Sex selection practices persist behind the curtains due to preference for male child: Supreme Court

The Supreme Court of India recently underscored the critical need for strict enforcement of the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 (PCPNDT Act). This directive came while dismissing a doctor's challenge to criminal proceedings initiated against him for alleged violations of the Act in the case of *Dr Ramesh vs State of Maharashtra*. The Court highlighted the persistent societal preference for a male child, which continues to drive sex selection practices "behind the curtains," despite legislative prohibitions. The ruling reinforces the judiciary's unwavering commitment to combating gender-biased sex selection and female foeticide, emphasizing that robust implementation of the Act remains essential until a fundamental shift in societal mindset is achieved.

The Supreme Court of India, in a recent pronouncement, has reiterated the imperative for stringent enforcement of the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 (PCPNDT Act). This significant observation was made by a Bench of Justices Sanjay Karol and Prashant Kumar Mishra on June 11, 2026, while adjudicating *Dr Ramesh vs State of Maharashtra*, a case involving a doctor challenging criminal proceedings under the said Act.

The Court's ruling reflects a deep concern over the enduring patriarchal bias for a male child and the clandestine nature of sex selection practices that continue to plague Indian society. Despite legislative efforts and awareness campaigns, the judiciary acknowledges that the goal of eradicating gender-biased sex selection remains elusive. This article delves into the Supreme Court's latest directive, examining its implications for legal practitioners and the ongoing fight against female foeticide, arguing that the judgment reinforces the judiciary's resolve to ensure the Act serves its intended purpose.

The Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994, was enacted by the Parliament of India with the primary objective of preventing the misuse of prenatal diagnostic techniques for sex determination, thereby curbing female foeticide and addressing the alarming decline in the child sex ratio. The Act was a response to the widespread use of ultrasound technology in the early 1990s, which facilitated sex-selective abortions and contributed to a skewed sex ratio. Census data revealed a concerning trend, with the national child sex ratio declining from 945 in 1991 to 927 in 2001, and further to 919 in 2011, underscoring the severity of the imbalance.

In 2003, the original Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act was amended and renamed the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994, to strengthen its provisions and encompass pre-conception sex selection techniques. Key features of the Act include the outright prohibition of sex determination before or after conception, strict regulation of genetic counselling centres, laboratories, and clinics, mandatory registration of all such facilities, and a ban on advertising services for sex determination. Furthermore, the Act mandates meticulous record-keeping, particularly the filling of Form F, detailing patient information and medical history, with any deficiency or inaccuracy amounting to a contravention of the provisions. Violations of the Act carry significant penalties, including imprisonment and fines, reflecting the legislature's intent to deter such practices.

The Supreme Court's recent observations in *Dr Ramesh vs State of Maharashtra*, 2026 INSC 635, arose from a doctor's appeal challenging criminal proceedings initiated under Section 23 of the PCPNDT Act for violations of Sections 4(3), 5, 6, and 29 of the Act and Rules 9, 8(5), and 18(9). The appellant had contested the authority of the Civil Surgeon to initiate proceedings and argued that errors or blanks in Form F were merely technical and inadvertent. However, the Court firmly rejected these contentions, emphasizing that deficient or inaccurate record-keeping, particularly in Form F, constitutes a substantive violation of the Act, not a mere technicality.

The Bench, comprising Justices Sanjay Karol and Prashant Kumar Mishra, observed that despite the existence of the PCPNDT Act and various government initiatives like "Beti Bachao, Beti Padhao," the preference for a male child continues to be a deep-seated issue, leading to persistent sex selection practices through unregistered machines and clandestine clinics. The Court underscored that while legislation alone cannot fundamentally alter societal mindsets, the PCPNDT Act remains a crucial instrument in combating sex-selective practices. This aligns with previous judicial pronouncements, such as *Centre for Enquiry into Health & Allied Themes (CEHAT) v. Union of India*, (2003) 8 SCC 398, and *Voluntary Health Association of Punjab v. Union of India*, (2015) 11 SCC 545, where the Supreme Court had previously highlighted the non-implementation of the Act and the manifold social problems stemming from female foeticide.

The Court's directive for strict enforcement signifies a judicial recognition of the ongoing challenges in achieving gender parity and the need for continuous vigilance. It reiterated that the integrity and strict enforcement of welfare-oriented legislation like the PCPNDT Act are essential until a widespread change in mentality occurs, replacing the perception of a woman's "inherent weakness" with true equality. The judgment serves as a strong reminder to medical professionals and diagnostic centres of their statutory obligations and the severe consequences of non-compliance, reinforcing that the law's goal is prevention, not merely punishment.

The Supreme Court's recent emphasis on the strict enforcement of the PCPNDT Act in *Dr Ramesh vs State of Maharashtra* sends a clear message to all stakeholders in the healthcare sector. For practising attorneys, this judgment underscores the heightened scrutiny that medical professionals and diagnostic centres will face regarding compliance with the Act's provisions, particularly concerning mandatory record-keeping and the prohibition of sex determination. Legal counsel advising healthcare providers must ensure their clients are meticulously adhering to all statutory requirements, as even perceived 'technical' errors in documentation can lead to substantive criminal proceedings.

This ruling signals a continued judicial resolve to combat the deeply entrenched societal bias against the girl child. Practitioners should anticipate increased vigilance from regulatory authorities, more frequent inspections, and stringent actions against offenders. It is crucial for legal professionals to not only guide their clients on legal compliance but also to advocate for broader awareness campaigns and ethical practices within the medical community. The ongoing efforts by both central and state governments, coupled with judicial pronouncements, will be critical in fostering a societal change where the birth of a girl child is celebrated without reservation, ultimately rendering the need for such protective legislation obsolete.