Concerns about privacy invasion and possible inconsistency with the current law regarding pregnancy termination have been raised by the Haryana Health Department’s recent decision requiring all pregnant women to register during the first trimester. It might also have unforeseen repercussions, such encouraging women to seek risky abortions outside of the official medical system.
The Director General Health Services (DGHS) issued an order two weeks ago with the goal of registering all pregnant women. This is a major improvement over the present 50–80% registration rates in different districts. The order mandates that ultrasound centres must register pregnant women before conducting examinations, with non-compliance resulting in a notice.
Women must enter their name, Aadhaar card number, husband’s name, residence, and caste in order to register on the Reproductive and Child Health (RCH) portal. In order to make women eligible for benefits under a variety of programs, the registration is meant to facilitate improved monitoring and reporting of RMNCH (reproductive, maternal, neonatal, and child health) programs.
A two-page letter to the DGHS stated that the order is in conflict with the current Medical Termination of Pregnancy (MTP) Act, despite the Indian Medical Association (IMA), Haryana, praising the effort to guarantee optimal antenatal services as a “great initiative” towards reducing pregnancy loss during the first 12 weeks and combating female foeticide. According to the Act, a woman’s reproductive rights are her own, as long as she is not a juvenile, and she is consequently exempt from needing consent from her husband or legal guardian in order to have an abortion.
The directive was also criticized by a number of specialists who said it was “issued in haste” and “without considering its implications and implementation.” The judgment violates the spirit of the MTP Act, which forbids revealing the names and other details of women who have had their pregnancies terminated, according to Ajay Mahajan, the former president of IMA, Haryana.
According to him, patient confidentiality may be jeopardized because local auxiliary nurse midwives (ANMs) are the only ones with the power to register expectant mothers on the RCH portal. “Letting a local ANM know about an unwanted pregnancy could lead to the identity of the woman being leaked in the neighbourhood. This might deter pregnant women who are unmarried and those seeking an abortion from getting themselves registered.”
According to Dr. Mahajan, these women may be pressured to seek dangerous and illegal abortions, which could lead them to seek advice from untrained professionals and endanger their lives. “Since the order is primarily aimed at curbing female foeticide, it could be amended to exempt pregnant women from registration for the first 14 weeks as sex determination isn’t possible during this period. The government could also allow self-registration or registration through doctors at private and government hospitals,” he said.
Similar worries were expressed by Dr. Ritu Jain, an infertility expert in Gurugram, who claimed that requiring registration would make it simple to monitor women and their maternity records across the country. “There could be a confidentiality issue for women who prefer to keep their pregnancies private. Even if the details are not shared with anyone, these women might seek care from quacks fearing their identities will be made public. We are awaiting further details on the order, but the government should consider exempting certain categories of women to address privacy concerns,” she said.
Gynecologist Jyoti Yadav promoted the MTP Act’s protection of expectant mothers’ right to privacy. She claimed that since the legislation allows for pregnancy terminations up to 20 weeks along, the government ought to exempt registration during this time.
She emphasized that in order to reduce abortions based on sex determination, the government must control the easy access of MTP kits at pharmacies. Wealthy families are prepared to travel overseas for sex determination tests, she said, and then use easily accessible medications to end pregnancies. She emphasized that in order to enhance the state’s sex ratio, this practice needs to end.
Supreme Court criminal lawyer Amit Mishra also stressed the importance of protecting the privacy of pregnant women, citing Section 5A of the MTP Act, amended in 2021. This section ensures confidentiality by prohibiting registered medical practitioners from disclosing the names and particulars of women who undergo termination of pregnancy, except to authorised persons. Mr. Mishra advocated for granting all pregnant women the right to apply for the RHC ID, which would safeguard their time and privacy.
Mr. Mishra said in Delhi, doctors can immediately conduct ultrasound scans by filling out Form F, ensuring confidentiality between government officials and prenatal diagnostic centres, with no access for third parties. He acknowledged the order’s good intentions, but expressed concerns about issues arising out of its implementation.
DGHS Manish Bansal emphasized that there is no conflict with the MTP Act and highlighted that the order’s only goal is to guarantee that all pregnant women are registered for health monitoring throughout the first trimester. “Pregnancy termination is a different matter,” he stated. Seeking the support of the medical fraternity in the implementation of the order, the official said it aims to promote the health of pregnant women and children, prevent illegal abortions by monitoring pregnancies, and address the skewed sex ratio. He dismissed concerns about invasion of privacy, terming them “unfounded”, and assured that all information would be securely stored within the government’s system.
The sex ratio at birth in Haryana has decreased, reaching its lowest level in eight years in 2024 at 910. In 2016, the State reached a major milestone when the sex ratio hit 914, surpassing the 900-mark for the first time in 20 years. Prior to the recent drop, it reached a peak of 923 in 2019.
