When womb turns grave: Sex-selective abortions continue unabated in Karnataka

Falling sex ratios in several districts in Karnataka point to the grim reality that administrative mechanisms and social hierarchies have failed to keep gender-biased abortions at bay.

'Vamsha illa’ (‘no heir apparent’) is what Shruthi’s mother-in-law expressed when she saw her granddaughter for the first time. The mother-in-law had visited several temples, praying for a baby boy. When the baby came, she refused to even hold her. “She was desperate for the first child to be male,” says Shruthi, a resident of Mandya. 

This singular insistence had begun months before. Soon after a routine scan after the first trimester, Shruthi’s husband and mother-in-law began pressuring her to terminate the pregnancy. They did not provide a valid reason. “I was not aware of sex determination tests then and did not know the gender of the foetus,” she says. When Shruthi did not yield to pressure, her mother-in-law went back to visiting temples, praying for a boy.

“We were a happy family until then. I am guessing they would have known the gender of the foetus after the scanning. Otherwise, why would their attitude change all of a sudden?” Shruthi wonders. 

Soon after the delivery, Shruthi was shocked when her husband stopped taking care of her and the baby. She was forced to rely on her parents for essential needs. Eventually, she parted ways with her husband after he physically assaulted her, leading to the termination of her second pregnancy. Now, she and her eight-year-old daughter live with her parents. Her husband has since remarried, and now has a son. 

While Shruthi was able to find support with her parents, others have not been able to withstand the pressure. Shruthi’s friend, for instance, gave in to her family’s pressure and aborted her baby girl. 

Violence, social ostracisation, lack of financial support and sustained pressure — these are only some of the most common consequences women face for ‘not bearing a male heir’. Two filicide-suicide attempts this year in Bagalkot district reveal the complexity of the issue. 

In August, a 26-year-old woman jumped into a well, along with her three children — a mere 21 days after she delivered her baby, a girl. While the children, two female and one male, lost their lives, the mother was rescued.

“Though times are changing, the general norm in our village is to have two boys and one girl. My sister wanted to undergo a family planning operation after this delivery and was upset as the baby was a girl. But this is our guess and we have not spoken about it as she needs time to overcome the tragedy,” says her brother. 

The grave reality is that thousands of girls continue to be killed in the womb even today.

Recent raids in Mandya and Mysuru exposed a prenatal sex-determination and female foeticide racket operating in the dark. Over 900 illegal abortions have been reportedly conducted by them in three years.

In fact, over the decades, Mandya and Belagavi have emerged as the top destinations for sex determination and female foetus abortion. Bagalkot has become the latest addition to the two sugar districts of Karnataka.

Studies attribute the preference for sons to the accumulation of wealth and the slow decline of women’s role in agriculture in the sugarcane belts. Bagalkot and Belagavi being bordering districts has allowed the proliferation of this crime. 

Decline in sex ratio

While female foeticide is common in these districts, the social evil is not limited to these regions. According to recent government data based on the civil registration system, only seven districts in the state have a healthy sex ratio at birth. Five districts — Chikkaballapur, Mandya, Bagalkot, Kalaburagi and Bidar — are in the red zone, with a sex ratio below 900. As many as 20 districts have seen a decline in the sex ratio (the number of female births per 1,000 male births) compared to the previous year. 

Interestingly, Belagavi, which recorded a sex ratio of 892 in 2020 (according to the National Family Health Survey) has seen an improvement with 937 female births per 1,000 male births in 2022. Urban areas are slightly better performers than rural areas.  

At the national level, Karnataka is one of the nine states that have seen a significant decline in sex ratio at birth between 2016 and 2020. And it has the second lowest sex ratio in South India, after Telangana.

What makes Karnataka a poor performer? As one examines causes and consequences, a convoluted story unravels.

The brutal practice that denies a girl the right to be born is driven by many factors — patriarchy, preference for sons, concerns about dowry, low social and economic status accorded to women, the disappearance of traditional roles in agriculture and the poor implementation of law. One recent addition, parents say, is fear around women’s safety.

With better education and awareness, women are also demanding their rightful share in ancestral property, which has put patriarchal families in a tough spot, says Varsha Deshpande, an advocate and activist striving for the implementation of the Pre-Conception and Pre-Natal Diagnostic Techniques Act, 1994 (PC-PNDT Act) in the country. “This is also resulting in female foeticide in affluent families,” she says. 

Varsha, who is a member of the National Inspection and Monitoring Committee under the Act, blames the government for a failure to implement adequate measures to stop discrimination against girls even prior to their birth.

The lackadaisical attitude could also be because, “there is a lack of urgency now since most people have come to believe that the problem is solved,” says Ravinder Kaur, a professor at the Indian Institute of Technology Delhi. Kaur has been involved in extensive work on gender-biased abortions in the country. 

Over the years, this notion has gained currency at various levels. For instance, Susheela, a women’s rights activist from Belagavi, explains that civil society organisations working in this space have all but disappeared in the district. Even in other parts of the state, organisations that were actively drawing attention to the issue seem to have shifted their attention. As a result, the lukewarm response of the administration goes unnoticed.

In reality, the problem is far from over.

Septuagenarian Gangamma (name changed) from Gejjala Gere in Mandya says that the number of people opting for female foeticide has increased in her village over the years. 

Gangamma knows at least 20 women who have undergone sex-selective abortions in her village in the last 15 years. About 10-15 women had to separate from their partners after giving birth to a girl child. “Everyone knows about it, but no one speaks. This situation prevails in many villages. No one is able to stop this practice,” she says.

Girija (name changed), a fellow villager, has tried to counsel a couple of women after she got a hint of their plans. However, her words of wisdom went unheard. “We can inform the police but from where do we get the evidence? If people come to know that we tipped off the police, it becomes difficult to continue to live in the same neighbourhood,” she says.  

A major hurdle in registering and processing complaints has been finding evidence in cases of illegal abortions. The racket of sex determination and abortions usually operates in far-off villages, districts or even states as evidenced in the recent Mandya-Mysuru case.

In such scenarios, locals are not able to point out even when or where the crime was committed, says a resident of Ullenahalli. This village is located just a kilometre away from the illegal sex-determination unit that was raided recently. “We did not have a clue about what was happening,” the villager says. 

There is a suspicion in the community that some of their fellow villagers might have visited this unit. “After all, one of the accused was known for his ‘helping nature’ and he also worked as a cable TV operator. He knew every household very well,” she says. 

Well-established networks

“Karnataka has several well-established networks of doctors, quacks and agents who drive gender-biased abortions. Mandya and some border districts are the focal points,” says Dr Sanjeev Kulkarni, a gynaecologist and pioneer in the fight against sex-selective abortion in India. 

It was based on his team’s research and advocacy that the Maharashtra government passed a Bill that provided for restriction of sex determination tests in 1988, the first such Act in the country. He currently practises in Dharwad. 

“About 1% of doctors become partners-in-crime under the PC-PNDT Act because there is huge money in it,” he adds.  

These elusive, well-networked criminals have flourished, taking advantage of society’s patriarchal mindset and the administration’s indifference. That only 100 cases have been filed in the state under the PC-PNDT Act since 2002 shows the lack of strict action on part of the departments concerned. The accused have been convicted under the Act only in 15 instances.   

A doctor, who has served as the district health officer (DHO) in a border district with a skewed sex ratio, says a more accurate picture would emerge if 10 cases were filed every month. 

However, the DHO’s team could file only one case in one year. "It becomes impossible to file a case as there is immense pressure from various quarters. It would help if there is a provision for teams from other districts or the state team to take action based on the intelligence provided by the home district team,” the doctor says.

An official from the health department says that a major drawback under the PC-PNDT Act is that there is little provision for the health department and the police to collaborate. He adds that it becomes difficult to monitor North Karnataka districts because of the distance and lack of initiative from district units. 

Inordinate delay in disposing cases adds to the problem. “Four judges have changed since I filed a case in 2014. Ironically, from the police to the lawyer, they come to me seeking more details about the provisions of the Act and the case,” says Janardhan, an activist who has been fighting against sex-selective abortion in Mandya and Ramanagara districts for the last two decades.

The network that has been busted in Mandya is just a tip of the iceberg, there is a suspicion that many more that are still operating, says Janardhan. He works with Vimochana - one of the few organisations that have continued to work against sex-selective abortion in the state.

Two years ago, his team had informed the district administration and the district unit of the health and family welfare department about the concerns that sex-determination units are functioning unabatedly at multiple locations in a specific part of the district. "When we visit villages, people share the concerns, but can't point out specifically. Why did the district administration not act immediately?" he asks. 

Administrative failure

While state and district-level committees have been set up to monitor, inspect and take action, many members or former members DH spoke to point to the laxity on the  part of the administration in planning and executing mandatory activities. The low level of awareness among committee members about the provisions of the Act makes these committees ineffective. For instance, only 3% of  inspections of scanning centres were conducted by the Bagalkot District Inspection and Monitoring Committee (DIMC) last year.

Anasuya, a State Inspection and Monitoring Committee (SIMC) member, feels the committee has failed to utilise the platform for public good. "I am not actively engaged in the fight against gender-biased abortion, even though I am nominated as a SIMC member. There are no regular meetings, planning or proactive action to inspect scanning centres as per the Act and Supreme Court guidelines. I was even unable to attend the last meeting due to short notice," she says. She also points out that the funds available in the department are not being channelled for public awareness campaigns, which are crucial to fight this social evil.

People also find ways to skirt the monitoring mechanism. An Anganawadi teacher says that the delay in applying for the ‘Thayi’ card (under the comprehensive maternal healthcare scheme) is a signal that something is amiss. “Sometimes, it might be due to irregular menstruation. But it is also because they wait till the gender of the foetus is determined. Of the 10 cases I get, two are generally late registrations,” she says.

Bagalkot, a red-zone district, has seen only 76% of pregnant women registering in the first trimester this year. Kalaburagi saw only 75% pregnant women registering in the first trimester last year. 

The consequences 

The consequences of sex-selective abortions are profound. Not only are these practices in violation of basic rights of girl children, but they also change the composition of a population – the effects of which are already visible in Mandya.  

Next month, Mandya will witness the second bachelors’ padayatra (walkathon) in a year. The first one, organised in February, aimed to network men who were struggling to find  partners. The conversations during the padayatra highlighted this issue, the case of missing girl children in the villages, says K M Shiva Prasad, the convener of the event.

Take Shiva Prasad’s village for instance, there are about 35 bachelors in the age group of 30-40, while there are only two unmarried girls in the age group. “The situation is the same in every village. We realised that skewed sex ratio is the root cause for our predicament,” he says.

Today, despite policy measures such as Beti Padhao, Beti Bachao and Bhagyalakshmi, people still consider girl children as liabilities. 

It is imperative that administrative networks to prevent such crimes become proactive. Dr Kulkarni says, “It is time we take the problem seriously and launch awareness campaigns.” He stresses that educational and religious institutes, which have a huge hold over the population, take the issue up and work towards solving the problem.

What Health Department Commissioner says

"The new modus operandi of mobile mode of scanning employed by quacks is a challenge to clamp down. Most of the time, such teams operate from different places to ward off suspicion. Now our decoy operation teams are tying the loose ends and using accurate leads from informers," Randeep D, Commissioner, Department of Health and Family Welfare, said,

"For general public and medical practitioners, awareness of the law is crucial. We will reorient various stakeholders, from district units to radiologists, doctors and the general public. No effort shall be spared in taking action on units that engage in sex determination and such illegal abortion. We will work in tandem with other depts like WCD, education and the police to address this larger social issue," he added.

He further said, "based on directions of the Hon’ble Health Minister, we are also studying best practices in other states under the PC-PNDT Act and seeing if we can bring in some changes in ground level enforcement. There is no scope for dereliction of duty and officials responsible for enforcement shall be held accountable."