Awareness of Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act and Gender preference among antenatal women attending a tertiary care hospital: A Cross- sectional Study

Abstract

Background: Prenatal sex determination and female feticide continue to be significant ethical
and social challenges in India despite the enforcement of the Pre-Conception and Pre-Natal
Diagnostic Techniques (PCPNDT) Act, 1994. Awareness of the Act among antenatal women is
essential for its effective implementation and for promoting gender equity.
Objectives: To assess awareness of the PCPNDT Act and gender preference among antenatal
women and to identify determinants and factors influencing awareness. Methods: A cross-sectional study was conducted in 2024 over 12 months among 172 pregnant
women attending the antenatal outpatient department at a tertiary care hospital in Puducherry.
After obtaining ethics committee approval and informed consent, data were collected using a
pre-validated questionnaire. Associations were assessed using the chi-square test and
multivariable logistic regression to identify independent predictors of awareness.
Results: Overall, 65.1% of participants were aware of the PCPNDT Act. Awareness increased
significantly with education (p = 0.004), parity (p = 0.044) and knowledge of sex ratio (p <
0.001) but not with occupation, gender preference, or family pressure for a male child.
Multivariable logistic regression demonstrated that secondary education (adjusted OR 3.19;
95% CI 1.09–9.30) and multigravidity (adjusted OR 2.41; 95% CI 1.16–5.00) were
independently associated with greater awareness.
Conclusion: Although a majority of antenatal women were aware of the PCPNDT Act,
important knowledge gaps persist. Higher educational status and previous pregnancy
experience were independently associated with greater awareness. Strengthening antenatal
counselling, community-based sensitisation, and legal literacy programs is vital to increase
awareness and reduce gender bias.