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At a rally in New Delhi in 2006. One estimate is that in India, 500,000 girls ‘go missing’ every year. (AP photo)

Sex-selection abortions continue, and are spreading

ASK THIS | September 06, 2011

One estimate from 2005 was that, in part because of sex selection, there are 163 million women and girls missing from the population in Asia. In addition, writes Mara Hvistendahl, skewed sex ratios are cropping up in places with no history of the problem, including the United States.

By Mara Hvistendahl

Results from the Indian and Chinese censuses released earlier this year show the sex ratio at birth becoming more skewed in both countries. China counted fully 118 boys born for every 100 girls, while India, which uses an alternative statistic, reported 914 girls for every 1,000 boys, ages 0-6. (The natural human sex ratio at birth, by contrast, is 105 boys per 100 girls.) Sex selection, mainly through abortion, has been practiced on a broad scale in South and East Asia since the early 1980s, when cheap ultrasound machines able to detect the sex of a fetus in the second trimester were first marketed in China, India, South Korea, and Taiwan. If Asia's sex ratio at birth had remained at its natural equilibrium over the past few decades, one demographer found in 2005, the continent would have an additional 163 million women and girls today. 

Equally alarming is the fact that sex selection is spreading. In the past fifteen years, skewed sex ratios have cropped up in countries with no history of the problem – including Vietnam, Georgia, Azerbaijan, Armenia, and Albania. Sex selection also occurs in the United States.

That more boys than girls are born is now widely accepted, as is the fact that gender imbalance on the scale of Asia's has serious societal implications. As millions of what demographers call “surplus males” grow up and cannot find wives, they are turning to poorer countries to buy them. Asia's sex ratio imbalance has also contributed to an increase in sex trafficking.

But the reasons sex selection has taken hold across such a wide variety of cultures at this juncture in history are poorly understood. Reports on the issue tend to be heavy on numbers and light on explanation.

There are good reasons why information is muddled. Some of the nongovernmental and aid organizations that have taken on the issue are wary of addressing abortion too frankly, in part because of America's history of defunding international family planning work involving abortion. On the other end of the political specrtrum, organizatons funded by the Christian right have embraced the issue of sex selection as a means to securing limits on abortion. Doctors, demographers, and parents living in communities with skewed sex ratios are generally better sources than representatives of nongovernmental organizations who may have conflicting agendas. Reporters who take on this topic will need to maintain a critical eye.

Q. From what survey was the sex ratio at birth taken?

Data from developing countries can be unreliable. It is important to check data against other surveys where available. Also, be careful not to confuse overall sex ratios – which look at entire populations and can skew because of high death or migration rates for one sex – with the sex ratio at birth. When in doubt, consult a demographer.

Q. Does the sex ratio at birth rise for second and third births?

Survey data from China, India, South Korea, and elsewhere show that most families do not select for sex on the first birth. If the sex ratio at birth spikes for second and third births, it's a good sign that sex selection is happening.

Q. If there are any population targets in place that limit the number of children couples have, to what degree are the targets enforced, and how relevant are they today?

Articles on sex selection in China tend to focus on the one-child policy, pointing out that the policy raises the stakes for women – increasing the chance they will resort to sex-selective abortion to ensure the birth of a son. The one-child policy is important in this sense, but reporters should also note that it is less strictly enforced today than it was in the 1980s. An international group of researchers, in fact, has found that enforcement may not even be necessary (and indeed a growing lobby of demographers and former government officials now advocate relaxing birth targets). In one survey of 18,000 women in Jiangsu province, only one third of women eligible to have a second child said they wanted one.  

Such self-imposed limits on family size may be just as significant as government pressure. Either way, women who stick to one child have a reduced chance of having a son without turning to technology.

Q. What is the current total fertility rate of the country, and how rapidly has it fallen in recent years? To what degree did population control and birth targets – either direct or implicit – play a role in the birth rate dropping?

China is hardly the only country where falling fertility rates have contributed to a rash of sex selection. In the past few decades India, South Korea, Vietnam, Albania, Georgia, Azerbaijan, and Armenia have all experienced a rapid drop in their total fertility rate (TFR), or the number of children the average woman is expected to have over her lifetime.

Some of these countries have a history of population control, even if they do not have birth targets in place today. This history is detailed in Columbia University historian Matthew Connelly's book Fatal Misconception. I explain what it has to do with sex selection in my own book, Unnatural Selection.

The East-West Center in Honolulu is a good resource for demographic information on Asia.

Q. What is the country's abortion rate? How many abortions does the average woman have over her lifetime?

High abortion rates contribute to the practice of sex selective abortion in some countries. Evidence that abortion is used in place of modern contraception methods like condoms and birth control pills may be significant.

Q. Is sex-selective abortion the only way to ensure a child of a certain sex? What about techniques like preimplantation genetic diagnosis?

Abortion is only the preferred method of sex selection in the developing world for now. Emerging pre-pregnancy technologies like preimplantation genetic diagnosis (PGD) and sperm sorting will likely become more common in years to come, particularly if they become cheaper and more accessible. Many fertility clinics in the United States offer PGD for sex selection for couples undergoing in-vitro fertilization. The technology is catching on among elites in developing countries as well. Pre-pregnancy methods are invisible and discreet, and they allow for selection before a couple has formed an attafhment to the fetus. The issue of prernatal selection will only become more pressing.

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