Missing Girls in India: Infanticide, Feticide and Made-to-Order Pregnancies? Insights from Hospital-Based Sex-Ratio-at-Birth over the Last Century

Abstract

BackgroundThere are 44 million missing women in India. Gender bias; neglect of girls, infanticides and feticides are responsible. The sex ratio at birth can be used to examine the influence of antenatal sex selection on the sex ratio.Materials and MethodsRecords from 321,991 deliveries at one hospital over 11 decades were utilized. The middle year in each decade was taken as representative of the decade. Data from 33,524 deliveries were then analyzed. Data for each decade was combined with that of previous decades and compared to the data of subsequent decades to look for any change in the trend. Sex ratio in the second children against sex of the first child was studied separately.ResultsThe mean sex ratio for the 110 years examined was 910 girls to 1000 boys (95% CI; 891 to 930). The sex ratio dropped significantly from 935 (CI: 905 to 967) before 1979, to 892 (CI: 868 to 918) after 1980 (P = 0.04). The sex ratio in the second child was significantly lower if the first child was a girl [716 (CI: 672 to 762] (P<0.001). On the other hand, there was an excess of girls born to mothers whose first child was boy [1140 girls per 1000 boys (CI: 1072 to 1212 P<0.001)].ConclusionsThe sex ratio fell significantly after 1980 when ultra sound machines for antenatal sex determination became available. The sex ratio in second children if the first was a girl was even lower. Sex selective abortions after antenatal sex determination are thus implicated. However data on second children especially the excess of girls born to mothers who have a previous boy seen in the decade before the advent of antenatal ultra sound machines, suggests that other means of sex selection are also used.

The human prenatal sex ratio: A major surprise

“…The slight male bias, typically ∼51.3% of live births, is so consistent ( Fig. 1A) that when birth sex ratios deviate much from it, suspicions are aroused of sex-specific abortion or infanticide (3,4). Putting together the birth sex ratio bias and the female survival advantage (5), we expect a monotonically declining sex ratio from birth to death, which is exactly what we find across cultures and across historical epochs (Fig.…”

Sex determination by ultrasound: ethical challenges of sex ratio imbalances and invidious discrimination

“…In China, the sex ratio, estimated to be about 120 males to 100 females, is thought to have resulted from China's one-child policy, imposed to control population growth, and the strong cultural preference for male offspring 2,3 . In India, the sex ratio has been estimated to be about 112 males to 100 females, again reflecting a strong cultural preference for male offspring, but in the absence of a one-child policy 4 . In both countries, it is apparent that there have been millions of abortions performed based on sex identification of a female fetus.…”

A Study to assess the knowledge and Attitude about Female Feticide among women attending outpatient department in a tertiary care hospital Punjab

“…In the Indian subcontinent, son is seen as the torch bearer of the family, the practice of giving dowry to the daughters and the widely held wish of the parents to reside with their sons only in their old age are some of the reasons that perpetuate the gender discrimination and result in abandonment of the girl child and female feticide. (5,6,7) The natural ratio of boys to girls is between 103-107. , any number above that indicates that females are being killed in the mother's womb. According to census data collected over the years this ratio of boys to girls in the age group 0-6 years has shown an ever widening distance, 102.4 males to 100 females in 1961,104.2 in 1980,107.5 in 2001and 108.9 in 2011.…”