In October 2001, when Dr. Anil Sabhani told a pregnant patient that she had a "female fetus and it would be taken care of," he wasn't talking about prenatal nutrition or health checks. He was talking about abortion.
With his conviction on Tuesday, Dr. Sabhani now faces two years in jail in the first-ever conviction under a 12-year old Indian law that forbids doctors from revealing the gender of a fetus to its parents. The law was aimed at preventing the all-too-common and growing practice of sex-determined abortions, which have left India with far more boys than girls.
Women's rights activists welcomed the convictions, but added that it will take more than a few high- profile trials to change India's centuries-old cultural preference for boys.
"This is 5,000 years of culture we're fighting against, but in the past decade, because of this [ultrasound] technique, and these unethical practices by medical professionals, the situation for girl children has gotten much worse," says Varsha Deshpande, an attorney for the Dalit Mahila Vikas Mandal, a Maharashtra-based advocacy group for underprivileged women.
Ms. Deshpande's group has also conducted sting operations at ultrasound clinics in the prosperous farm belt of central Maharashtra, and has helped to file 16 criminal cases against doctors accused of sex-determination. "Culture is a difficult thing to change, it can take generations, but if we control this technique, these machines, then it will send a signal to these doctors that this will not be tolerated."
All told, there are dozens of cases pending in state courts around the country, but even activists agree that they are fighting an uphill battle. Economic pressures and cultural traditions encourage families to have boys, mostly to keep land and property in the family. Girls are often seen as a drain on family wealth, since the girl's family is required by centuries of tradition to provide a dowry to her husband's family when she marries.
Today, the illegal practice of sex-determination has brought girl-to-boy ratios to their lowest levels in recorded history, raising significant social problems for the future.
"If you find a government and a district medical officer and police officials who are all serious about the law, then you can make a difference," says Sabu George, a researcher for the Center for Women's Development Studies in New Delhi. "But that is very rare."
The conviction of Saghani follows a controversial study, published in early January in the British medical journal, The Lancet. The study claimed that up to 5 million girls were aborted since the practice of sex-determination was banned in 1994.
Ultrasound equipment is found in every district of the country, but in the areas where ultrasound clinics are in highest concentration, particularly wealthy farming districts in Punjab, Haryana, Gujarat, and in the capital city of New Delhi, the ratios of girls to boys are at their lowest. The ban notwithstanding, the number of girls per thousand boys aged 0 to 6 in the state of Punjab has dropped from 875 in 1991 down to 793 in 2001, according to 2001 Census figures. In Haryana, there were 879 girls for every thousand boys in 1991 and 820 in 2001.
The conviction in Haryana sprung from a frustrated doctor called Rekha Mishra, who teamed up with activists to conduct a sting operation on doctors in nearby ultrasound clinics.
Pregnant women were sent into the clinics, with audio and sometimes video equipment, to record their conversations with clinic doctors. In 12 cases, doctors, including Dr. Sabhani, offered to abort female fetuses. In Haryana, 11 of those criminal cases are still pending.
"It was very difficult to get pregnant ladies persuaded to do this, and you are not conducting a case against just one person, you are getting psychological pressure, your own family is saying, 'Nobody else is doing this. Why are you doing it?'" says Dr. Mishra, a private doctor from Faridabad, south of New Delhi. "But if I get support from the authorities, and a letter authorizing me to do this, we can do this all over the country."
"We can't eliminate this practice," she adds. "But we can at least stop it to some extent."
Activists like Deshpande and George call the practice "genocide," and India's medical community has promised to do what it can to prevent the practice. But Vinay Agarwal, president of the Indian Medical Association, says that lasting change can only come through broad-based community education.
"The medical profession is doing all it can though we have to address this as a social evil," Dr. Agarwal, president of the Indian Medical Association, told the BBC. "People should be proud to have a girl child."