Introduction:
In X and Another v. State of Karnataka (WP 34203/2025), the Karnataka High Court examined the legality and constitutional validity of a State Government circular dated March 18, 2024 issued by the Department of Health and Family Welfare Services which imposed a complete prohibition on entry of attendants, including spouses, inside ultrasound scan rooms in medical establishments registered under the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act. The petition was filed by a married couple, with petitioner No. 1 being a pregnant woman and petitioner No. 2 being her husband, who is an advocate and an expecting father. The petitioners approached the High Court challenging the circular as unconstitutional, arbitrary, and violative of Articles 14 and 21 of the Constitution of India. They sought permission for the husband to accompany his wife during ultrasound procedures and prayed for interim relief by way of a stay on the circular. The case brought to the forefront competing constitutional concerns between the individual reproductive autonomy and emotional support rights of pregnant women on one hand and the State’s regulatory responsibility to prevent misuse of prenatal diagnostic techniques for sex determination and female foeticide on the other. The matter was heard by Justice B.M. Shyam Prasad, who while acknowledging the concerns raised by the petitioners, declined to grant interim relief at the present stage and directed the petitioners to continue pursuing the cause through detailed adjudication. The decision highlights the delicate balance courts must maintain between protecting individual rights and addressing systemic social evils that have historically affected gender equality in India.
Arguments Of The Petitioners:
The petitioners argued that the impugned circular imposed an absolute and blanket restriction on entry of attendants including the spouse into ultrasound scan rooms which is arbitrary, unreasonable, and disproportionate. They contended that the circular violates the fundamental rights guaranteed under Articles 14 and 21 of the Constitution of India. The petitioners submitted that Article 21 guarantees not only the right to life but also encompasses the right to dignity, privacy, bodily autonomy, and reproductive choice. According to them, pregnancy is an intimate and emotionally significant phase in a woman’s life and denying her the presence of her spouse during critical medical procedures undermines her emotional well-being and psychological comfort. The petitioners emphasised that companionship during pregnancy is an essential aspect of reproductive autonomy and maternal health. They argued that the impugned circular disregards the emotional and psychological support that a husband may provide to his pregnant spouse during medical examinations and thereby interferes with the couple’s reproductive rights and personal liberty.
The husband who is petitioner No. 2 specifically submitted that his presence during ultrasound procedures is intended only to provide emotional and moral support to his wife and not for any illegal or unethical purpose. He assured the court that neither he nor his wife intended to ascertain the sex of the unborn child. The petitioners further highlighted that under the Pre-Conception and Pre-Natal Diagnostic Techniques Rules, individuals are required to submit declarations under Form G affirming that they do not intend to determine the sex of the foetus. The husband argued that he and his wife were not required to submit such a declaration and reiterated their bona fide intention to comply with all legal requirements.
The petitioners also challenged the jurisdiction of the State Government to issue such a circular imposing an absolute prohibition on attendants. They contended that the Pre-Conception and Pre-Natal Diagnostic Techniques Act does not expressly mandate exclusion of spouses or attendants during ultrasound procedures and therefore the State Government exceeded its statutory authority by issuing the circular. They argued that any regulatory measure must be proportionate and should not unnecessarily infringe upon fundamental rights. According to them, instead of imposing a complete ban, the State could have implemented reasonable safeguards such as obtaining written undertakings, installing surveillance mechanisms, or enforcing stricter monitoring procedures to prevent illegal sex determination practices.
The petitioners also relied upon evolving jurisprudence on reproductive rights and bodily autonomy recognised by constitutional courts. They argued that reproductive rights include the right of a woman to make decisions regarding her pregnancy in consultation with her spouse and healthcare providers. They emphasised that the presence of a spouse during ultrasound procedures is increasingly recognised as part of patient-centred healthcare and maternal support systems. The petitioners asserted that denying such presence without adequate justification amounts to an excessive and disproportionate restriction on personal liberty.
The petitioners therefore sought interim relief in the form of a stay on the operation of the circular and requested the court to permit the husband to accompany his wife during ultrasound examinations subject to reasonable safeguards and compliance with applicable laws.
Arguments Of The State:
The State Government defended the circular by emphasising its obligation to strictly implement the provisions of the Pre-Conception and Pre-Natal Diagnostic Techniques Act which was enacted to prevent sex selection and female foeticide. The State submitted that illegal sex determination continues to remain a serious social menace in India and strict regulatory measures are necessary to prevent misuse of prenatal diagnostic technologies. It argued that the circular was issued as a preventive measure to eliminate any possibility of pressure being exerted on pregnant women or medical practitioners for disclosure of the sex of the foetus.
The State contended that allowing attendants including spouses inside ultrasound scan rooms creates a potential risk of coercion or undue influence being exerted on the pregnant woman or the medical professional. It argued that in many instances societal and familial pressure contributes to illegal sex determination and female foeticide and therefore regulatory restrictions are necessary to safeguard pregnant women from such pressures. The State further submitted that the circular was issued in public interest to ensure strict compliance with the objectives of the Pre-Conception and Pre-Natal Diagnostic Techniques Act.
The State also argued that the circular falls within its administrative and regulatory powers under public health legislation and that it has the authority to issue guidelines to ensure effective enforcement of statutory provisions. It contended that the restriction imposed by the circular is reasonable and proportionate considering the magnitude of the social problem that the legislation seeks to address. The State emphasised that the circular does not interfere with medical treatment or access to healthcare but merely regulates the presence of attendants during ultrasound procedures.
The State further submitted that any relaxation of the restriction may lead to practical difficulties in monitoring compliance and may create loopholes that could be exploited for illegal sex determination. It argued that allowing exceptions at an interim stage without comprehensive examination may undermine the enforcement framework and defeat the purpose of the legislation. The State therefore urged the court to reject the request for interim relief and allow the matter to be decided after detailed hearing and examination of all relevant legal and policy considerations.
Court’s Judgment:
Justice B.M. Shyam Prasad while hearing the matter acknowledged the assurances given by the petitioners and recorded that the court was persuaded to accept their statement that the husband’s presence was not intended to ascertain the sex of the unborn child. The court also noted that petitioner No. 2 is a member of the legal profession and had made a clear affirmation regarding his intentions. However, the court emphasised that the issue raised in the petition has broader implications extending beyond the individual case of the petitioners and involves examination of public interest considerations.
The court observed that the challenge raised against the circular involves important questions regarding the State Government’s jurisdiction to issue regulatory directions and the balance between individual rights and public welfare objectives. The court held that at the interim stage it would not be appropriate to carve out exceptions solely based on individual assurances without undertaking a comprehensive examination of the legal and policy framework governing the issue.
The court expressed concern that allowing the husband to be present during ultrasound procedures at an interim stage may create precedents requiring the court to evaluate similar requests in other cases. The court observed that in certain circumstances pregnant women may be subjected to direct or indirect pressure by family members or attendants regarding the sex of the unborn child. The court emphasised that such pressure may sometimes operate subtly or inadvertently and may not always be visible to regulatory authorities or medical practitioners.
The court further observed that the objective of the Pre-Conception and Pre-Natal Diagnostic Techniques Act is to eliminate sex selection and protect the dignity and autonomy of women. The court recognised that regulatory measures aimed at achieving this objective must be examined from a broader societal perspective rather than through isolated individual circumstances. The court held that it must carefully evaluate whether permitting exceptions to the circular would undermine the effectiveness of the regulatory framework.
The court concluded that a comprehensive adjudication involving detailed examination of statutory provisions, administrative authority, constitutional rights, and public interest considerations is necessary before granting any relief. The court therefore declined to grant interim relief or stay the operation of the circular at this stage. However, the court granted liberty to the petitioners to continue pursuing their challenge against the circular through full hearing and adjudication.
The court orally observed that while it has taken a prima facie view regarding the interim relief, the petitioners are free to present detailed arguments challenging the validity of the circular. The court’s decision reflects judicial restraint and highlights the importance of balancing individual rights with regulatory objectives aimed at addressing systemic social issues. The matter has been listed for further hearing on February 24, where the court is expected to undertake a detailed examination of the constitutional and statutory questions raised by the petitioners.