India’s ratio of boy to girl babies is widening, aided by illegal tests that help parents selectively abort female fetuses, a study found.
As many as 600,000 girls are selectively aborted annually in India, compared with as many as 410,000 terminations a decade ago and 200,000 in 1991, according to a study today in the medical journal The Lancet. There are now 914 girls for every 1,000 boys ages 0-6 years, down from 945 per 1,000 20 years ago.
“Selective abortion of girls in India has grown in the past two decades and accounts for most of the large and growing imbalance,” Prabhat Jha of the Centre for Global Health Research at the University of Toronto and colleagues wrote in the study. “Increases in selective abortion of girls are probably because of persistent son preference.”
The findings suggest a 1996 ban on testing fetuses to identify sex is being flouted partly because the financial incentive for doctors to perform scans is greater than the fines they face if caught, S.V. Subramanian of the Harvard School of Public Health in Boston and Daniel J. Corsi of McMaster University in Hamilton, Ontario, wrote in an accompanying commentary. The market for sex determination and selective abortion may be worth at least $100 million annually, they wrote.
“The demand for sons among wealthy parents is being satisfied by the medical community,” Subramanian and Corsi wrote. “There is little evidence that the law is accomplishing its goal,” they said, adding that 800 court cases against doctors in 17 states have led to only 55 convictions.
The authors assessed sex ratios by birth order in 250,000 deliveries in national surveys from 1990 to 2005 and estimated selective abortions of girls by assessing the birth cohorts of children aged 0-6 years in the 1991, 2001, and 2011 censuses.
There were 4.2 million to 12.1 million selective abortions of girls from 1980 to 2010, the authors estimate. Proportionally fewer girls are born in urban areas compared with rural regions, with little differences occurring between Hindu and Muslim households, they said.
Son preference varies little by education or income, though selective abortion of girls is more common in educated or wealthier households, presumably because they can afford ultrasound and abortion services more readily than uneducated or poorer households, the authors wrote.
“Recent increases in literacy and Indian per-person income might have thus contributed to increased selective abortion of girls,” they said. Women with one of more girls were more likely to abort a female fetus, the researchers said.
“Our results are consistent with reports that ultrasound and abortions are far more common in second-order and third- order births than in firstborns,” they said.
The study received funding from the Fogarty International Centre of the U.S. National Institutes of Health, the International Development Research Centre, the Canadian Institute of Health Research and the Li Ka Shing Knowledge Institute at St Michael’s Hospital and University of Toronto.
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