Karnataka High Court Denies Interim Stay in Plea Challenging Ultrasound Attendant Ban

In a decision that underscores the delicate balance between individual reproductive rights and public health imperatives, the Karnataka High Court on January 30, 2025, refused to grant interim relief to a husband seeking permission to accompany his pregnant wife during ultrasound scans. The plea challenged a state government circular prohibiting attendants, including spouses, from entering ultrasound rooms in facilities registered under the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 (PC-PNDT Act). While accepting the petitioners' assurance that their intent was not to determine the sex of the child, Justice B.M. Shyam Prasad emphasized the need for a comprehensive hearing before making exceptions, citing potential risks of duress on expectant mothers in similar cases. The court encouraged the couple to "pursue the cause," with the matter listed for further hearing on February 24, 2025. This ruling highlights ongoing tensions in Indian jurisprudence between family privacy and efforts to curb female foeticide, raising critical questions for legal practitioners navigating constitutional challenges to administrative policies.

The case, titled X and Another v. State of Karnataka (Writ Petition No. 34203/2025), arrives at a time when reproductive rights are increasingly under scrutiny amid evolving gender justice frameworks. For legal professionals, it serves as a reminder of how seemingly routine medical access issues can intersect with fundamental rights under Articles 14 and 21 of the Constitution, potentially setting precedents for spousal involvement in healthcare decisions.

Background: The PC-PNDT Act and the Controversial Circular

The Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994, was enacted to address the alarming decline in India's child sex ratio, a direct consequence of widespread female foeticide and sex-selective abortions. The legislation prohibits the use of prenatal diagnostic techniques for sex determination, mandating strict registration of ultrasound facilities and requiring declarations—such as Form G—from pregnant women and their families affirming no interest in sex disclosure. Violations carry severe penalties, including imprisonment and fines, reflecting the Act's role as a cornerstone of gender equality initiatives.

Amendments in 2003 strengthened enforcement by expanding the ban to preconception stages and imposing accountability on medical practitioners. Despite these measures, challenges persist, with India's sex ratio at birth hovering around 929 females per 1,000 males as per recent National Family Health Survey data. In this context, the Karnataka government issued a circular on March 18, 2024, from the Department of Health and Family Welfare Services. This directive imposed a "complete restriction" on the entry of any attendants, including spouses, into ultrasound scan rooms in registered hospitals and centers. The stated objective was to prevent covert sex determination by ensuring procedures occur in privacy, free from external influence or pressure.

Critics, including the petitioners in this case, argue that such blanket prohibitions overlook the emotional and supportive role spouses play in prenatal care. Globally, practices vary: in many Western countries, birth partners are encouraged for psychological support, but in India, stringent rules stem from cultural and historical patterns of gender bias. The circular's validity is now under question, as it may exceed the PC-PNDT Act's scope, which focuses on prohibiting sex selection rather than broadly restricting family presence. Legal scholars note that while the Act allows for regulatory guidelines, administrative circulars must align with statutory intent and not impinge on constitutional protections unnecessarily.

This backdrop is crucial for understanding the petitioners' grievance. The wife, referred to as Petitioner No. 1, is in an advanced stage of pregnancy, and the couple sought not just a personal exemption but a broader declaration that the circular is ultra vires, arbitrary, and violative of equality (Article 14) and the right to life, liberty, and privacy (Article 21). The latter draws from landmark rulings like Justice K.S. Puttaswamy v. Union of India (2017), which affirmed privacy as intrinsic to dignity, particularly in intimate spheres like reproduction.

The Petition: Arguments for Spousal Accompaniment

The writ petition was filed by an anonymous couple, with the husband—an advocate and expectant father—serving as Petitioner No. 2. He argued that excluding spouses from ultrasound rooms undermines the wife's reproductive autonomy and the couple's shared right to informed decision-making. Emphasizing that neither he nor his wife intended to learn the child's sex, the husband invoked the non-mandatory nature of Form G declarations in their situation, asserting no legal barrier to his presence.

The plea contended that the circular represents an overreach by the state, lacking statutory backing under the PC-PNDT Act. It sought a stay on the circular's implementation, a declaration of its unconstitutionality, and directions permitting the husband to accompany his wife during scans, subject to "reasonable safeguards" such as affidavits or supervised entry. This framing positioned the issue not as defiance of anti-sex selection norms but as a claim to familial support amid medical vulnerability.

For legal professionals, the petition's strategy is noteworthy: it leverages the husband's professional standing to bolster credibility, while framing the challenge around positive rights (support in healthcare) rather than confrontation. This approach echoes evolving jurisprudence on reproductive rights, where courts have increasingly recognized emotional companionship as part of dignified maternity, as seen in cases involving surrogacy or assisted reproduction.

Court's Observations and Refusal of Interim Relief

Justice B.M. Shyam Prasad, hearing the matter on January 30, 2025, adopted a measured stance. The court was "persuaded to accept the statement made by the petitioners," particularly given the husband's status as a member of the bar, affirming satisfaction that the presence was not motivated by sex determination. However, it declined interim relief, stating: "The request for interim order is not admitted at this stage."

Delving deeper, the judge articulated concerns about systemic implications. In a detailed oral observation, he noted:

"...but at this stage when the State is to be heard on its jurisdiction to issue a Circular to bar presence of attendants including a spouse, this court must consider whether it would be expedient even when there is an affirmation to this court's satisfaction that presence is not to ascertain sex of the child to be born, to permit petitioner no. 2 to be present. If the present case is one, there could be other where this court will have to at an interim stage, decide on whether the mother to be would be under any duress, even inadvertently, by others because of the sex of the child to be born on the balance, this court is of the view that unless there is a comprehensive consideration, exception cannot be made."

This reasoning highlights the court's caution: while the petitioners' case appears genuine, granting relief prematurely could open floodgates to scenarios where expectant mothers face subtle coercion, perpetuating gender biases the PC-PNDT Act seeks to eradicate. The judge reserved liberty for the petitioners to "pursue the cause," signaling openness to merits-based arguments post-state response.

Legal Analysis: Constitutionality and Balancing Rights

At its core, this case pits individual autonomy against state regulatory power. Under Article 21, the right to privacy encompasses decisions in reproductive health, including who provides support during procedures. The petitioners' claim that the circular violates this by severing spousal bonds resonates with post-Puttaswamy interpretations, where privacy extends to "bodily integrity" and "informational autonomy." Denying accompaniment could be seen as an infringement on the wife's dignity, especially if it heightens isolation during potentially anxiety-inducing scans.

Article 14 adds another layer: the circular's blanket ban is arguably arbitrary, treating all attendants uniformly without differentiated safeguards (e.g., for non-sex-determination intents). Is the restriction proportionate to the goal of curbing sex selection? Legal tests from cases like Modern Dental College v. State of Madhya Pradesh (2016) require means-ends scrutiny, and a total prohibition may fail if less intrusive alternatives—like video monitoring or affidavits—exist.

On jurisdiction, the circular's ultra vires challenge questions whether the Health Department can impose such rules absent explicit PC-PNDT authorization. The Act empowers Appropriate Authorities for enforcement but defers to rules on procedures, not ancillary access. If deemed executive overreach, it could be struck down, compelling reliance on statutory mechanisms.

Yet, the court's hesitation reflects a countervailing principle: the doctrine of parens patriae, where the state protects vulnerable groups from societal harms. In a country with persistent son preference, inadvertent duress—such as familial pressure on mothers—remains a valid concern. Balancing this requires "comprehensive consideration," as the judge noted, potentially involving evidence on duress prevalence or international best practices (e.g., WHO guidelines supporting companions in maternal care).

Hypothetically, if the court later mandates exceptions, it could redefine "reasonable safeguards," influencing how PC-PNDT is implemented nationwide. Conversely, upholding the circular might reinforce strict enforcement but at the cost of alienating families, potentially deterring prenatal care uptake.

Broader Implications for Legal Practice and Policy

For litigators in constitutional and health law, this case offers strategic insights. Challenging circulars via writs under Article 226 demands robust evidence of rights infringement, as courts prioritize policy goals in public health. Family law practitioners may increasingly advise on spousal roles in medical consents, drawing parallels to labor room access debates post-COVID.

On policy, the ruling could prompt Karnataka—and other states with similar directives—to refine guidelines, incorporating opt-in mechanisms for verified non-sex intent. Nationally, it aligns with the Ministry of Health's push for PC-PNDT compliance amid Beti Bachao Beti Padhao campaigns, but underscores needs for gender-sensitive reforms that don't isolate women further.

Impacts on the justice system include heightened scrutiny of administrative actions: lawyers must now probe circulars' statutory alignment, potentially leading to a spate of challenges in high courts. For the legal community, it fosters discourse on intersectional rights—reproductive justice intertwined with gender equity—urging amicus briefs from women's rights groups in future hearings.

Ethically, it raises questions for medical professionals: how to balance empathy with compliance? Hospitals may face dilemmas enforcing bans, risking litigation if support is denied.

Looking Ahead: Next Hearing and Potential Outcomes

Listed for February 24, 2025, the case awaits the state's response on the circular's jurisdiction. A full merits hearing could declare the policy unconstitutional, mandating nuanced exceptions, or validate it with caveats. Regardless, it signals evolving jurisprudence: from rigid bans to rights-affirming frameworks.

In conclusion, this plea transcends one couple's quest, illuminating the judiciary's role in harmonizing privacy with protection. Legal professionals should monitor closely, as outcomes may reshape prenatal care norms, ensuring policies empower rather than exclude families in India's ongoing battle for gender parity.