The Supreme Court on Thursday stressed the need for strict enforcement of the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 (PCPNDT Act), while dismissing a doctor's plea challenging criminal proceedings initiated against him for alleged violations of the law.

A Bench of Justices Sanjay Karol and Prashant Kumar Mishra observed that deep-rooted patriarchal preferences for male children and the continued prevalence of sex-selection practices make rigorous implementation of the PCPNDT Act imperative in the fight against female foeticide.

The Court said welfare legislation such as the PCPNDT Act would remain necessary until there is a fundamental shift in societal attitudes towards women and girls.

In a judgment authored by Justice Sanjay Karol, the Court began by quoting verses from poet Subhadra Kumari Chauhan’s poem Balika Ka Parichay, which celebrates the birth of a daughter. Referring to the poem, the Bench remarked that the objective of the PCPNDT Act is to ensure that every woman can experience the joy associated with the birth of a girl child.

The Court examined government data and welfare measures aimed at improving the status of girls, noting that although India has witnessed significant progress since the mid-1990s, the gains remain uneven.

“The progress made is incomplete and uneven. Consequently, the integrity and strict enforcement of welfare-oriented legislation such as the PCPNDT Act remain essential ... till the time there is a widespread change in mentality,” the Court observed, adding that a stage must be reached where there is no question of whether a girl child deserves to be born.

Referring to data from the National Family Health Survey (NFHS), the Bench noted that India’s overall sex ratio improved from 991 females per 1,000 males in NFHS-4 (2015-16) to 1,020 females per 1,000 males in NFHS-5 (2019-21). However, it pointed out that the sex ratio at birth remains considerably lower at 929 girls per 1,000 boys.

The Court also highlighted concerns at the global level, noting that India’s ranking in the World Economic Forum’s Global Gender Gap Report 2025 had slipped to 131 out of 148 countries from 129 the previous year.

Tracing the decline in the child sex ratio from 945 in 1991 to 919 in 2011, the Bench observed that recent improvements represent only a partial correction rather than the achievement of genuine equality.

While acknowledging that States such as Haryana and Punjab have recorded improvements following stricter enforcement measures and awareness campaigns, the Court noted that several States continue to report sex ratios at birth below the national average.

“This shows the continuing presence of deep-seated patriarchal preferences towards a male child and the ‘behind the curtains’ prevalence of sex-selection practices,” the judgment stated.

The Court further observed that initiatives such as Beti Bachao Beti Padhao and Janani Suraksha Yojana reflect ongoing efforts to eliminate systemic discrimination against girls in a patriarchal social structure.

The case arose from an inspection of Dr Ramesh’s sonography centre, during which authorities allegedly detected deficiencies in mandatory Form F records and other violations of the PCPNDT Act. Following the inspection, a Judicial Magistrate First Class took cognisance of offences under the Act. Challenges mounted by the doctor before the revisional court and the Bombay High Court were unsuccessful, leading him to approach the Supreme Court.

Before the apex court, the doctor contended that the District Civil Surgeon who initiated the proceedings was not the competent authority under the Act and argued that the deficiencies in Form F were merely technical and inadvertent errors.

Rejecting the contention, the Supreme Court reiterated the critical role of Form F records in ensuring compliance with the PCPNDT Act. Relying on its earlier decision in Federation of Obstetrics & Gynaecological Societies of India v. Union of India, the Bench observed that the importance of maintaining Form F records is no longer open to debate.

“The keeping of records is essential to the Act and its avowed purpose. It is true that in general terms, the declining sex ratio issue is better and has shown considerable improvement but, however, diluting the provisions of law, or letting infractions thereof slide cannot be countenanced,” the Court held.

Accordingly, the Court dismissed the appeal.

Advocate Rajiv Shankar Dwivedi appeared for the petitioner, while Advocate Aniruddha Pande represented the respondents.

Case Title: Dr Ramesh v. State of Maharashtra.