Sex-selective abortion

Sex-selective abortion

Sex-selective abortion is the practice of terminating a pregnancy based upon the predicted sex of the baby. The selective abortion of female fetuses is most common in areas where cultural norms value male children over female children,[1] especially in parts of People's Republic of China, India, Pakistan, Korea, Taiwan, and the Caucasus.[1][2] Sex-selective infanticide is killing a child based on the child's sex, usually shortly after birth (sex selective neonaticide). In 1994 over 180 states signed the Programme of Action of the International Conference on Population and Development, agreeing to "eliminate all forms of discrimination against the girl child".[3] In 2011 the resolution of PACE's Committee on Equal Opportunities for Women and Men condemned the practice of prenatal sex selection.[4]

A 2005 study estimated that over 90 million females were "missing" from the expected population in Afghanistan, Bangladesh, China, India, Pakistan, South Korea and Taiwan alone, and suggested that sex-selective abortion plays a role in this deficit.[2][5] India's 2011 census shows a serious decline in the number of girls under the age of seven - activists believe eight million female fetuses may have been aborted between 2001 and 2011.[6] Some research suggests that culture plays a larger role than economic conditions in gender preference and sex-selective abortion, because such deviations in sex ratios do not exist in sub-Saharan Africa, Latin America, and the Caribbean.[2] Other demographers, however, argue that perceived gender imbalances may arise from the underreporting of female births, rather than sex-selective abortion or infanticide.[7][8] Sex-selective abortion was rare before the late 20th century, because of the difficulty of determining the sex of the fetus before birth, but ultrasound has made such selection easier. Prior to this, parents would alter family sex compositions through infanticide.


Practical aspects

Prenatal sex discernment can be performed by the means of one of the two standard genetic tests, CVS and amniocentesis. These may, in principle, be performed as early as the 8th and the 9th week of pregnancy. The difficulty of these tests and the risk of damage to the fetus, potentially resulting in miscarriage or congenital abnormalities (especially when done early during the pregnancy), make them quite rare during the first trimester. In the United States, CVS and amniocentesis are most commonly performed after the 11th and the 15th week of pregnancy, respectively, and even then procedures are normally only recommended for mothers whose age or family background places them at the elevated risk for genetic disorders (such as Down's syndrome).

Outside the developed world, neither CVS nor amniocentesis account for the bulk of supposed sex-selective abortions, due to their difficulty and high cost. The most common method, instead, is ultrasound. Ultrasound is a simple, non-invasive method that involves scanning the abdomen of the pregnant woman with sound waves that create a visual representation of tissues inside her body (including the fetus), and allows the technician who performs it to attempt to locate fetus's genitals - and, therefore, to make a judgment about his or her gender. Unfortunately, ultrasound is nowhere near as accurate as genetic testing: it does not reach near-100% accuracy till as late as the 20th week of pregnancy (however, some novel methods of interpreting ultrasound images exist that allow fairly accurate reading by the 14th week.[9])

There are also tests which looks for DNA from the fetus in the mother's blood. A meta-analysis published in 2011 found that such tests are reliable more than 98% of the time, as long as they are taken after the seventh week of pregnancy.[10][11]

Reasons for sex-selective abortion

Cultural preference

The selective abortion of female fetuses is most common in areas where cultural norms value male children over female children.[1] A son is often preferred as an "asset" since he can earn and support the family; a daughter is a "liability" since she will be married off to another family, and so will not contribute financially to her parents. The patriarchal structure of a society is the single most important factor skewing the sex ratio in favor of males, accentuated in some cultures by the burden of raising a dowry for a daughter's marriage. Openness to the very concept of sex selection is a significant factor: among societies which practice selective female abortion nowadays, many were systematically practicing female infanticide (either directly or by withholding postnatal care from children of undesirable sex) long before abortion became a viable option.[12]

In modern East Asia, a large part of the pattern of preferences leading to this practice can be condensed simply as a desire to have a male heir. Monica Das Gupta (2005) observes that, in late 1980s to early 1990s China, there was no evidence of selective abortion of female fetuses among firstborn children, or in families with one or more existing sons (in fact, families with multiple sons were, if anything, more likely to abort a boy than a girl). But, at the same time, families with existing daughters appeared very likely to abort any further female fetuses, resulting in heavily skewed sex ratios.[12]


Gender-linked genetic abnormalities, such as several forms of colorblindness, are linked to recessive genes on the X chromosome. Pre-implantation genetic diagnosis can identify some life-threatening genetic abnormalities in embryo. The easiest way to select against embryos which may have a gender-linked genetic abnormality is to choose only female embryos. Embryos which are not implanted are usually discarded.


Sex-selective abortion is thought to be most common in South and East Asia, including parts of People's Republic of China, Korea, Taiwan, India, and Pakistan.[1][2][13]

It is possible that sex-selective abortions have caused an increase in the imbalances between sex ratios of various Asian countries. Studies have estimated that, by 1995, prenatal sex selection has increased the ratio of males to females from the natural average of 105-106 males per 100 females to 113 males per 100 females in both South Korea and China, 110 males per 100 females in Taiwan and 107 males per 100 females among Chinese populations living in Singapore and parts of Malaysia.[14] However, a similar trend does not exist in North Korea, possibly due to limited access to prenatal sex-testing technologies.[15] The worst ratio on record is thought to be in the city of Lianyungang, China, at 163 boys per 100 girls under the age of 5.[16]

Sex-selective abortion has been seen as worsening the sex ratio in India, affecting gender issues related to sex compositions of Indian households.[17] According to the decennial Indian census, the sex ratio in the 0-6 age group in India went from 104.0 males per 100 females in 1981, to 105.8 in 1991, to 107.8 in 2001, to 109.4 in 2011. The ratio is significantly higher in certain states such as Punjab and Haryana (126.1 and 122.0, as of 2001).[18] The use of ultrasound and abortion for sex selection has been banned since 1994 in India and 1995 in China,[19] however, there is evidence that such bans are rarely enforced,[20] and numerous dedicated sex selection clinics operate in many regions of those countries.[21] The practice is most common among educated and wealthy residents, who are most likely to afford the procedure.[22] An article published in The Lancet[23] analyzed Indian census data and concluded that selective abortion of female fetuses has increased in India over the past few decades due to increased prenatal sex determination and has contributed to a widening imbalance in the child sex ratio, though the basis of the finding has been questioned.[24]

Abnormal sex ratios at birth, possibly explained by growing incidence of sex-selective abortion, have also been noted in some other countries outside South and East Asia. According to the 2011 CIA World Factbook, countries with more than 110 males per 100 females at birth also include Albania and former Soviet republics of Georgia, Armenia, and Azerbaijan.

Sex-selection practices also occur among some South Asian immigrants in the United States: A study of the 2000 United States Census observed definite male bias in families of Chinese, Korean and Indian immigrants, which was getting increasingly stronger in families where first one or two children were female. In those families where the first two children were girls, the sex ratio of the third child was observed to be 1.51:1 in favor of boys.[25]

Societal effects

Gender bias can broadly impact a society, and it is estimated that by 2020 there could be more than 35 million young "surplus males" in China and 25 million in India.[26]

Census information shows the problem is worsening. In India overall, by 2011, there were little more than 9 girls younger than 6 years old for every 10 boys. In India, the 2011 census showed that the ratio of girls to boys under the age of 6 years old has dropped even during the past decade, from 927 girls for every 1000 boys in 2001 to 918 girls for every 1000 boys in 2011. Maharashtra state's ratio is 883 girls, and Satara is even lower at 881. In India, hospitals are banned from giving out the gender of an unborn fetus to prevent sex-selection abortions, although evidence indicates that the information is often revealed.[27]

Evidence exists for a link between sex ratios and violence. In a society with an artificial shortage of women, a combination of surplus of males and increased upward mobility of females results in accumulation of unmarried, lower-class males, who tend to be violence-prone. In the recent decades both in China and in India, regions with highest sex-selection rates experienced crime waves.[28] In China, due to its long history of son preference, there is even a term for such males, guang gun-er ("bare branches"). It has been argued that most bandits in historical China were bare branches, and that their prevalence was a major factor behind the massive Nien Rebellion in the mid-19'th century.[29]

Shortage of females has the effect of driving human trafficking and mail-order bride phenomena. There are reports of women from Vietnam, Myanmar, and North Korea systematically trafficked to mainland China and Taiwan and sold into forced marriages.[28] In South Korea and Taiwan, high male sex ratios and declining birth rates several decades ago have led to over 10% of marriages in those countries being between local men and foreign women, often from countries such as mainland China, Vietnam and the Philippines.[30]

During the 1994 United Nations International Conference on Population and Development in Cairo, Egypt, policy objectives intended to eliminate sex-selective abortion and infanticide, along with discrimination against female children, were stated in Article 4.15 of the Programme of Action: " eliminate all forms of discrimination against the girl child and the root causes of son preference, which results in harmful and unethical practices regarding female infanticide and prenatal sex selection".[14]

It has been argued that by having a one-child policy, China has increased the rate of abortion of female fetuses, thereby accelerating a demographic decline.[31] As most Chinese families are given incentives to have only one child, and would often prefer at least one son. Researchers have expressed concern that prenatal sex selection may reduce the number of families in the next generation.[32]

Since 2005, test kits such as the Baby Gender Mentor have become available for purchase over the Internet.[33] These tests have been criticized for making it easier to perform a sex-selective abortion earlier in a pregnancy.[34] Concerns have also been raised about their accuracy.[35][36]

In popular culture

The Manish Jha film, Matrubhoomi-A Nation Without Women (2003), depicts a future dystopia in a village in India, populated exclusively by males due to female infanticide, and which is reduced to barbarianism.[37]

See also


  1. ^ a b c d Goodkind, Daniel (1999). "Should Prenatal Sex Selection be Restricted?: Ethical Questions and Their Implications for Research and Policy". Population Studies 53 (1): 49–61. doi:10.1080/00324720308069. JSTOR 2584811. 
  2. ^ a b c d A. Gettis, J. Getis, and J. D. Fellmann (2004). Introduction to Geography, Ninth Edition. New York: McGraw-Hill. pp. 200. ISBN 0-07-252183-X
  3. ^ "Preventing gender-biased sex selection". UNFPA. Retrieved 1 November 2011. 
  4. ^ "Prenatal sex selection". PACE. Retrieved 1 November 2011. 
  5. ^ Layout 1
  6. ^ Pandey, Geeta (May 23, 2011). "India's unwanted girls". BBC News. Retrieved 23 May 2011. 
  7. ^ Johansson, Sten; Nygren, Olga (1991). "The missing girls of China: a new demographic account". Population and Development Review 17 (1): 35–51. doi:10.2307/1972351. JSTOR 1972351. 
  8. ^ Merli, M. Giovanna; Raftery, Adrian E. (2000). "Are births underreported in rural China?". Demography 37 (1): 109–126. doi:10.2307/2648100. JSTOR 2648100. PMID 10748993. 
  9. ^ "Special FAQ on the gender of the fetus". 
  10. ^ Devaney SA, Palomaki GE, Scott JA, Bianchi DW (2011). "Noninvasive Fetal Sex Determination Using Cell-Free Fetal DNA". JAMA 306 (6): 627–636. doi:10.1001/jama.2011.1114. PMID 21828326. 
  11. ^ Roberts, Michelle (10 August 2011). "Baby gender blood tests 'accurate'". BBC News Online. 
  12. ^ a b Das Gupta, Monica, "Explaining Asia's Missing Women": A New Look at the Data", 2005
  13. ^ Study shows girls increasingly aborted in India
  14. ^ a b Goodkind, Daniel (1995). "On Substituting Sex Preference Strategies in East Asia: Does Prenatal Sex Selection Reduce Postnatal Discrimination?". Population and Development Review 22 (1): 111–125. JSTOR 2137689. 
  15. ^ Goodkind, Daniel (1999). "Do Parents Prefer Sons in North Korea?". Studies in Family Planning 30 (3): 212–218. doi:10.1111/j.1728-4465.1999.00212.x. JSTOR 172197. PMID 10546312. 
  16. ^ "The women shortage: How sex selection of babies has led to a huge surplus of men and why that’s bad for all of us". 
  17. ^ Sabarwal, Shwetlena. Son Preference in India: Prevelance, Trends and Agents of Change. Retrieved March 13, 2007.
  18. ^ Arnold, Fred, Kishor, Sunita, & Roy, T. K. (2002). "Sex-Selective Abortions in India". Population and Development Review 28 (4): 759–785. doi:10.1111/j.1728-4457.2002.00759.x. JSTOR 3092788. 
  19. ^ "Sex selection". 
  20. ^ "Gender selection: In India, abortion of girls on the rise". 
  21. ^ "Sex selection in India exaggerated: doctors". CBC News. January 11, 2006. 
  22. ^ "India's 'girl deficit' deepest among educated". 
  23. ^ Jha P, Kesler MA, Kumar R, et al. (June 2011). "Trends in selective abortion of female foetuses in India: analysis of nationally representative birth histories from 1990–2005 and census data from 1991–2011". Lancet 377 (9781): 1921–8. doi:10.1016/S0140-6736(11)60649-1. PMC 3166246. PMID 21612820. 
  24. ^ "Selective Abortion of Female Fetuses in India- Some Questions on the Lancet Article". Source:; Retrieved June 20, 2011.
  25. ^ Roberts, Sam (June 15, 2009). "U.S. Births Hint at Bias for Boys in Some Asians". The New York Times. Retrieved May 23, 2010. 
  26. ^ "Surplus Males: The Need for Balance." (Fall 2000). Bridges. Retrieved March 13, 2007.
  27. ^ Babu, Chaya. "285 Indian girls no longer called "unwanted"". MSNBC, Associated Press. Retrieved October 22, 2011. 
  28. ^ a b Last, Jonathan V. (June 24, 2011). "The War Against Girls". The Wall Street Journal. 
  29. ^ Hudson, Valerie M., Andrea Den Boer. "A Surplus of Men, A Deficit of Peace: Security and Sex Ratios in Asia's Largest States". 
  30. ^
  31. ^ Hesketh T, Lu L, Xing ZW (September 2005). "The effect of China's one-child family policy after 25 years". N. Engl. J. Med. 353 (11): 1171–6. doi:10.1056/NEJMhpr051833. PMID 16162890. 
  32. ^ Das Gupta, Monica, Zhenghua, Jiang, Bobua, Li, Zbenming, Xie, Chung, Woo-in, & Hwa-Ok, Bae. (December 2002). Why is Son Preference so Persistent in East and South Asia?: A Cross-Country Study of China, India, and the Republic of Korea. Retrieved March 13, 2007.
  33. ^ Goldberg, Carey (2005-06-27). "Test reveals gender early in pregnancy". The Boston Globe. Retrieved 2007-01-16. 
  34. ^ Masters, Clare (May 12, 2007). "Pick-your-baby test investigated". The Daily Telegraph.,22049,21715528-5001021,00.html. Retrieved 2007-05-18. 
  35. ^ Boyce, Nell (2005-09-29). "Critics Question Accuracy of Fetus Sex Test". National Public Radio. Retrieved 2007-01-16. 
  36. ^ Boyce, Nell (2005-10-10). "Questions Raised Over Accuracy of Gender Test". National Public Radio. Retrieved 2007-01-23. 
  37. ^ "Matrubhoomi (2003)". New York Times. 

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