) of the Chorion, which is the tissue surrounding the foetus, through the cervix. The tissue cells are tested to determine the sex of the foetus. This technique enables sex determination between the first 6–13 weeks of pregnancy and abortion can be carried out in the first trimester itself.
    • Ultra-sonography/ultrasonic–here inaudible (to humans) sound waves are used to get a visual image of the foetus on a screen. Normally, it is used to determine the foetal position or abnormalities, but it can also be used to find the sex if external genitalia of a male foetus are seen on the screen. It is normally performed around the 10th week of pregnancy. It is the most commonly and rampantly used method for sex determination.
    • Pre-conception techniques to select sex–
    • Ericsson method or (X and Y chromosome sperm separation)—A male child requires an XY combination of chromosomes. Sperms may have either X or Y chromosomes, but eggs have only X chromosomes. In this method, sperms are separated into those bearing X chromosomes and those bearing Y chromosomes by filtration when put in a chemical solution. The faster moving Y sperms penetrate the solution's denser bottom layers. The egg is then fertilised with a high concentration of Y sperms to produce a male.
    • Pre-implantation genetic diagnosis—one of the latest technologies to be used for sex selection, it involves chromosomal analysis of a few cells taken from a test tube embryo (fertilisation is done outside the uterus) to determine the sex.
    Figure Appendix 1.1 State Average Child Sex Ratio in 1991–2001 Decade

    A declining sex ratio has various socio-economic and health implications. A woman's health suffers as she is forced to undergo multiple pregnancies and abortions. A decreasing number of females in society can increase sex-related crimes and violence against women. Imbalance is likely to cause a rise in social problems like dowry deaths, forced polyandry, rape, child marriages, bride-selling and kidnapping of women for marriage. For example, a recent newspaper article says that in Hathin (Haryana), two decades of female foeticide have caught up with the people. Men are resorting to the tactic of buying brides from other states like Assam and West Bengal. The price put on such a girl is much less than what people pay for cattle! After marriage, they are condemned to a life of slavery. (Hindustan Times, 12 July 2003, New Delhi).

    It is clear from the above figure that the sex ratio in the age group 0–6 has diminished all over the country. One thing is clear that the imbalance that has been set in this early age group is difficult to be removed and would remain to haunt the population for a long time to come. To say the least, demographically, the sex ratio in the age group 0–6 does not appear to augur well for the future of the country.

    Table Appendix. 1.1 Declining Child Sex Ratio in Delhi

    Some more revealing statistics (UNFPA and Registrar General of India 2003) are given below.

    • A large number of well-off states like Maharashtra, Gujarat, Punjab, Himachal Pradesh and Haryana have recorded a more than 50-point decline in the ratio since 1991
    • The ratio has declined to less than 900 girls per 1,000 boys in states like Delhi, Gujarat, Haryana and Punjab
    • Some of the most prosperous regions have one of the lowest ratio–south west district of Delhi–845 (a drop of 59 points from 904 girls in 1991), Ahmedabad in Gujarat–814, and Kurukshetra in Haryana–only 770
    • In 1991, no state had a ratio of less than 800, but in 2001, four states (Punjab, Haryana, Himachal Pradesh, Gujarat) fell in that category
    • In 2001, there are fewer districts with a child sex ratio of over 950 compared to 1991
    History of the Campaigns against Sex Determination and Female Foeticide

    The drive against female foeticide and sex determination techniques gained strength in the 1980s. The 1976 partial ban on sex determination tests in government hospitals had only led to the proliferation of private clinics/hospitals offering the facility. The ban was imposed because the advent of amniocentesis in 1975 caused a dramatic increase in female foeticide cases. Since then, different parts of the country have witnessed several campaigns against the misuse of science and technology to continue discrimination against women. In 1982, the Centre for Women's Development Studies (CWDS) launched the first campaign. It was initiated by Dr Veena Mazumdar and Dr Lotika Sarkar in Delhi as a protest against an advertisement for Bhandari ante-natal sex determination clinic, Amritsar, Punjab. The clinic was openly advertising its services through the press, in railway compartments and other public places. The advertisement referred to daughters as ‘liabilities’ to the family and a threat to the nation, and exhorted expectant parents to avail of the services of the clinics to rid themselves of this ‘danger’.

    More campaigns like the Forum Against Sex Determination and Sex Pre-Selection (FASDSP) in 1985 in Maharashtra and the Campaign Against Sex-Selective Abortion (CASSA), Tamil Nadu came up. FASDSP lobbied to regulate the practice of sex determination in Maharashtra by formulating a separate legislation, instead of modifying the Medical Termination of Pregnancy (MTP) Act, 1971, that had the danger of curtailing women's right to abort, the Maharashtra Regulation of Use of Prenatal Diagnostic Techniques Act, 1988, came into being.

    Serious drawbacks in the state legislation and poor implementation caused the awakening of interest in the issue across the entire country. A move for an all-India ban on sex determination tests gained momentum, and the Pre-Natal Diagnostic Tests (Regulation and Prohibition of Misuse) Act, 1994, (called the PNDT Act) came into existence. Though the PNDT Act entered into force in January 1996, no evidence of decline in the practice of female foeticide came forth even after four years. Lack of concern and political will to implement the legislation by the Centre and states led to a Public Interest Litigation (PIL) in the Supreme Court (SC). The PIL was filed by three petitioners—Dr Sabu George—a social activist, Mahila Sarvangeen Utkarsh Mandal (MASUM), Pune, and Centre for the Enquiry of Health and Allied Themes (CEHAT), Mumbai, in February 2000. In May 2001, the SC directed the Centre to implement the PNDT Act in all its aspects and called upon all state governments to take necessary steps to implement the Act (See V. Patel 2002 and 2003). However, a further dip in the 2001 sex ratio suggests that a lot more needs to be done in this regard.

    In the light of new techniques available to determine sex before conception, it was considered necessary to amend the Act. From February 14th 2003, the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Amendment Act, 2002 came into force. The PNDT Act 1994 was renamed as ‘the Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994.

    The Delhi Students and Teachers Campaign Against Female Foeticide

    The Campaign Against Female Foeticide, supported by the Centre for Women's Development Studies, was launched in Delhi in July, 2002. One of the immediate urgencies was to mobilise teachers and students of Delhi University and other educational institutions in Delhi, to build pressure on the Parliamentarians to pass the PNDT Amendment Bill. The other overarching aim of the campaign was to generate awareness about the disastrous consequences of female foeticide and to initiate a spirit of voluntarism amongst teachers and students of Delhi in order to combat this heinous practice. It was felt that sensitising students to this issue would serve a dual purpose. It would not only orient them to the issue but they would also play an important role in arresting female foeticide in their communities by acting as an advocacy group. Delhi has had an accelerated fall in child sex ratio which has declined from 915 in 1991 to 865 in 2001.

    Some of the main objectives of the Campaign, therefore, are:

    • To orient college teachers and students regarding the issue of female foeticide and the importance of the girl child.
    • To initiate voluntarism among teachers and students and facilitate them to act as an advocacy group against female foeticide and for the cause of the girl child.
    • To spread awareness about the PNDT Act in order to prevent and arrest the rampant practice of sex determination leading to female foeticide.

    Many of the student volunteers did not know the meaning of female foeticide in the beginning. However, their energy and effervescence maintained the initiative, leading to a vibrant campaign.

    The Campaign was initiated with a teacher's orientation meeting and then various societies within colleges like the WDC, the NSS were used to raise the issue, discuss its causes and initiate debate. Experts from all fields addressed them and apprised them of the situation. Reactions and responses have more or less been favourable, students have understood female foeticide as gender violence and shared a sense of concern, anguish and outrage. The Campaign mobilised a ‘March to Parliament’ on 31st July, 2002 and again in November, 2002 urging immediate passage of the PNDT Amendment Bill. More than 500 students and teachers of colleges of Delhi University and JNU joined these marches on each occasion.

    Apart from this, street plays are organised regularly and films on the issue are shown in different colleges. Creative competitions like poster making, slogan writing, etc. are also organised. An inter-college choreography show depicting the theme, was held in association with CII. Some of the other noteworthy programmes include a cloth banner rally, a mobile exhibition ‘Nipped in the Bud’ and participation in the national campaign protesting violence against women in Delhi.

    When the students were addressed their immediate response was mixed, ‘yes we understand the problem and we pledge not to practise female foeticide in our married life but what else can we do?’ But after sustained efforts of trying to reach them through various methods like the screening of films, using an emotive medium like the street play, presentation of the Census data, presentation of case studies, etc, their response changed to a more positive and enthusiastic ‘yes, what can we do, tell us’.

    So now there are about 100 volunteers spread over 19 colleges. They organise street plays on the issue, initiate debate and write papers on it and also have choreography shows on the issue. More importantly they carry the message to their homes and communities and report about their ability to convince others about the widespread occurrence of sex-selective abortions and how it affects child sex ratio and escalates gender violence. In fact, a core group of volunteers have given the names of various clinics where their relatives have had sex-selective abortions. They are monitoring the actions that are being taken.

    Some of the Main Achievements of the Campaign
    • Ability to maintain initiative and information.
    • Ability to create a vibrant campaign and mobilise a large group of teachers and students.
    • Effectively rallied for the passage of the PNDT amendment bill.
    • Raising student voluntarism.
    • Facilitating the development of a sense of ownership towards the issue.
    Some of the Lessons Learnt in the Process of the Campaign are
    • Although it was easy to increase volunteerism amongst students, it was not the same with teachers. Teachers were hard-pressed for time and therefore found it difficult to maintain their interest and energy specifically for this cause.
    • One of the main problems faced was over the question about abortion. Some students felt that abortion should be banned thereby protecting every child's right to life. It was, however, maintained that the right to abortion must remain as an essential right to women, a right to determine their life, their body and fertility.
    • There was lesser involvement of male students who viewed this as a women's issue and not something concerning them.
    • It was difficult to have access to the women student volunteers after their marriage.
    • There was a problem in maintaining continuity and sustainability because students are a floating mass.
    • Some students felt that this awareness generation was more appropriate for slum dwellers and rural people, as teachers and students were generally gender-sensitive. Through presentations of data (specifically of Delhi), it was shown how female foeticide breaks through the rural-urban divide and is more prevalent in posh, developed, urban areas and among the educated well-off and middle class.
    • No powerful message has been sent to the unethical, medical practitioners who have a strong lobby.
    Major Recommendations

    Some of the major recommendations emerging from the various workshops and orientation programmes of the Campaign include:

    • A need to do advocacy with medical students and professionals on the issue.
    • Steps should be taken to bring about quick implementation of the PNDT Act against erring doctors and other perpetrators.
    • Special programmes to be organised to be focused on gender equality and importance of the girl child.
    • To bring about a sustained media advocacy programme on the issue.
    • To bring about the enforcement of laws in respect of dowry, child marriage, sexual harassment, violence against women and child abuse.
    • To bring about participation and consultation of students on this issue.

    In order to make this campaign a success, there is a need to sustain the energy levels that have been created. The struggle against the patriarchal order of state and society and the elimination of gender violence can only be possible with the participation of each and every member of the civil society. The teaching-learning community has a leading role in shaping society's orientation and attitudes and must continue to protest against sex determination and sex-selection, leading to female foeticide. This is highly discriminatory, illegal, unethical and, therefore, not to be tolerated.

    References
    Census of India. 1991. Office of the Registrar General of India. New Delhi.
    Census of India. 2001. Office of the Registrar General of India. New Delhi.
    Hindustan Times. 2003. New Delhi: 12 July.
    Patel, Vibhuti. 2002. Women's Challenges of the New Millennium. New Delhi: Gyan Publications.
    Patel, Vibhuti. 2003. ‘Sons are Rising, Daughters Setting’, Humanscape, September, 2003: 14–16.
    United Nations Population Fund, Office of the Registrar General and Census Commissioner. 2003. Missing…: Mapping the Adverse Child Sex Ratio in India. New Delhi: Ministry of Health and Family Welfare, June.

    Appendix 2: PNDT (Regulation and Prevention of Misuse) Act 1994

    ACT NO. 57 OF 1994

    [20th September, 1994]

    An Act to provide for the regulation of the use of pre-natal diagnostic techniques for the purpose of detecting genetic or metabolic disorders or chromosomal abnormalities or certain congenital malformations or sex linked disorders and for the prevention of the misuse of such techniques for the purpose of pre-natal sex determination leading to female foeticide; and, for matters connected there with or incidental thereto.

    Be it enacted by Parliament in the Forty-fifth Year of the Republic of India as follows:—

    Chapter I: Preliminary
    • Short title, extent and commencement:
      • This Act may be called the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994.
      • It shall extend to the whole of India except the State of Jammu and Kashmir.
      • It shall come into force on such date as the Central Government may, by notification in the Official Gazette, appoint.
    • Definitions: In this Act, unless the context otherwise requires,—
      • ‘Appropriate Authority’ means the Appropriate Authority appointed under section 17;
      • ‘Board’ means the Central Supervisory Board constituted under section 7;
      • ‘Genetic Counselling Centre’ means an institute, hospital, nursing home or any place, by whatever name called, which provides for genetic counselling to patients;
      • ‘Genetic Clinic’ means a clinic, institute, hospital, nursing home or any place, by whatever name called, which is used for conducting pre-natal diagnostic procedures;
      • ‘Genetic Laboratory’ means a laboratory and includes a place where facilities are provided for conducting analysis or tests of samples received from Genetic Clinic for pre-natal diagnostic test;
      • ‘Gynaecologist’ means a person who possesses a post-graduate qualification in gynaecology and obstetrics;
      • ‘Medical geneticist’ means a person who possesses a degree or diploma or certificate in medical genetics in the field of pre-natal diagnostic techniques or has experience of not less than two years in such field after obtaining—
        • any one of the medical qualifications recognised under the Indian Medical Council Act, 1956 (102 of 1956); or
        • a post-graduate degree in biological sciences;
      • ‘Pediatrician’ means a person who possesses a post-graduate qualification in pediatrics;
      • ‘Pre-natal diagnostic procedures’ means all gynecological or obstetrical or medical procedures such as ultrasonography foetoscopy, taking or removing samples of amniotic fluid, chorionic villi, blood or any tissue of a pregnant woman for being sent to a Genetic Laboratory or Genetic Clinic for conducting pre-natal diagnostic test;
      • ‘Pre-natal diagnostic techniques’ includes all pre-natal diagnostic procedures and pre-natal diagnostic tests;
      • ‘Pre-natal diagnostic test’ means ultrasonography or any test or analysis of amniotic fluid, chorionic villi, blood or any tissue of a pregnant woman conducted to detect genetic or metabolic disorders or chromosomal abnormalities or congenital anomalies or haemoglobinopathies or sex-linked diseases;
      • ‘Prescribed’ means prescribed by rules made under this Act;
      • ‘Registered medical practitioner’ means a medical practitioner who possesses any recognised medical qualification as defined in clause (h) of section 2 of the Indian Medical Council Act, 1956, (102 of 1956.) and whose name has been entered in a State Medical Register;
      • ‘Regulations’ means regulations framed by the Board under this Act.
    Chapter II: Regulation of Genetic Counselling Centres, Genetic Laboratories and Genetic Clinics

    3. Regulation of Genetic Counselling Centres, Genetic Laboratories and Genetic Clinics—On and from the commencement of this Act,—

    • 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;
    • no Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic shall employ or cause to be employed any person who does not possess the prescribed qualifications;
    • 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.
    Chapter III: Regulation of Pre-Natal Diagnostic Techniques

    4. Regulation of pre-natal diagnostic techniques—On and from the commencement of this Act,—

    • no place including a registered Genetic Counselling Centre or Genetic Laboratory or Genetic Clinic shall be used or caused to be used by any person for conducting pre-natal diagnostic techniques except for the purposes specified in clause (2) and after satisfying any of the conditions specified in clause (3);
    • no pre-natal diagnostic techniques shall be conducted except for the purposes of detection of any of the following abnormalities, namely:—
      • chromosomal abnormalities;
      • genetic metabolic diseases;
      • haemoglobinopathies;
      • sex-linked genetic diseases;
      • congenital anomalies;
      • any other abnormalities or diseases as may be specified by the Central Supervisory Board;
    • no pre-natal diagnostic techniques shall be used or conducted unless the person qualified to do so is satisfied that any of the following conditions are fulfilled, namely:—
      • age of the pregnant woman is above thirty-five years;
      • the pregnant woman has undergone two or more spontaneous abortions or foetal loss;
      • the pregnant woman had been exposed to potentially teratogenic agents such as drugs, radiation, infection or chemicals;
      • the pregnant woman has a family history of mental retardation or physical deformities such as spasticity or any other genetic disease;
      • any other condition as may be specified by the Central Supervisory Board;
    • no person, being a relative or the husband of the pregnant woman shall seek or encourage the conduct of any pre-natal diagnostic techniques on her except for the purpose specified in clause (2).

    5. Written consent of pregnant woman and prohibition of communicating the sex of foetus.

    • No person referred to in clause
    • of section 3 shall conduct the pre-natal diagnostic procedures unless—
      • he has explained all known side and after effects of such procedures to the pregnant woman concerned;
      • he has obtained in the prescribed form her written consent to undergo such procedures in the language which she understands; and
      • a copy of her written consent obtained under clause (b) is given to the pregnant woman.
    • No person conducting pre-natal diagnostic procedures shall communicate to the pregnant woman concerned or her relatives, the sex of the foetus by words, signs or in any other manner.

    6. Determination of sex prohibited—On and from the commencement of this Act,—

    • 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 ultrasonography, for the purpose of determining the sex of a foetus;
    • no person shall conduct or cause to be conducted any pre-natal diagnostic techniques including ultrasonography for the purpose of determining the sex of a foetus.
    Chapter IV: Central Supervisory Board

    7. Constitution of Central Supervisory Board—

    • The Central Government shall constitute a Board to be known as the Central Supervisory Board to exercise the powers and perform the functions conferred on the Board under this Act.
    • The Board shall consist of—
      • the Minister in charge of the Ministry or Department of Family Welfare, who shall be the Chairman, ex-officio;
      • the Secretary to the Government of India in charge of the Department of Family Welfare, who shall be the Vice-Chairman, ex-officio;
      • two members to be appointed by the Central Government to represent the Ministries of Central Government in charge of Woman and Child Development and of Law and Justice, ex-officio;
      • the Director General of Health Services of the Central Government, ex-officio;
      • ten members to be appointed by the Central Government, two each from amongst—
        • eminent medical geneticists;
        • eminent gynaecologists and obstetricians;
        • eminent paediatricians;
        • eminent social scientists; and
        • representatives of women welfare organisations;
      • three women Members of Parliament, of whom two shall be elected by the House of the People and one by the Council of States;
      • four members to be appointed by the Central Government by rotation to represent the States and the Union territories, two in alphabetical order and two in the reverse alphabetical order:

        Provided that no appointment under this clause shall be made except on the recommendation of the State Government or, as the case may be, the Union territory;

      • 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.

    8. Term of office of members.—

    • The term of office of a member, other than an ex officio member, shall be,—
      • in case of appointment under clause (e) or clause (f) of subsection (2) of section 7, three years; and
      • in case of appointment under clause (g) of the said subsection, one year.
    • If a casual vacancy occurs in the office of any other member, whether by reason of his death, resignation or inability to discharge his functions owing to illness or other incapacity, such vacancy shall be filled by the Central Government by making a fresh appointment and the member so appointed shall hold office for the remainder of the term of office of the person in whose place he is so appointed.
    • The Vice-Chairman shall perform such functions as may be assigned to him by the Chairman from time to time.
    • The procedure to be followed by the members in the discharge of their functions shall be such as may be prescribed.

    9. Meetings of the Board—

    • The Board shall meet at such time and place, and shall observe such rules of procedure in regard to the transaction of business at its meetings (including the quorum at such meetings) as may be provided by regulations:

      Provided that the Board shall meet at least once in six months.

    • The Chairman and in his absence the Vice-Chairman shall preside at the meetings of the Board.
    • If for any reason the Chairman or the Vice-Chairman is unable to attend any meeting of the Board, any other member chosen by the members present at the meeting shall preside at the meeting.
    • All questions which come up before any meeting of the Board shall be decided by a majority of the votes of the members present and voting, and in the event of an equality of votes, the Chairman, or in his absence, the person presiding, shall have and exercise a second or casting vote.
    • Members other than ex-officio members shall receive such allowances, if any, from the Board as may be prescribed.

    10. Vacancies, etc., not to invalidate proceedings of the Board. No act or proceeding of the Board shall be invalid merely by reason of—

    • any vacancy in, or any defect in the constitution of, the Board; or
    • any defect in the appointment of a person acting as a member of the Board; or
    • any irregularity in the procedure of the Board not affecting the merits of the case.

    11. Temporary association of persons with the Board for particular purposes.

    • The Board may associate with itself, in such manner and for such purposes as may be determined by regulations, any person whose assistance or advice it may desire in carrying out any of the provisions of this Act.
    • 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 to that purpose, but shall not have a right to vote at a meeting of the Board and shall not be a member for any other purpose.

    12. Appointment or officers and other employees of the Board—

    • For the purpose of enabling it efficiently to discharge its functions under this Act, the Board may, subject to such regulations as may be made in this behalf, appoint (whether on deputation or otherwise) such number of officers and other employees as it may consider necessary:

      Provided that the appointment of such category of officers, as may be specified in such regulations, shall be subject to the approval of the Central Government.

    • Every officer or other employee appointed by the Board shall be subject to such conditions of service and shall be entitled to such remuneration as may be specified in the regulations.

    13. Authentication of orders and other instruments of the Board. All orders and decisions of the Board shall be authenticated by the signature of the Chairman or any other member authorised by the Board in this behalf, and all other instruments issued by the Board shall be authenticated by the signature of the Member-Secretary or any other officer of the Board authorised in like manner in this behalf.

    14. Disqualifications for appointment as member. A person shall be disqualified for being appointed as a member if, he—

    • has been convicted and sentenced to imprisonment for an offence which, in the opinion of the Central Government, involves moral turpitude; or
    • is an undischarged insolvent; or
    • is of unsound mind and stands so declared by a competent court; or
    • has been removed or dismissed from the service of the Government or a Corporation owned or controlled by the Government; or
    • has, in the opinion of the Central Government, such financial or other interest in the Board as is likely to affect prejudicially the discharge by him of his functions as a member; or
    • has, in the opinion of the Central Government, been associated with the use or promotion of pre-natal diagnostic technique for determination of sex.

    15. Eligibility of member for re-appointment—Subject to the other terms and conditions of service as may be prescribed, any person ceasing to be a member shall be eligible for re-appointment as such member.

    16. Functions of the Board. The Board shall have the following functions, namely:—

    • to advise the Government on policy matters relating to use of pre-natal diagnostic techniques;
    • to review implementation of the Act and the rules made thereunder and recommend changes in the said Act and rules to the Central Government;
    • to create public awareness against the practice of pre-natal determination of sex and female foeticide;
    • to lay down the code of conduct to be observed by persons working at Genetic Counselling Centres, Genetic Laboratories and Genetic Clinics;
    • any other functions as may be specified under the Act.
    Chapter V: Appropriate Authority and Advisory Committee

    17. Appropriate Authority and Advisory Committee—

    • The Central Government shall appoint, by notification in the Official Gazette, one or more Appropriate Authorities for each of the Union territories for the purposes of this Act.
    • The State Government shall appoint, by notification in the Official Gazette, one or more Appropriate Authorities for the whole or part of the State for the purposes of this Act having regard to the intensity of the problem of pre-natal sex determination leading to female foeticide.
    • The officers appointed as Appropriate Authorities under subsection (1) or sub-section (2) shall be,—
      • when appointed for the whole of the State or the Union territory, of or above the rank of the Joint Director of Health and Family Welfare; and
      • when appointed for any part of the State or the Union territory, of such other rank as the State Government or the Central Government, as the case may be, may deem fit.
    • The Appropriate Authority shall have the following functions, namely:—
      • to grant, suspend or cancel registration of a Genetic Coun selling Centre, Genetic Laboratory or Genetic Clinic;
      • to enforce standards prescribed for the Genetic Counselling Centre, Genetic Laboratory and Genetic Clinic;
      • to investigate complaints of breach of the provisions of this Act or the rules made thereunder and take immediate action; and
      • to seek and consider the advice of the Advisory Committee, constituted under sub-section (5), on application for registration and on complaints for suspension or cancellation of registration.
    • The Central Government or the State Government, as the case may be, shall constitute an Advisory Committee for each Appropriate Authority to aid and advise the Appropriate Authority in the discharge of its functions, and shall appoint one of the members of the Advisory Committee to be its Chairman.
    • The Advisory Committee shall consist of—
      • three medical experts from amongst gynaecologists, obstericians, paediatricians and medical geneticists;
      • one legal expert;
      • one officer to represent the department dealing with information and publicity of the State Government or the Union territory, as the case may be;
      • three eminent social workers of whom not less than one shall be from amongst representatives of women's organisations.
    • No person who, in the opinion of the Central Government or the State Government, as the case may be, has been associated with the use or promotion of pre-natal diagnostic technique for determination of sex shall be appointed as a member of the Advisory Committee.
    • The Advisory Committee may meet as and when it thinks fit or on the request of the Appropriate Authority for consideration of any application for registration or any complaint for suspension or cancellation of registration and to give advice thereon:

      Provided that the period intervening between any two meetings shall not exceed the prescribed period.

    • 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 as may be prescribed.
    Chapter VI: Registration of Genetic Counselling Centres, Genetic Laboratories and Genetic Clinics

    18. Registration of Genetic Counselling Centres, Genetic Laboratories or Genetic Clinics.

    • 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 jointly under this Act.
    • Every application for registration under sub-section (1), shall be made to the Appropriate Authority in such form and in such manner and shall be accompanied by such fees as may be prescribed.
    • Every Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic engaged, either partly or exclusively, in counselling or conducting pre-natal diagnostic techniques for any of the purposes mentioned in section 4, immediately before the commencement of this Act, shall apply for registration within sixty days from the date of such commencement.
    • 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 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.
    • No Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic shall be registered under this Act unless the Appropriate Authority 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. Certificate of registration—

    • The Appropriate Authority shall, after holding an inquiry 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, as the case may be.
    • If, after the inquiry and after giving an opportunity 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, for reasons to be recorded in writing, reject the application for registration.
    • Every certificate of registration shall be renewed in such manner and after such period and on payment of such fees as may be prescribed.
    • The certificate of registration shall be displayed by the registered Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic in a conspicuous place at its place of business.

    20. Cancellation or suspension of registration—

    • The Appropriate Authority may suo moto, or on complaint, issue a notice to the Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic to show cause why its registration should not be suspended or cancelled for the reasons mentioned in the notice.
    • If, after giving a reasonable opportunity of being heard to the Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic and having regard to the advice of the Advisory Committee, the Appropriate Authority is satisfied that there has been a breach of the provisions of this Act or the rules, it may, without prejudice to any criminal action that it may take against such Centre, Laboratory or Clinic, suspend its registration for such period as it may think fit or cancel its registration, as the case may be.
    • Notwithstanding anything contained in sub-sections (1) and (2), if the Appropriate Authority is, of the opinion that it is necessary or expedient so to do in the public interest, it may, for reasons to be recorded in writing, suspend the registration of any Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic without issuing any such notice referred to in sub-section (1).

    21. Appeal. 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—

    • the Central Government, where the appeal is against the order of the Central Appropriate Authority; and
    • the State Government, where the appeal is against the order of the State Appropriate Authority, in the prescribed manner.
    Chapter VII: Offences and Penalties

    22. Prohibition of advertisement relating to pre-natal determination of sex and punishment for contravention

    • No person, organisation, Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic shall issue or cause to be issued any advertisement in any manner regarding facilities of pre-natal determination of sex available at such Centre, Laboratory, Clinic or any other place.
    • No person or organisation shall publish or distribute or cause to be published or distributed any advertisement in any manner regarding facilities of pre-natal determination of sex available at any Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic or any other place.
    • Any person who contravenes the provisions of sub-section (1) or sub-section (2) shall be punishable with imprisonment for a term which may extend to three years and with fine which may extend to ten thousand rupees.

    Explanation—For the purposes of this section, ‘advertisement’ includes any notice, circular, label wrapper or other document and also includes any visible representation made by means of any light, sound, smoke or gas.

    23. Offences and penalties—

    • Any medical geneticist, gynaecologist, registered medical practitioner or any person who owns a Genetic Counselling Centre, a Genetic Laboratory or a Genetic Clinic or is employed in such a Centre, Laboratory or Clinic and renders his professional or technical services to or at such a Centre, Laboratory or Clinic, whether on an honorary basis or otherwise, and who contravenes any of the provisions of this Act or rules made thereunder shall be punishable with imprisonment for a term which may extend to three years and with fine which may extend to ten thousand rupees and on any subsequent conviction, with imprisonment which may extend to five years and with fine which may extend to fifty thousand rupees.
    • The name of the registered medical practitioner who has been convicted by the court under sub-section (1), shall be reported by the Appropriate Authority to the respective State Medical Council for taking necessary action including the removal of his name from the register of the Council for a period of two years for the first offence and permanently for the subsequent offence.
    • Any person who seeks the aid of a Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic or of a medical geneticist, gynaecologist or registered medical practitioner for conducting prenatal diagnostic techniques on any pregnant woman (including such woman unless she was compelled to undergo such diagnostic techniques) for purposes other than those specified in clause (2) of section 4, shall, be punishable with imprisonment for a term which may extend to three years and with fine which may extend to ten thousand rupees and on any subsequent conviction with imprisonment which may extend to five years and with fine which may extend to fifty thousand rupees.

    24. Presumption in the case of conduct of pre-natal diagnostic techniques—Notwithstanding anything in the Indian Evidence Act, 1872 (1 of 1872), the court shall presume unless the contrary is proved that the pregnant woman has been compelled by her husband or the relative to undergo pre-natal diagnostic technique and such person shall be liable for abetment of offence under subsection (3) of section 23 and shall be punishable for the offence specified under that section.

    25. Penalty for contravention of the provisions of the Act or rules for which no specific punishment is provided. Whoever contravenes any of the provisions of this Act or any rules made thereunder, for which no penalty has been elsewhere provided in this Act, shall be punishable with imprisonment for a term which may extend to three months or with fine, which may extend to one thousand rupees or with both and in the case of continuing contravention with an additional fine which may extend to five hundred rupees for every day during which such contravention continues after conviction for the first such contravention.

    26. Offences by companies—

    • Where any offence, punishable under this Act has been committed 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 be proceeded against and punished accordingly:

      Provided that nothing contained in this sub-section shall render any such person liable to any punishment, if he proves that the offence was committed without his knowledge or that he had exercised all due diligence to prevent the commission of such offence.

    • 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, secretary or other officer shall also be deemed to be guilty of that offence and shall be liable to be proceeded against and punished accordingly.

      Explanation—For the purposes of this section,—

      • ‘company’ means any body corporate and includes a firm or other association of individuals, and
      • ‘director’, in relation to a firm, means a partner in the firm.

    27. Offence to be cognizable, non-bailable and non-compoundable—Every offence under this Act shall be cognizable, non-bailable and non-compoundable.

    28. Cognizance of offences.

    • No court shall take cognizance of an offence under this Act except on a complaint made by—
      • the Appropriate Authority concerned, or any officer authorised in this behalf by the Central Government or State Government, as the case may be, or the Appropriate Authority; or
      • a person who has given notice of not less than thirty days in the manner prescribed, to the Appropriate Authority, of the alleged offence and of his intention to make a complaint to the court.

        Explanation—For the purpose of this clause, ‘person’ includes a social organisation.

    • 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.
    • Where a complaint has been made under clause (b) of subsection (1), the court may, on demand by such person, direct the Appropriate Authority to make available copies of the relevant records in its possession to such person.
    Chapter VIII: Miscellaneous

    29. Maintenance of records.

    • All records, charts, forms, reports, consent letters and all other documents required to be maintained under this Act and the rules shall be preserved for a period of two years or for such period as may be prescribed:

      Provided that, if any criminal or other proceedings are instituted against any Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic, the records and all other documents of such Centre, Laboratory or Clinic shall be preserved till the final disposal of such proceedings.

    • All such records shall, at all reasonable times, be made available for inspection to the Appropriate Authority or to any other person authorised by the Appropriate Authority in this behalf.

    30. Power to search and seize records, etc.—

    • If the Appropriate Authority has reason to believe that an offence under this Act has been or is being committed at any Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic, such Authority or any officer authorised thereof in this behalf may, subject to such rules as may be prescribed, enter and search at all reasonable times with such assistance, if any, as such authority or officer considers necessary, such Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic and examine any record, register, document, book, pamphlet, advertisement or any other material object found therein and seize the same if such Authority or officer has reason to believe that it may furnish evidence of the commission of an office punishable under this Act.
    • The provisions of the Code of Criminal Procedure, 1973 (2 of 1974) relating to searches and seizures shall, so far as may be, apply to every search or seizure made under this Act.

    31. Protection of action taken in good faith. No suit, prosecution or other legal proceeding shall lie against the Central or the State Government or the Appropriate Authority or any officer authorised by the Central or State Government or by the Authority for anything which is in good faith done or intended to be done in pursuance of the provisions of this Act.

    32. Power to make rules—

    • The Central Government may make rules for carrying out the provisions of this Act.
    • In particular and without prejudice to the generality of the foregoing power, such rules may provide for—
      • the minimum qualifications for persons employed at a registered Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic under clause (1) of section 3;
      • the form in which consent of a pregnant woman has to be obtained under section 5;
      • the procedure to be followed by the members of the Central Supervisory Board in the discharge of their functions under sub-section (4) of section 8;
      • allowances for members other than ex-officio members admissible under sub-section (5) of section 9;
      • the period intervening between any two meetings of the Advisory Committee under the proviso to sub-section (8) of section 17;
      • 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 under sub-section (9) of section 17;
      • the form and manner in which an application shall be made for registration and the fee payable thereof under sub-section (2) of section 18;
      • the facilities to be provided, equipment and other standards to be maintained by the Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic under sub-section (5) of section 18;
      • the form in which a certificate of registration shall be issued under sub-section (1) of section 19;
      • the manner in which and the period after which a certificate of registration shall be renewed and the fee payable for such renewal under sub-section (3) of section 19;
      • the manner in which an appeal may be preferred under section 21;
      • the period up to which records, charts, etc., shall be preserved under sub-section (1) of section 29;
      • the manner in which the seizure of documents, records, objects, etc., shall be made and the manner in which seizure list shall be prepared and delivered to the person from whose custody such documents, records or objects were seized under sub-section (1) of section 30;
      • any other matter that is required to be, or may be, prescribed.

    33. Power to make regulations—The Board may, with the previous sanction of the Central Government, by notification in the Official Gazette, make regulations not inconsistent with the provisions of this Act and the rules made thereunder to provide for—

    • the time and place of the meetings of the Board and the procedure to be followed for the transaction of business at such meetings and the number of members which shall form the quorum under sub-section (1) of section 9;
    • the manner in which a person may be temporarily associated with the Board under sub-section (1) of section 11;
    • the method of appointment, the conditions of service and the scales of pay and allowances of the officer and other employees of the Board appointed under section 12;
    • generally for the efficient conduct of the affairs of the Board.

    34. Rules and regulations to be laid before Parliament—Every rule and every regulation made under this Act shall be laid, as soon as may be after it is made, before each House of Parliament, while it is in session, for a total period of thirty days which may be comprised in one session or in two or more successive sessions, and if, before the expiry of the session immediately following the session or the successive sessions aforesaid, both Houses agree in making any modification in the rule or regulation or both Houses agree that the rule or regulation 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; so, however, that any such modification or annulment shall be without prejudice to the validity of anything previously done under that rule or regulation.

    Appendix 3: PNDT (Regulation and Prevention of Misuse) Amendment Act 2002

    PNDT Amendment Act 2002, Registered No. DL-33004/2003

    The Gazette of India

    Extraordinary

    PART II – Section I

    Published by Authority

    No. 15

    New Delhi, Monday, January 20, 2003/Pausa 30, 1924

    Ministry of Law and Justice

    (Legislative Department)

    New Delhi, the 20th January, 2003/Pausa 30, 1924 (Saka)

    The following Act of Parliament received the assent of the President on the 17th January, 2003, and is hereby published for general information:

    The Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Amendment Act, 2002 Known as Pcpndt Act, 2002

    No. 14 of 2003

    [17th January, 2003]

    An Act further to amend the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994. BE it enacted by Parliament in the Fifty-third year of the Republic of India as follows:-

      • This Act may be called the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Amendment Act, 2002.
      • It shall come into force on such date as the Central Government may, by notification in the Official Gazette, appoint. Short title and commencement 57 of 1994.
    • In the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994 (hereinafter referred to as the principal Act), for the long title, the following long title shall be substituted, namely:—‘An Act to provide for the prohibition of sex selection, before or after conception, and for regulation of pre-natal diagnostic techniques for the purposes of detecting genetic abnormalities or metabolic disorders or chromosomal abnormalities or certain congenital malformations or sex-linked disorders and for the prevention of their misuse for sex determination leading to female foeticide and for matters connected therewith or incidental thereto.’ Substitution of long title.

    Amendment of section 1.3.

    In section 1 of the principal Act, in sub-section (1), for the words and brackets ‘the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse)’, the words and brackets ‘the Pre-conception and Prenatal Diagnostic Techniques (Prohibition of Sex Selection)’ shall be substituted.

    Amendment of section 2.4. In section 2 of the principal Act,—

    • after clause (b), the following clauses shall be inserted, namely:—
      • “conceptus” means any product of conception at any stage of development from fertilisation until birth including extra embryonic membranes as well as the embryo or foetus;
      • “embryo” means a developing human organism after fertilisation till the end of eight weeks (fifty-six days);
      • “foetus” means a human organism during the period of its development beginning on the fifty-seventh day following fertilisation or creation (excluding any time in which its development has been suspended) and ending at the birth;’;
    • in clause (d), the following Explanation shall be added, namely:-‘Explanation– For the purpose of this clause, “Genetic Clinic” includes a vehicle, where ultrasound machine or imaging machine or scanner or other equipment capable of determining sex of the foetus or a portable equipment which has the potential for detection of sex during pregnancy or selection of sex before conception, is used;’;
    • in clause (e), the following Explanation shall be added, namely:—‘Explanation—For the purposes of this clause “Genetic Laboratory” includes a place where ultrasound machine or imaging machine or scanner or other equipment capable of determining sex of the foetus or a portable equipment which has the potential for detection of sex during pregnancy or selection of sex before conception, is used;’;
    • for clause (g), the following clause shall be substituted, namely:-

      ‘(g) “medical geneticist” includes a person who possesses a degree or diploma in genetic science in the fields of sex selection and pre-natal diagnostic techniques or has experience of not less than two years in any of these fields after obtaining–

      • any one of the medical qualifications recognised under the Indian Medical Council Act, 1956; or
      • a post-graduate degree in biological sciences;’;
    • for clause (i), the following clause shall be substituted, namely:—‘(i) “pre-natal diagnostic procedures” means all gynaecological or obstetrical or medical procedures such as ultrasonography, foetoscopy, taking or removing samples of amniotic fluid, chorionic villi, embryo, blood or any other tissue or fluid of a man, or of 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;’;
    • for clause (k), the following clause shall be substituted, namely:—‘(k) “pre-natal diagnostic test” means ultrasonography or any test or analysis of amniotic fluid, chorionic villi, blood or any tissue or fluid of a pregnant woman or conceptus conducted to detect genetic or metabolic disorders or chromosomal abnormalities or congenital anomalies or haemoglobinopathies or sex-linked diseases;’;
    • after clause (n), the following clauses shall be inserted, namely:—‘(o) “sex selection” includes any procedure, technique, test or administration or prescription or provision of anything for the purpose of ensuring or increasing the probability that an embryo will be of a particular sex;

      • “sonologist or imaging specialist” means a person who possesses any one of the medical qualifications recognised under the Indian Medical Council Act, 1956 or who possesses a post-graduate qualification in ultrasonography or imaging techniques or radiology;
      • “State Board” means a State Supervisory Board or a Union territory Supervisory Board constituted under section 16 A;
      • “State Government” in relation to Union territory with Legislature means the Administrator of that Union territory appointed by the President under article 239 of the Constitution.’ 102 of 1956.
    • In section 3 of the principal Act, for clause (2), the following clause shall be substituted, namely:—‘(2) no Genetic Counselling Centre or Genetic Laboratory or Genetic Clinic shall employ or cause to be employed or take services of any person, whether on honorary basis or on payment who does not possess the qualifications as may be prescribed.’.

    Amendment of section 3. 6. After section 3 of the principal Act, the following sections shall be inserted, namely:—

    ‘3A. No person, including a specialist or a team of specialists in the field of infertility, shall conduct or cause to be conducted or aid in conducting by himself or by any other person, sex selection on a woman or a man or on both or on any tissue, embryo, conceptus, fluid or gametes derived from either or both of them.

    3B. No person shall sell any ultrasound machine or imaging machine or scanner or any other equipment capable of detecting the sex of the foetus to any Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic or any other person not registered under the Act.’. Insertion of new sections 3A and 3B. Prohibition of sex-selection. Prohibition on sale of ultrasound machine etc. to persons, laboratories, clinics etc. not registered under the Act.

    • In section 4 of the principal Act, for clauses (3) and (4), the following clauses shall be substituted, namely:—

      • no pre-natal diagnostic techniques shall be used or conducted unless the person qualified to do so is satisfied for reasons to be recorded in writing that any of the following conditions are fulfilled namely:—

        • age of the pregnant woman is above thirty-five years,
        • the pregnant woman has undergone two or more spontaneous abortions or foetal loss;
        • the pregnant woman had been exposed to potentially teratogenic agents such as, drugs, radiation, infection or chemicals;
        • the pregnant woman or her spouse has a family history of mental retardation or physical deformities such as, spasticity or any other genetic disease;
        • any other condition as may be specified by the Board: Provided that the person conducting ultrasonography on a pregnant woman shall keep complete record thereof in the clinic in such manner, as may be prescribed, and any deficiency or inaccuracy found therein shall amount to contravention of the provisions of section 5 or section 6 unless contrary is proved by the person conducting such ultrasonography;
      • no person including a relative or husband of the pregnant woman shall seek or encourage the conduct of any pre-natal diagnostic techniques on her except for the purposes specified in clause (2);

      • no person including a relative or husband of a woman shall seek or encourage the conduct of any sex-selection technique on her or him or both.’

    Amendment of section 4.

    Amendment of section 5.8. In section 5 of the principal Act, for subsection (2), the following sub-section shall be substituted, namely:—

    • No person including the person conducting pre-natal diagnostic procedures shall communicate to the pregnant woman concerned or her relatives or any other person the sex of the foetus by words, signs, or in any other manner.’

    Amendment of section 6.

    9. In section 6 of the principal Act, after clause (b), the following clause shall be inserted, namely:—

    • no person shall, by whatever means, cause or allow to be caused selection of sex before or after conception.’

    Amendment of Section 7.

    10. In section 7 of the principal Act,- (i) in sub-section (2), for clause (c), the following clause shall be substituted, namely:—

    • three members to be appointed by the Central Government to represent the Ministries of Central Government in charge of Women and Child Development, Department of Legal Affairs or Legislative Department in the Ministry of Law, Justice, and Indian System of Medicine and Homeopathy, ex-officio;’;

      • in clause (e), for sub-clause (ii), the following sub-clause shall be substituted, namely:—
      • eminent gynaecologist and obstetrician or expert of stri-roga or prasuti-tantra.’.

    Amendment of section 14.11.

    In section 14 of the principal Act, for clause (f), the following clause shall be substituted, namely:—

    • has, in the opinion of the Central Government, been associated with the use or promotion of pre-natal diagnostic technique for determination of sex or with any sex selection technique.’.

    Amendment of section 15.12. In section 15 of the principal Act, the following proviso shall be inserted, namely:—

    ‘Provided that no member other than an ex-officio member shall be appointed for more than two consecutive terms.’.

    Substitution of new section for section 16.

    Functions of the Board. 13. For section 16 of the principal Act, the following section shall be substituted, namely:—‘16. The Board shall have the following functions, namely:—

    • to advise the Central Government on policy matters relating to use of pre-natal diagnostic techniques, sex selection techniques and against their misuse;
    • to review and monitor implementation of the Act and rules made thereunder and recommend to the Central Government changes in the said Act and rules.
    • to create public awareness against the practice of pre-conception sex selection and pre-natal determination of sex of foetus leading to female foeticide;
    • to lay down a code of conduct to be observed by persons working at Genetic Counselling Centres, Genetic Laboratories and Genetic Clinics;
    • to oversee the performance of various bodies constituted under the Act and take appropriate steps to ensure its proper and effective implementation;
    • any other functions as may be prescribed under the Act.’.

    14. After section 16 of the principal Act, the following section shall be inserted, namely:—

    ‘16A(1) Each State and Union territory having Legislature shall constitute a Board to be known as the State Supervisory Board or the Union territory Supervisory Board, as the case may be, which shall have the following functions:—

    • to create public awareness against the practice of pre-conception sex selection and pre-natal determination of sex of foetus leading to female foeticide in the State;
    • to review the activities of the Appropriate Authorities functioning in the State and recommend appropriate action against them;
    • to monitor the implementation of provisions of the Act and the rules and make suitable recommendations relating thereto, to the Board;
    • to send such consolidated reports as may be prescribed in respect of the various activities undertaken in the State under the Act to the Board and the Central Government; and (v) any other functions as may be prescribed under the Act.
    • The State Board shall consist of:—
      • the Minister in-charge of Health and Family Welfare in the State, who shall be the Chairperson, ex officio;
      • Secretary in-charge of the Department of Health and Family Welfare who shall be the Vice-Chairperson, ex officio;
      • Secretaries or Commissioners in charge of Departments of Women and Child Development, Social Welfare, Law and Indian System of Medicines and Homeopathy, ex-officio, or their representatives;
      • Director of Health and Family Welfare or Indian System of Medicines and Homeopathy of the State Government, ex-officio;
      • three women members of Legislative Assembly or Legislative Council;
      • ten members to be appointed by the State Government out of which two each shall be from the following categories:—
        • eminent social scientists and legal experts;
        • eminent women activists from non-governmental organisations or otherwise;
        • eminent gynaecologists and obstetricians or experts of stri-roga or prasuti-tantra;
        • eminent pediatricians or medical geneticists;
        • eminent radiologists or sonologists;
      • an officer not below the rank of Joint Director in-charge of Family Welfare, who shall be the Member Secretary, ex-officio
    • The State Board shall meet at least once in four months.
    • The term of office of a member, other than an ex-officio member, shall be three years.
    • If a vacancy occurs in the office of any member other than an ex-officio member, it shall be filled by making fresh appointment.
    • If a member of the Legislative Assembly or member of the Legislative Council who is a member of the State Board, becomes Minister or Speaker or Deputy Speaker of the Legislative Assembly or Chairperson or Deputy Chairperson of the Legislative Council, she shall cease to be a member of the State Board.
    • One-third of the total number of members of the State Board shall constitute the quorum.
    • The State Board may co-opt a member as and when required, provided that the number of co-opted members does not exceed one-third of the total strength of the State Board.
    • The co-opted members shall have the same powers and functions as other members, except the right to vote and shall abide by the rules and regulations.
    • In respect of matters not specified in this section, the State Board shall follow procedures and conditions as are applicable to the Board.’. Insertion of new section 16A. Constitution of State Supervisory Board and Union territory Supervisory Board.

    Amendment of section 17.15. In section 17 of the principal Act:—

    • in sub-section (3), for clause (a), the following clause shall be substituted, namely:—‘(a) when appointed for the whole of the State or the Union territory, consisting of the following three members-
      • an officer of or above the rank of the Joint Director of Health and Family Welfare–Chairperson;
      • an eminent woman representing a women's organisation; and
      • an officer of Law Department of the State or the Union territory concerned: Provided that it shall be the duty of the State or the Union territory concerned to constitute multi-member State or Union territory level Appropriate Authority within three months of the coming into force of the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Amendment Act, 2002: Provided further that any vacancy occurring therein shall be filled within three months of the occurrence.’;
    • in sub-section (4), after clause (d), the following clauses shall be inserted, namely:—
      • to take appropriate legal action against the use of any sex selection technique by any person at any place, suo-moto or brought to its notice and also to initiate independent investigations in such matter;
      • to create public awareness against the practice of sex selection or pre-natal determination of sex;
      • to supervise the implementation of the provisions of the Act and rules;
      • to recommend to the Board and State Boards modifications required in the rules in accordance with changes in technology or social conditions;
        • to take action on the recommendations of the Advisory Committee made after investigation of complaint for suspension or cancellation of registration.’;
    • for sub-section (7), the following sub-section shall be substituted, namely:—‘(7) No person who has been associated with the use or promotion of pre-natal diagnostic techniques for determination of sex or sex selection shall be appointed as a member of the Advisory Committee.’.
    • After section 17 of the principal Act, the following section shall be inserted, namely:—
    • The Appropriate Authority shall have the powers in respect of the following matters, namely:—
      • summoning of any person who is in possession of any information relating to violation of the provisions of this Act or the rules made thereunder;
      • production of any document or material object relating to clause (a);
      • issuing search warrant for any place suspected to be indulging in sex selection techniques or pre-natal sex determination; and
      • any other matter which may be prescribed.’. Insertion of new section 17A.

        Powers of Appropriate Authorities

    • In section 18 of the principal Act, for sub-section (1), the following sub-section shall be substituted, namely:—
      • No person shall open any Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic, including clinic, laboratory or centre having ultrasound or imaging machine or scanner or any other technology capable of undertaking determination of sex of foetus and sex selection, or render services to any of them, after the commencement of the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Amendment Act, 2002 unless such centre, laboratory or clinic is duly registered under the Act.’.

    Amendment of section 18. 18. For section 22 of the principal Act, the following section shall be substituted, namely:—

    • No person, organisation, Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic, including clinic, laboratory or centre having ultrasound machine or imaging machine or scanner or any other technology capable of undertaking determination of sex of the foetus or sex selection shall issue, publish, distribute, communicate or cause to be issued, published, distributed or communicated any advertisement, in any form, including internet, regarding facilities of pre-natal determination of sex or sex selection before conception available at such centre, laboratory, clinic or at any other place.
    • No person or organisation including Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic shall issue, publish, distribute, communicate or cause to be issued, published, distributed or communicated any advertisement in any manner regarding pre-natal determination or pre-conception selection of sex by any means whatsoever, scientific or otherwise.
    • Any person who contravenes the provisions of sub-section (1) or sub-section (2) shall be punishable with imprisonment for a term which may extend to three years and with a fine which may extend to ten thousand rupees.

    Explanation:—For the purposes of this section, “advertisement” includes any notice, circular, label, wrapper or any other document including advertisement through internet or any other media in electronic or print form and also includes any visible representation made by means of any hoarding, wall-painting, signal, light, sound, smoke or gas.’. Substitution of new section for section 22.

    Prohibition of advertisement relating to pre-conception and pre-natal determination of sex and punishment for contravention. Amendment of section 23.19. In section 23 of the principal Act, for sub-sections (2) and (3), the following sub-sections shall be substituted, namely:—

    • The name of the registered medical practitioner shall be reported by the Appropriate Authority to the State Medical Council concerned for taking necessary action including suspension of the registration if the charges are framed by the court and till the case is disposed of and on conviction for removal of his name from the register of the Council for a period of five years for the first offence and permanently for the subsequent offence.
    • Any person who seeks the aid of any Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic or ultrasound clinic or imaging clinic or of a medical geneticist, gynaecologist, sonologist or imaging specialist or registered medical practitioner or any other person for sex selection or for conducting pre-natal diagnostic techniques on any pregnant women for the purposes other than those specified in sub-section (2) of section 4, he shall, be punishable with imprisonment for a term which may extend to three years and with fine which may extend to fifty thousand rupees for the first offence and for any subsequent offence with imprisonment which may extend to five years and with fine which may extend to one lakh rupees.
    • For the removal of doubts, it is hereby provided, that the provisions of sub-section (3) shall not apply to the woman who was compelled to undergo such diagnostic techniques or such selection.’.

    Presumption in the case of conduct of pre-natal diagnostic techniques. 20. For section 24 of the principal Act, the following section shall be substituted, namely:—

    ‘24 Notwithstanding anything contained in the Indian Evidence Act, 1872, the court shall presume unless the contrary is proved that the pregnant woman was compelled by her husband or any other relative, as the case may be, to undergo pre-natal diagnostic technique for the purposes other than those specified in sub-section (2) of section 4 and such person shall be liable for abetment of offence under sub-section (3) of section 23 and shall be punishable for the offence specified under that section.’.

    Substitution of new section for section 24. 21. In section 28 of the principal Act, in sub-section (1), in clause (b), for the words ‘thirty days’, the words ‘fifteen days’ shall be substituted. Amendment of section 28.

    22. In section 30 of the principal Act, for sub-section (1), the following sub-section shall be substituted, namely:—

    • If the Appropriate Authority has reason to believe that an offence under this Act has been or is being committed at any Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic or any other place, such Authority or any officer authorised in this behalf may, subject to such rules as may be prescribed, enter and search at all reasonable times with such assistance, if any, as such Authority or officer considers necessary, such Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic or any other place and examine any record, register, document, book, pamphlet, dvertisement or any other material object found therein and seize and seal the same if such Authority or officer has reason to believe that it may furnish evidence of the commission of an offence punishable under this Act.’. Amendment of section 30.

    23. After section 31 of the principal Act, the following section shall be inserted, namely:—

    • If any difficulty arises in giving effect to the provisions of the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Amendment Act, 2002, the Central Government may, by order published in the Official Gazette, make such provisions not inconsistent with the provisions of the said Act as appear to it to be necessary or expedient for removing the difficulty: Provided that no order shall be made under this section after the expiry of a period of three years from the date of commencement of the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Amendment Act, 2002.
    • Every order made under this section shall be laid, as soon as may be after it is made, before each House of Parliament.’. Insertion of new section 31 A.

    Removal of difficulties. 24. In section 32, in sub-section (2)-(i) for clause (i), the following clauses shall be substituted, namely:—

    • the minimum qualifications for persons employed at a registered Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic under clause (2) of section 3; (ia) the manner in which the person conducting ultrasonography on a pregnant woman shall keep record thereof in the Clinic under the proviso to sub-section (3) of section 4;’
    • after clause (iv), the following clauses shall be inserted, namely:—
      • code of conduct to be observed by persons working at Genetic Counselling Centres, Genetic Laboratories and Genetic Clinics to be laid down by the Central Supervisory Board under clause (iv) of section 16;
      • the manner in which reports shall be furnished by the State and Union territory Supervisory Boards to the Board and the Central Government in respect of various activities undertaken in the State under the Act under clause (iv) of sub-section (1) of section 16A;
      • empowering the Appropriate Authority in any other matter under clause (d) of section 17A;’. Amendment of section 32.
    K.N.Chaturvedi
    Additional Secretary to the Government of India

    Appendix 4: PNDT (Regulation and Prevention of Misuse) Amendment Rules 2003

    PNDT Amendment Rules, 2003 Regd. No. D.L.-33004/99

    The Gazette of India

    Extraordinary

    PART II-Section 3-Sub-section(i)

    Published by Authority

    No. 74 New Delhi, Friday, 14 February 2003/Magha 25, 1924

    Ministry of Health and Family Welfare

    (Department of Family Welfare)

    Notification

    New Delhi, the 14th February, 2003

    The Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Amendment Rules, 2003. known as PCPNDT Rules, 2003

    G.S.R.109(E).—In exercise of the powers conferred by section 32 of the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994 (57 of 1994), the Central Government hereby makes the following amendments to the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Rules, 1996.

      • These may be called the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Amendment Rules, 2003.
      • They shall come into force on the date of their publication in the official gazette.
    • In the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Rules, 1996 (hereinafter referred to as the said rules) in rule 1, for sub-rule (1) the following sub-rule shall be substituted, namely:—
      • These Rules may be called the Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Rules, 1996.’
    • In the said rules, in rule 2, clause (d) shall be omitted.
    • In the said rules, for rule 3 the following rule shall be substituted, namely:—

      ‘3. The qualifications of the employees, the requirement of equipment etc. for a Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic, Ultrasound Clinic and Imaging Centre shall be as under:

      • Any person being or employing
        • a gynaecologist or a paediatrician having six months experience or four weeks training in genetic counseling or
        • a medical geneticist, having adequate space and educational charts/models/equipments for carrying out genetic counselling may set up a genetic counselling centre and get it registered as a genetic counselling centre.
        • Any person having adequate space and being or employing
          • a Medical Geneticist and
          • a laboratory technician, having a B.Sc. degree in Biological Sciences or a degree or diploma in medical laboratory course with at least one year experience in conducting appropriate prenatal diagnostic techniques, tests or procedures may set up a genetic laboratory.
        • Such laboratory should have or acquire such of the following equipments as may be necessary for carrying out chromosomal studies, bio-chemical studies and molecular studies:—
          • Chromosomal studies:
            • Laminar flow hood with ultraviolet and fluorescent light or other suitable culture hood.
            • Photo-microscope with fluorescent source of light.
            • Inverted microscope.
            • Incubator and oven.
            • Carbon dioxide incubator or closed system with 5% CO2 atmosphere.
            • Autoclave.
            • Refrigerator.
            • Water bath.
            • Centrifuge.
            • Vortex mixer.
            • Magnetic stirrer.
            • pH Meter.
            • A sensitive balance (preferably electronic) with sensitivity of 0.1 milligram.
            • Double distillation apparatus (glass).
            • Such other equipments as may be necessary.
          • Biochemical studies: (requirements according to tests to be carried out)
            • Laminar flow hood with ultraviolet and fluorescent light or other suitable culture hood.
            • Inverted microscope.
            • Incubator and oven.
            • Carbon dioxide incubator or closed system with 5% CO2 atmosphere.
            • Autoclave.
            • Refrigerator.
            • Water bath.
            • Centrifuge.
            • Electrophoresis apparatus and power supply.
            • Chromatography chamber.
            • Spectro-photometer and Elisa reader or Radio-immunoassay system (with gamma beta-counter) or fluorometer for various bio-chemical tests.
            • Vortex mixer.
            • Magnetic stirrer.
            • pH meter.
            • A sensitive balance (preferably electronic) with sensitivity of 0.1 milligram.
            • Double distillation apparatus (glass).
            • Liquid nitrogen tank.
            • Such other equipments as may be necessary.
          • Molecular studies:
            • Inverted microscope.
            • Incubator.
            • Oven.
            • Autoclave.
            • Refrigerators (4 degree and minus 20 degree Centigrade).
            • Water bath.
            • Microcentrifuge.
            • Electrophoresis apparatus and power supply.
            • Vertex mixer.
            • Magnetic stirrer.
            • pH meter.
            • A sensitive balance (preferably electronic) with sensitivity of 0.1 milligram.
            • Double distillation apparatus (glass).
            • P.C.R. machine.
            • Refrigerated centrifuge.
            • U.V. Illuminator with photographic attachment or other documentation system.
            • Precision micropipettes.
            • Such other equipments as may be necessary.
      • Any person having adequate space and being or employing
        • Gynaecologist having experience of performing at least 20 procedures in chorionic villi aspirations per vagina or per abdomen, chorionic villi biopsy, amniocentesis, cordocentesis foetoscopy, foetal skin or organ biopsy or foetal blood sampling etc. under supervision of an experienced gynaecologist in these fields, or
        • a 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, or.
        • A medical geneticist may set up a genetic clinic/ultrasound clinic/imaging centre.
      • The Genetic Clinic/ultrasound clinic/imaging centre should have or acquire such of the following equipments, as may be necessary for carrying out the tests or procedures-
        • Equipment and accessories necessary for carrying out clinical examination by an obstetrician or gynaecologist.
        • An ultra-sonography machine including mobile ultrasound machine, imaging machine or any other equipment capable of conducting foetal ultrasonography.
        • Appropriate catheters and equipment for carrying out chorionic villi aspirations per vagina or per abdomen.
        • Appropriate sterile needles for amniocentesis or cordocentesis.
        • A suitable foetoscope with appropriate accessories for foetoscopy, foetal skin or organ biopsy or foetal blood sampling shall be optional.
        • Equipment for dry and wet sterilization.
        • Equipment for carrying out emergency procedures such as evacuation of uterus or resuscitation in case of need.
        • Genetic Works Station.’.
    • In the said rules, after rule 3 a new rule 3A shall be inserted as follows, namely:—
      • Sale of ultrasound machines/imaging machines:
        • No organisation including a commercial organization or a person, including manufacturer, importer, dealer or supplier of ultrasound machines/imaging machines or any other equipment, capable of detecting sex of foetus, shall sell distribute, supply, rent, allow or authorize the use of any such machine or equipment in any manner, whether on payment or otherwise, to any Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic, Ultrasound Clinic, Imaging Centre or any other body or person unless such Centre, Laboratory, Clinic, body or person is registered under the Act.
        • The provider of such machine/equipment to any person/body registered under the Act shall send to the concerned State/UT Appropriate Authority and to the Central Government, once in three months a list of those to whom the machine/equipment has been provided.
        • Any organization or person, including manufacturer, importer, dealer or supplier of ultrasound machines/imaging machines or any other equipment capable of detecting sex of foetus selling, distributing, supplying or authorizing, in any manner, the use of any such machine or equipment to any Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic, Ultrasound Clinic, Imaging Centre or any other body or person registered under the Act shall take an affidavit from the Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic, Ultrasound Clinic, Imaging Centre or any other body or person purchasing or getting authorization for using such machine/equipment that the machine/equipment shall not be used for detection of sex of foetus or selection of sex before or after conception.’.
    • In the said rules, in rule 4 for sub-rule (1) the following sub-rule shall be substituted, namely:—
      • An application for registration shall be made to the Appropriate Authority, in duplicate, in Form A, duly accompanied by an Affidavit containing–
        • an undertaking to the effect that the Genetic Centre/Laboratory/Clinic/Ultrasound Clinic/Imaging Centre/Combination thereof, as the case may be, shall not conduct any test or procedure, by whatever name called, for selection of sex before or after conception or for detection of sex of foetus except for diseases specified in Section 4(2) nor shall the sex of foetus be disclosed to any body; and
        • an undertaking to the effect that the Genetic Centre/Laboratory/Clinic/Combination thereof, as the case may be, shall display prominently a notice that they do not conduct any technique, test or procedure etc. by whatever name called, for detection of sex of foetus or for selection of sex before or after conception.’.
    • In the said rules, for rule 5, the following rule shall be substituted, namely:—
      • Application Fee– (1) Every application for registration under Rule 4 shall be accompanied by an application fee of:—
        • Rs 3000 for Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic, Ultrasound Clinic or Imaging Centre.
        • Rs 4000 for an institute, hospital, nursing home, or any place providing jointly the service of a Genetic Counselling Centre, Genetic Laboratory and Genetic Clinic, Ultrasound Clinic or Imaging Centre or any combination thereof.

      Provided that if an application for registration of any Genetic Clinic/Laboratory/Centre etc. has been rejected by the Appropriate Authority, no fee shall be required to be paid on re-submission of the application by the applicant for the same body within 90 days of rejection. Provided further that any subsequent application shall be accompanied with the prescribed fee. Application fee once paid will not be refunded.

      • The application fee shall be paid by a demand draft drawn in favour of the Appropriate Authority, on any scheduled bank payable at the headquarters of the Appropriate Authority concerned. The fees collected by the Appropriate Authorities for registration of Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic, Ultrasound Clinic and Imaging Centre or any other body or person under sub-rule (1), shall be deposited by the Appropriate Authority concerned in a bank account opened in the name of the official designation of the Appropriate Authority concerned and shall be utilized by the Appropriate Authority in connection with the activities connected with implementation of the provisions of the Act and these rules.’.
    • In the said rules, in rule 9,—
      • for sub-rule (1), the following sub-rule shall be substituted, namely:—
        • Every Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic, Ultrasound Clinic and Imaging Centres shall maintain a register showing, in serial order, the names and addresses of the men or women given genetic counselling, subjected to pre-natal diagnostic procedures or pre-natal diagnostic tests, the names of their spouse or father and the date on which they first reported for such counselling, procedure or test.’;
      • for sub-rule (3), the following sub-rule shall be substituted, namely:—
        • The record to be maintained by every Genetic Laboratory, in respect of each man or woman subjected to any pre-natal diagnostic procedure/technique/test, shall be as specified in Form E.’;
      • for sub-rule (4), the following sub-rule shall be substituted, namely:—
        • The record to be maintained by every Genetic Clinic, in respect of each man or woman subjected to any pre-natal diagnostic procedure/technique/test, shall be as specified in Form F.’;
      • after sub-rule (7), the following sub-rule shall be inserted, namely:—
        • Every Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic, Ultrasound Clinic and Imaging Centres shall send a complete report in respect of all pre-conception or pregnancy related procedures/techniques/tests conducted by them in respect of each month by 5th day of the following month to the concerned Appropriate Authority.’.
    • In the said rules, in rule 10,—
      • for sub-rule (1), the following sub-rule shall be substituted, namely:—
        • Before conducting preimplantation genetic diagnosis, or any pre-natal diagnostic technique/test/procedure such as amniocentesis, chorionic villi biopsy, foetoscopy, foetal skin or organ biopsy or cordocentesis, a written consent, as specified in Form G, in a language the person undergoing such procedure understands, shall be obtained from her/him.’;
      • after sub-rule (1), the following new sub-rule (1A) shall be inserted, namely:—
        • Any person conducting ultrasonography/image scanning on a pregnant woman shall give a declaration on each report on ultrasonography/image scanning that he/she has neither detected nor disclosed the sex of foetus of the pregnant woman to any body. The pregnant woman shall before undergoing ultrasonography/image scanning declare that she does not want to know the sex of her foetus.’.
    • In the said rules, for rule 11, the following rule shall be substituted, namely:—‘11. Facilities for inspection.—
      • Every Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic, Ultrasound Clinic, Imaging Centre, nursing home, hospital, institute or any other place where any of the machines or equipments capable of performing any procedure, technique or test capable of pre-natal determination of sex or selection of sex before or after conception is used, shall afford all reasonable facilities for inspection of the place, equipment and records to the Appropriate Authority or to any other person authorised by the Appropriate Authority in this behalf for registration of such institutions, by whatever name called, under the Act, or for detection of misuse of such facilities or advertisement therefore or for selection of sex before or after conception or for detection/disclosure of sex of foetus or for detection of cases of violation of the provisions of the Act in any other manner.
      • The Appropriate Authority or the officer authorized by it may seal and seize any ultrasound machine, scanner or any other equipment, capable of detecting sex of foetus, used by any organisation if the organisation has not got itself registered under the Act. These machines of the organisations may be released if such organisation pays penalty equal to five times of the registration fee to the Appropriate Authority concerned and gives an undertaking that it shall not undertake detection of sex of foetus or selection of sex before or after conception.’.
    • In the said rules, in rule 12 for sub-rule (1), the following sub-rule shall be substituted, namely:—
      • Procedure for search and seizure.—(1) The Appropriate Authority or any officer authorised in this behalf may enter and search at all reasonable times any Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic, Imaging Centre or Ultrasound Clinic in the presence of two or more independent witnesses for the purposes of search and examination of any record, register, document, book, pamphlet, advertisement, or any other material object found therein and seal and seize the same if there is reason to believe that it may furnish evidence of commission of an offence punishable under the Act. Explanation:—In these Rules–
      • “Genetic Laboratory/Genetic Clinic/Genetic Counselling Centre” would include an ultrasound centre/imaging centre/nursing home/hospital/institute or any other place, by whatever name called, where any of the machines or equipments capable of selection of sex before or after conception or performing any procedure, technique or test for pre-natal detection of sex of foetus, is used;
      • “material object” would include records, machines and equipments; and
      • “seize” and “seizure” would include “seal” and “sealing” respectively.’.
    • In the said rules, after rule 17, the following rules shall be inserted, namely:—
      • Code of Conduct to be observed by persons working at Genetic Counselling Centres, Genetic Laboratories, Genetic Clinics, Ultrasound Clinics. Imaging Centres etc.

        All persons including the owner, employee or any other persons associated with Genetic Counselling Centres, Genetic Laboratories, Genetic Clinics, Ultrasound Clinics, Imaging Centres registered under the Act/these Rules shall–

        • not conduct or associate with, or help in carrying out detection or disclosure of sex of foetus in any manner;
        • not employ or cause to be employed any person not possessing qualifications necessary for carrying out pre-natal diagnostic techniques/procedures, techniques and tests including ultrasonography;
        • not conduct or cause to be conducted or aid in conducting by himself or through any other person any techniques or procedure for selection of sex before or after conception or for detection of sex of foetus except for the purposes specified in sub-section (2) of section 4 of the Act;
        • not conduct or cause to be conducted or aid in conducting by himself or through any other person any techniques or test or procedure under the Act at a place other than a place registered under the Act/these Rules;
        • ensure that no provision of the Act and these Rules are violated in any manner;
        • ensure that the person, conducting any techniques, test or procedure leading to detection of sex of foetus for purposes not covered under section 4 (2) of the Act or selection of sex before or after conception, is informed that such procedures lead to violation of the Act and these Rules which are punishable offences;
        • help the law-enforcing agencies in bring to book the violators of the provisions of the Act and these Rules;
        • display his/her name and designation prominently on the dress worn by him/her;
        • write his/her name and designation in full under his/her signature;
        • on no account conduct or allow/cause to be conducted female foeticide;
        • not commit any other act of professional misconduct.
      • Appeals.–
        • Anybody aggrieved by the decision of the Appropriate Authority at sub-district level may appeal to the Appropriate Authority at district level within 30 days of the order of the sub-district level Appropriate Authority.
        • Anybody aggrieved by the decision of the Appropriate Authority at district level may appeal to the Appropriate Authority at State/UT level within 30 days of the order of the District level Appropriate Authority.
        • Each appeal shall be disposed of by the District Appropriate Authority or by the State/Union Territory Appropriate Authority, as the case may be, within 60 days of its receipt.
        • If an appeal is not made within the time as prescribed under sub-rule (1), (2) or (3), the Appropriate Authority under that sub-rule may condone the delay in case he/she is satisfied that appellant was prevented for sufficient cause from making such appeal.’.
    • In the said rules, Schedule I, Schedule II and Schedule III shall be omitted.
    • In the said rules, for the words ‘Genetic Counselling Centre, Genetic Laboratory and Genetic Clinic’, the words ‘Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic, Ultrasound Clinic and Imaging Centres’ shall be substituted wherever they occur.
    • In the said rules, for Form A, Form B, Form C, Form D, Form E, Form F, Form G, and Form H, the following forms shall be substituted respectively, namely:—

    ‘Form A

    [See rules 4(1) and 8(1)]

    (To be submitted in Duplicate with supporting documents as enclosures)

    Form of Application for Registration or Renewal of Registration of A Genetic Counselling Centre/Genetic Laboratory/Genetic Clinic/Ultrasound Clinc/Imaging Centre

    • Name of the applicant (Indicate name of the organisation sought to be registered)
    • Address of the applicant
    • Type of facility to be registered (Please specify whether the application is for registration of a Genetic Counselling Centre/Genetic Laboratory/Genetic Clinic/Ultrasound Clinic/Imaging Centre or any combination of these)
    • Full name and address/addresses of Genetic Counselling Centre/Genetic Laboratory/Genetic Clinic/Ultrasound Clinic/Imaging Centre with Telephone/Fax number(s)/Telegraphic/Telex/E-mail address (s).
    • Type of ownership of Organisation (individual ownership/partnership/company/co-operative/any other to be specified). In case type of organization is other than individual ownership, furnish copy of articles of association and names and addresses of other persons responsible for management, as enclosure.
    • Type of Institution (Govt. Hospital/Municipal Hospital/Public Hospital/Private Hospital/Private Nursing Home/Private Clinic/Private Laboratory/any other to be stated.)
    • Specific pre-natal diagnostic procedures/tests for which approval is sought
      • Invasive (i) amniocentesis/chorionic villi aspiration/chromosomal/biochemical/molecular studies
      • Non-Invasive Ultrasonography Leave blank if registration is sought for Genetic Counselling Centre only.
    • Equipment available with the make and model of each equipment (List to be attached on a separate sheet).
    • (a) Facilities available in the Counselling Centre. (b) Whether facilities are or would be available in the Laboratory/Clinic for the following tests:
      • Ultrasound
      • Amniocentesis
      • Chorionic villi aspiration
      • Foetoscopy
      • Foetal biopsy
      • Cordocentesis

      Whether facilities are available in the Laboratory/Clinic for the following:

      • Chromosomal studies
      • Biochemical studies
      • Molecular studies
      • Preimplantation genetic diagnosis
    • Names, qualifications, experience and registration number of employees (may be furnished as an enclosure).
    • State whether the Genetic Counselling Centre/Genetic Laboratory/Genetic Clinic/Ultrasound clinic/Imaging centre [1] qualifies for registration in terms of requirements laid down in Rule 3]
    • For renewal applications only:
      • Registration No.
      • Date of issue and date of expiry of existing certificate of registration.
    • List of Enclosures: (Please attach a list of enclosures/supporting documents attached to this application.)

    Date:

    (…………………)

    Place:

    Name, designation and signature of the person authorized to sign on behalf of the organisation to be registered.

    Declaration

    I, Sh./Smt./Kum./Dr……………………… son/daughter/wife of …………………… aged ……… years resident of …………………………… working as (indicate designation) …………… in (indicate name of the organisation to be registered) …………………………… hereby declare that I have read and understood the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994 (57 of 1994) and the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Rules, 1996, I also undertake to explain the said Act and Rules to all employees of the Genetic Counselling Centre/Genetic Laboratory/Genetic Clinic/ultrasound clinic/imaging centre in respect of which registration is sought and to ensure that Act and Rules are fully complied with.

    Date:

    (…………………)

    Place:

    Name, designation and signature of the person authorized to sign on behalf of the organisation to be registered [Seal of The Organisation Sought to be Registered]

    Acknowledgement

    [See Rules 4(2) and 8(1)]

    The application in Form A in duplicate for grant*/renewal* of registration of Genetic Counselling Centre*/Genetic Laboratory*/Genetic Clinic*/Ultrasound Clinic*/Imaging Centre* by ……………………… (Name and address of applicant) has been received by the Appropriate Authority ………………… On (date). *The list of enclosures attached to the application in Form A has been verified with the enclosures submitted and found to be correct. OR

    *On verification it is found that the following documents mentioned in the list of enclosures are not actually enclosed. This acknowledgement does not confer any rights on the applicant for grant or renewal of registration.

    (…………………)

    Signature and Designation of Appropriate Authority, or authorized person in the Office of the Appropriate Authority.

    Date:

    Place:

    Seal

    Original/Duplicate for Display

    Form B

    [See Rules 6(2), 6(5) and 8(2)]

    Certificate of Registration (To be issued in duplicate)

    • In exercise of the powers conferred under Section 19 (1) of the Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994 (57 of 1994), the Appropriate Authority …………… hereby grants registration to the Genetic Counselling Centre*/Genetic Laboratory*/Genetic Clinic*/Ultrasound Clinic*/Imaging Centre* named below for purposes of carrying out Genetic Counselling/Pre-natal Diagnostic Procedures*/Pre-natal Diagnostic Tests/ultrasonography under the aforesaid Act for a period of five years ending on ……………
    • This registration is granted subject to the aforesaid Act and Rules thereunder and any contravention thereof shall result in suspension or cancellation of this Certificate of Registration before the expiry of the said period of five years apart from prosecution.
      • Name and address of the Genetic Counselling Centre*/Genetic Laboratory*/Genetic Clinic*/Ultrasound Clinic*/Imaging Centre*.
      • Pre-natal diagnostic procedures* approved for (Genetic Clinic). Non-Invasive
        • Ultrasound Invasive
        • Amniocentesis
        • Chorionic villi biopsy
        • Foetoscopy
        • Foetal skin or organ biopsy
        • Cordocentesis
        • Any other (specify)
      • Pre-natal diagnostic tests* approved (for Genetic Laboratory)
        • Chromosomal studies
        • Biochemical studies
        • Molecular studies
      • Any other purpose (please specify)
    • Model and make of equipments being used (any change is to be intimated to the Appropriate Authority under rule 13). Registration No. allotted
    • Period of validity of earlier Certificate of Registration.

    (For renewed Certificate of Registration only) From ……… To ……

    Signature, name and designation of The Appropriate Authority

    Date:

    Seal

    Display One Copy of This Certificate at A Conspicuous Place at The Place of Business

    Form C

    [See Rules 6(3), 6(5) and 8(3)] Form for Rejection of Application for Grant/Renewal of Registration

    In exercise of the powers conferred under Section 19(2) of the Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994, the Appropriate Authority ………………… hereby rejects the application for grant*/renewal* of registration of the undermentioned Genetic Counselling Centre*/Genetic Laboratory*/Genetic Clinic*/Ultrasound Clinic*/Imaging Centre*.

    • Name and address of the Genetic Counselling Centre*/Genetic Laboratory*/Genetic Clinic*/Ultrasound Clinic*/Imaging Centre*
    • Reasons for rejection of application for grant/renewal of registration:

    Signature, name and designation of the Appropriate Authority with SEAL of Office

    Date:

    Place:

    *Strike out whichever is not applicable or necessary.

    Form D

    [See rule 9(2)]

    Form for Maintenance of Records by The Genetic Counselling Centre

    • Name and address of Genetic Counselling centre.
    • Registration No.
    • Patient's name
    • Age
    • Husband's/Father's name
    • Full address with Tel. No., if any
    • Referred by (Full name and address of Doctor(s) with registration No.(s) (Referral note to be preserved carefully with case papers)
    • Last menstrual period/weeks of pregnancy
    • History of genetic/medical disease in the family (specify) Basis of diagnosis:
      • Clinical
      • Bio-chemical
      • Cytogenetic
      • Other (e.g. radiological, ulrasonography)
    • Indication for pre-natal diagnosis
      • Previous child/children with:
        • Chromosomal disorders
        • Metabolic disorders
        • Congenital anomaly
        • Mental retardation
        • Haemoglobinopathy
        • Sex linked disorders
        • Single gene disorder
        • Any other (specify)
      • Advanced maternal age (35 years or above)
      • Mother/father/sibling having genetic disease (specify)
      • Others (specify)
    • Procedure advised[2]
      • Ultrasound
      • Amniocentesis
      • Chorionic villi biopsy
      • Foetoscopy
      • Foetal skin or organ biopsy
      • Cordocentesis
      • Any other (specify)
    • Laboratory tests to be carried out
      • Chromosomal studies
      • Biochemical studies
      • Molecular studies
      • Pre-implantation genetic diagnosis
    • Result of diagnosis. If abnormal give details. Normal/Abnormal
    • Was MTP advised?
    • Name and address of Genetic Clinic* to which patient is referred.
    • Dates of commencement and completion of genetic counselling.

    Name, Signature and Registration No. of the Medical Geneticist/Gynaecologist/Paediatrician administering Genetic Counselling.

    Place:

    Date:

    Form E

    [See Rule 9(3)]

    Form for Maintenance of Records by Genetic Laboratory

    • Name and address of Genetic Laboratory
    • Registration No
    • Patient's name
    • Age
    • Husband's/Father's name
    • Full address with Tel. No., if any
    • Referred by/sample sent by (full name and address of Genetic Clinic) (Referral note to be preserved carefully with case papers)
    • Type of sample: Maternal blood/Chorionic villus sample/amniotic fluid/Foetal blood or other foetal tissue (specify)
    • Specify indication for pre-natal diagnosis
      • Previous child/children with
        • Chromosomal disorders
        • Metabolic disorders
        • Malformation(s)
        • Mental retardation
        • Hereditary haemolytic anaemia
        • Sex linked disorder
        • Single gene disorder
        • Any other (specify)
      • Advanced maternal age (35 years or above)
      • Mother/father/sibling having genetic disease (specify)
      • Other (specify)
    • Laboratory tests carried out (give details)
      • Chromosomal studies
      • Biochemical studies
      • Molecular studies
      • Preimplantation gentic diagnosis
    • Result of diagnosis if abnormal give details. Normal/Abnormal
    • Date(s) on which tests carried out.

    The results of the Pre-natal diagnostic tests were conveyed to ………………… on …………………… Name, Signature and Registration No. of the Medical Geneticist/Director of the Institute.

    Place:

    Date:

    Form F

    [See Proviso to Section 4(3), Rule 9(4) and Rule 10(1A)]

    Form for Maintenance of Record in Respect of Pregnant Woman by Genetic Clinic/Ultrasound Clinic/Imaging Centre

    • Name and address of the Genetic Clinic/Ultrasound Clinic/Imaging Centre.
    • Registration No.
    • Patient's name and her age
    • Number of children with sex of each child
    • Husband's/Father's name
    • Full address with Tel. No., if any
    • Referred by (full name and address of Doctor(s)/Genetic Counselling Centre (Referral note to be preserved carefully with case papers)/self referral
    • Last menstrual period/weeks of pregnancy
    • History of genetic/medical disease in the family (specify) Basis of diagnosis:
      • Clinical
      • Bio-chemical
      • Cytogenetic
      • Other (e.g. radiological, ultrasonography etc. specify)
    • Indication for pre-natal diagnosis
      • Previous child/children with:
        • Chromosomal disorders
        • Metabolic disorders
        • Congenital anomaly
        • Mental retardation
        • Haemoglobinopathy
        • Sex linked disorders
        • Single gene disorder
        • Any other (specify)
      • Advanced maternal age (35 years)
      • Mother/father/sibling has genetic disease (specify)
      • Other (specify)
    • Procedures carried out (with name and registration No. of Gynaecologist/Radiologist/Registered Medical Practitioner) who performed it. Non-Invasive
      • Ultrasound (specify purpose for which ultrasound is to done during pregnancy) [List of indications for ultrasonography of pregnant women are given in the note below] Invasive (ii) Amniocentesis
      • Chorionic Villi aspiration
      • Foetal biopsy
      • Cordocentesis
      • Any other (specify)
    • Any complication of procedure–please specify
    • Laboratory tests recommended[3]
      • Chromosomal studies
      • Biochemical studies
      • Molecular studies
      • Preimplantation genetic diagnosis
    • Result of
      • pre-natal diagnostic procedure (give details)
      • Ultrasonography Normal/Abnormal (specify abnormality detected, if any).
    • Date(s) on which procedures carried out.
    • Date on which consent obtained. (In case of invasive)
    • The result of pre-natal diagnostic procedure were conveyed to ……… on ……………
    • Was MTP advised/conducted?
    • Date on which MTP carried out.

    Date:

    Name, Signature and Registration number of the Place Gynaecologist/Radiologist/Director of the Clinic

    Declaration of Pregnant Woman

    I, Ms. ……………… (name of the pregnant woman) declare that by undergoing ultrasonography/image scanning etc. I do not want to know the sex of my foetus.

    Signature/Thumb impression of pregnant woman …………… 3 Strike out whichever is not applicable or not necessary Declaraton of Doctor/Person Conducting Ultrasonography/Image Scanning

    I, …………………… (name of the person conducting ultrasonography/image scanning) declare that while conducting ultrasonography/image scanning on Ms. ………………… (name of the pregnant woman), I have neither detected nor disclosed the sex of her foetus to any body in any manner.

    Name and signature of the person conducting ultrasonography/image scanning/Director or owner of genetic clinic/ultrasound clinic/imaging centre.

    Important Note:

    • Ultrasound is not indicated/advised/performed to determine the sex of foetus except for diagnosis of sex-linked diseases such as Duchenne Muscular Dystrophy, Haemophilia A & B etc.
    • During pregnancy Ultrasonography should only be performed when indicated. The following is the representative list of indications for ultrasound during pregnancy.
      • To diagnose intra-uterine and/or ectopic pregnancy and confirm viability.
      • Estimation of gestational age (dating).
      • Detection of number of foetuses and their chorionicity.
      • Suspected pregnancy with IUCD in-situ or suspected pregnancy following contraceptive failure/MTP failure.
      • Vaginal bleeding/leaking.
      • Follow-up of cases of abortion.
      • Assessment of cervical canal and diameter of internal os.
      • Discrepancy between uterine size and period of amenorrhoea.
      • Any suspected adenexal or uterine pathology/abnormality.
      • Detection of chromosomal abnormalities, foetal structural defects and other abnormalities and their follow-up.
      • To evaluate foetal presentation and position.
      • Assessment of liquor amnii.
      • Preterm labour/preterm premature rupture of membranes.
      • Evaluation of placental position, thickness, grading and abnormalities (placenta praevia, retroplacental haemorrhage, abnormal adherence etc.).
      • Evaluation of umbilical cord–presentation, insertion, nuchal encirclement, number of vessels and presence of true knot.
      • Evaluation of previous Caesarean Section scars.
      • Evaluation of foetal growth parameters, foetal weight and foetal well being.
      • Colour flow mapping and duplex Doppler studies.
      • Ultrasound guided procedures such as medical termination of pregnancy, external cephalic version etc. and their follow-up.
      • Adjunct to diagnostic and therapeutic invasive interventions such as chorionic villus sampling (CVS), amniocenteses, foetal blood sampling, foetal skin biopsy, amnio-infusion, intrauterine infusion, placement of shunts etc.
      • Observation of intra-partum events.
      • Medical/surgical conditions complicating pregnancy.
      • Research/scientific studies in recognised institutions. Person conducting ultrasonography on a pregnant women shall keep complete record thereof in the clinic/centre in Form–F and any deficiency or inaccuracy found therein shall amount to contravention of provisions of section 5 or section 6 of the Act, unless contrary is proved by the person conducting such ultrasonography.

    Form G

    [See Rule 10]

    Form of Consent

    (For invasive techniques)

    I, ………………………………… wife/daughter of ………………… Age ……… years residing at ……………………………… hereby state that I have been explained fully the probable side-effects and after effects of the pre-natal diagnostic procedures.

    I wish to undergo the pre-implantation/pre-natal diagnostic technique/test/procedures in my own interest to find out the possibility of any abnormality (i.e. disease/deformity/disorder) in the child I am carrying.

    I undertake not to terminate the pregnancy if the pre-natal procedure/technique/test conducted show the absence of disease/deformity/disorder. I understand that the sex of the foetus will not be disclosed to me. I understand that breach of this undertaking will make me liable to penalty as prescribed in the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994 (57 of 1994) and rules framed thereunder.

    Date:

    Signature of the pregnant woman.

    Place:

    I have explained the contents of the above to the patient and her companion (Name ……………………… ……… Address …………… Relationship ………………………………) in a language she/they understand.

    Name, Signature and/Registration number of Gynaecologist/Medical Geneticist/Radiologist/Paediatrician/Director of the Clinic/Centre/Laboratory

    Date:

    Name, Address and Registration number of Genetic Clinic/Institute

    Seal

    Form H

    [See Rule 9(5)]

    Form for Maintenance of Permanent Record of Applications for Grant/Rejection of Registration Under The Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994.

    • Sl. No.
    • File number of Appropriate Authority.
    • Date of receipt of application for grant of registration.
    • Name, Address, Phone/Fax etc. of Applicant:
    • Name and address(es) of Genetic Counselling Centre*/Genetic Laboratory*/Genetic Clinic*/Ultrasound Clinic*/Imaging Centre*.
    • Date of consideration by Advisory Committee and recommendation of Advisory Committee, in summary.
    • Outcome of application (state granted/rejected and date of issue of orders-record date of issue of order in Form B or Form C).
    • Registration number allotted and date of expiry of registration.
    • Renewals (date of renewal and renewed upto).
    • File number in which renewals dealt.
    • Additional information, if any.

    Name, Designation and Signature of Appropriate Authority Guidance for Appropriate Authority

    • Form H is a permanent record to be maintained as a register, in the custody of the Appropriate Authority.
    • * Means strike out whichever is not applicable.
    • On renewal, the Registration Number of the Genetic Counselling Centre/Genetic Laboratory/Genetic Clinic/Ultrasound Clinic/Imaging Centre will not change. A fresh registration Number will be allotted in the event of change of ownership or management.
    • Registration number shall not be allotted twice.
    • Each Genetic Counselling Centre/Genetic Laboratory/Genetic Clinic/Ultrasound Clinic/Imaging Centre may be allotted a folio consisting of two pages of the Register for recording Form H.
    • The space provided for “additional information” may be used for recording suspension, cancellations, rejection of application for renewal, change of ownership/management, outcome of any legal proceedings, etc.
    • Every folio (i.e. 2 pages) of the Register shall be authenticated by signature of the Appropriate Authority with date, and every subsequent entry shall also be similarly authenticated.’.

    (Ms. K. Sujatha Rao)

    Joint Secretary to the Government of India.

    [No.N.24026/14/2002-PNDT Cell]

    Footnote:—The Principal Notification was published in the Gazette of India vide No.G.S.R. 1(E) dated 1st January, 1996. This is the first amendments to the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Rules, 1996.

    • Strike out whichever is not applicable or not necessary. All enclosures are to be authenticated by signature of the applicant.
    • Strike out whichever is not applicable or necessary.

    Glossary

    Afsossympathy, expressed upon birth of a girl, especially if she is not the first child
    Amritdhariblessed Sikh, one who has taken a religious vow
    Apadtimes of distress
    Baragamtwelve Lewa Patidar villages
    Baratithe party of people accompanying the groom for wedding
    Bhagfate/destiny/share
    Booraa sect of the sun god in Orissa
    Dailocal birth attendant, traditionally the occupation of a low caste woman
    Datta homaoblations of clarified butter to fire
    Dattakaadopted son
    Derahermitage/ashram, sacred place (not fully a temple) where a mystic/saint devoted to religion/sect resides and is visited by devotees/followers
    Dhabaskiosks or small sheds working as make-do restaurants
    Diwalifestival of lights, fireworks and worship of Laksmi, the goddess of wealth; it is celebrated in October-November
    Dudhapiticustomary practice of female infanticide by putting opium on the mother's nipple and feeding the baby, suffocating her in a rug, or placing the afterbirth over the infant's face
    Ekadas/golsendogamous circles
    Gotraan exogenous patrilineal clan whose members claim descent from a single mythological sage, the family name
    GurudwaraSikh temple
    Holifestival of colours and fire worship that falls in February
    Huani/huasnigeneric term in Rajasthan for a daughter of the household/family
    Janchliterally, test; used for ultrasound test to determine the sex of a foetus
    Jethutidaughter of the husband's elder brother
    Kabaridealer in waste or recyclable goods, also known as kabriwallah
    kanya bhroonfemale foetus, sanskritised term used in formal contexts
    kanya bhroon hatyakilling of female foetus, sanskritised term used in formal contexts
    Kapadaliterally, clothes; but when used in a context it means menstrual period (or clothes?)
    kanyadangift of a virgin, i.e. giving away a daughter in marriage
    Karmaaccount based on the accumulation of good and bad deeds in past life
    Karwa Chautha day of fasting by a wife for her husband's long life and welfare; it falls a few days before Diwali
    khadi sareecoarse cotton sari, implying austere and simple wedding
    kothibungalow
    Kuri mar Lifafagirl-killer, implies infanticide and now foeticide too literally, envelope; money given to the groom and his relatives in envelopes
    Lohriritual of fire worship in mid-January on the eve of the winter solstice
    Mehndiliterally, henna; the ritual of applying henna is getting increasingly elaborate
    Nas bandiliterally, to tie the tube/cord; refers to sterilisation, i.e., to prevent conception
    Niyogathe practice of appointing a widow to a male relative with a view to beget a son for the deceased
    Panchali systempolyandry, a woman married to five men
    Pandits Paraya dhanliterally, scholars, priests, refers also to Brahmins literally, others wealth; expression used for a girl implying she belongs to others, not to her parents
    Parchungroceries
    Pheriwallasthose selling wares on push-carts
    Pindascakes of boiled rice offered to deceased ancestors in sraddhas
    Pira priest/mystic at a shrine/tomb belonging to the Sufi order
    Punyareligious merit
    Rajto rule, refers to the government and/or the state
    Rakhiannual ritual when a thread is tied to a boy by his sister, symbolic of his protection pledged for the sister
    Sastrasthe codes of sacred and social duties
    Satiliterally, the truthful; the Hindu practice of a widow immolating herself on her husband's funeral pyre
    Savitripious female protagonist of an Upanishad tale; her piety saved her husband from death by arguing with Yamraj (the harbinger of death in Hinduism)
    Shaktienergy and power
    Sitathe ideal wife in the epic Ramayana
    Smritisthe law codes
    Sraddhasa ritual in propitiation of the deceased ancestors
    Thakabooking the prospective groom or bride for marriage, a ritual prior to betrothal
    Uperasongeneric term for surgery, it is used commonly for sterilisation unless otherwise specified

    About the Editor and Contributors

    Editor

    Tulsi Patel is Professor of Sociology at the Delhi School of Economics, University of Delhi, Delhi.

    She has recently been Rotating Chair, India Studies at Heidelberg University, Germany for a full semester (2005–06). An Honorary Research Associate at the Department of Sociology, University of Manchester (2001–04), she has also undertaken teaching assignments at the London School of Economics and the Royal Holloway College of the University of London (1996–97). Professor Patel has previously taught at Jamia Millia Islamia, New Delhi and Miranda House (University of Delhi).

    Her areas of interest include gender, anthropology of fertility and reproduction, medical sociology, sociology of the family, and old age. She has authored Fertility Behaviour: Population and Society in a Rajasthan Village (1994, 2nd edn 2006) and edited The Family in India: Structure and Practice (2005). In addition, she has published several articles in national and international journals.

    Contributors

    Reema Bhatia is a Reader in the Department of Sociology, Miranda House, University of Delhi. Her area of specialisation is in the field of Sociology of Medicine. For over ten years she has been researching on health related issues and the practice of female foeticide. The section included in this book is a part of her larger research.

    Ashish Bose is Honorary Professor, Institute of Economic Growth, Delhi and Distinguished Professor at the Institute of Integrated Learning in Management (IILM), New Delhi. Associated with the Voluntary Health Association of India (VHAI), he is also Chairman, Society for Applied Research in Humanities. He was formerly President of the Indian Association for the Study of Population (IASP), Chairman of the Expert Committee on ‘Analysis of Religion Data in Census’, and is a member of the National Commission on Population headed by the Prime Minister.

    He has written extensively on population and development. His latest book is Beyond Demography: Dialogue with People.

    Rainuka Dagar is Regional Representative of the Altus Global Alliance in the Institute for Development and Communication (IDC), Chandigarh (India). She specialises in the area of gender justice and identity politics. She has undertaken research on forms of gender violence, construction of masculinities, gender in conflict and post-conflict contexts and the interface of gender with criminal justice system. She has edited a manual on Women's Development and Gender Justice (1996) Ministry of Human Resource Development, Government of India, co-authored Victims of Militancy (1998) UNICEF, besides authoring other articles and reports.

    Rashmi Kapoor teaches at the Department of African Studies, University of Delhi. She obtained her M.A. and M. Phil. in Sociology from the Department of Sociology, Delhi School of Economics, and Ph.D. from the Department of African Studies, University of Delhi. She recently did fieldwork on social mobility in Mauritius where she has also studied child adoption. She has written extensively and published articles on the Indian diaspora in Africa (in Swahili language), child abuse and child adoption in India. She is a member of the Sudan Study Unit in the Department of African Studies, University of Delhi.

    Bijayalaxmi Nanda teaches Political Science at Miranda House, University of Delhi. Her areas of interest are political theory and gender. She also coordinates a campaign against female foeticide for the Centre for Women's Development Studies (CWDS), New Delhi. She has written extensively on the issue of female foeticide for various journals and policy documents. Her recent publications include a book on Human Rights, Gender and Environment.

    Vibhuti Patel is Director, Department of Post Graduate Studies and Research, and professor and head of the Department of Economics, SNDT Women's University, Mumbai. She is a trustee of Anusandhan Trust and its institution, Centre for Enquiry into Health and Allied Themes (CEHAT) that filed a petition in the Supreme Court of India for effective implementation of the PNDT Act, 1994 and was responsible for PCPNDT Act, 2002. She is a trustee of VACHA, Women's Research and Action Group (WRAG) and Satya Vijay Seva Samaj in Mumbai. She is the Governing Board member of Vikas Adhyayan Kendra, Mumbai, Women Power Connect, Delhi and Institute for Community Organisation and Research, Mumbai. She has co-authored Indian Women—Change and Challenge and Reaching for Half the Sky and has written the book Women's Challenges of the New Millennium (2002).

    Alpana D. Sagar, a medical doctor with training in public health, is on the faculty of the Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi. She worked in the villages of Ramgarh Block, Nainital district, Kumaon, and in the Gautam Nagar slum of Delhi before moving into academics. Her research work has involved understanding the gaps between the felt needs of poor people, especially women, and the medical services provided by the Government. She is currently working on examining the organisation of public health services in India and the challenge of improving health service planning and delivery, especially for the poor. Her work has an emphasis on gender issues.

    Leela Visaria is Professor and Director, Gujarat Institute of Development Research, Ahmedabad, India. Her research interests include historical demography, health, education and demographic transition. She has been published in reputed journals. She is the coauthor of Contraceptive Use and Fertility in India: A Case Study of Gujarat (1995) and co-editor of a volume Maternal Education and Child Survival: Pathways and Evidence (1997). She has also co-authored a book India in the 21st Century (2004). Since 1996 she is the coordinator of HealthWatch, a network of non-governmental organisations (NGOs), researchers and women activists.

    L. S. Vishwanath is an M.A. in History from St. Stephen's College, Delhi and Ph.D in Sociology from the Department of Sociology, Delhi University. Till his retirement in August 2005, he was the Professor and Head of the Department of History, Pondicherry University. He was also the Director of the Centre for Canadian Studies in the same University. His publications include the book Female Infanticide and Social Structure and articles in reputed journals.


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