Disturbing trend

A recent study finds that selective abortion of girls, especially for pregnancies after a firstborn girl, has increased substantially in India.

CENSUS 2011, which brought out several positive features with regard to education, literacy and fertility rates, also confirmed the disturbing trend that had been reported for the first time in the 1991 Census the increasing gap between the figures for male and female children in the 0-6 age group. A recent online study published in The Lancet (May 24, 2011), based on an assessment of sex ratios by birth in 0.25 million births in three rounds of the National Family Health Survey (NFHS) data covering the period 1990 to 2005, indicated that selective abortion of girls, especially for pregnancies after a firstborn girl, had increased substantially.

The researchers compared the sex ratios of second-order births after firstborn girls with second-order sex ratios after firstborn boys. They found a sharp decline in the girl-to-boy sex ratio for second-order births when the firstborn was a girl. That is to say that the sex ratio in the second-order births was skewed, implying that selective abortion of girls was rampant, with families preferring not to have any more girls.

What the multi-author study, which included Jayanta Kumar Banthia, the former Registrar-General of India, found was that selective abortions was between 4.2 and 12.1 million from 1980 to 2010, with a higher rate of increase observed in the 1990s than in 2000. The joint study, done by nine investigators and social scientists representing a wide gamut of national and international institutions, including the Centre for Global Health Research, the Mumbai-based International Institute for Population Sciences, and the Chandigarh-based Postgraduate Institute of Medical Research & Education, showed that selective abortions of girls had gone up in the last two decades and accounted for much of the growing imbalance in the 0-6 age group.

Census 2011 figures show that the number of girls is 7.1 million fewer than the number of boys in the age group 0-6, whereas the number of girls was six million fewer during the previous Census period and 4.2 million fewer during the 1991 Census period. Census 2011 showed the worst decline in the figure in the last three decades even though States that had the worst child sex ratios earlier showed a marked improvement in this respect in the latest round.

The world over, taking the yardstick of the developed countries, boys outnumbered girls slightly at birth, and the global ratios for the rich countries were anywhere between 950-975 girls to 1,000 boys. Even though more girls than boys died at ages one to 59 months, this was offset by more boys dying within the first month of birth. With the feeder population balancing out in this way, the adult sex ratio balanced out in favour of both sexes.

Even if the sex ratio varied at birth, it did not for subsequent births as there was no agency to ensure that more boys than girls would be born. In India, what the study observed was that the sex ratio for the second birth, especially when the firstborn was a girl, was much lower than when the firstborn was a boy.

Clearly, extraneous factors were at play. People did not want to have more girls if their firstborns were girls and as a result the sex ratio for subsequent births was bound to be skewed. When Frontline interviewed families in Jhajjar district, Haryana, a State that has the dubious distinction of having the worst child sex ratio in the country (despite high rates of female literacy in the district), people said it was very rare that anyone would abort the first pregnancy. No one does it. It is considered wrong, a villager said.

But this moral commitment to carry forward subsequent pregnancies, especially if they were detected to be female foetuses, was not there. If the first pregnancy happened to be a female baby, it was allowed to live, but the second or third pregnancies definitely had to be male.

The study published in The Lancet also found that there was little evidence to suggest selective abortion of firstborn female foetuses. But to suggest, as the study does, that it was because India did not follow the one-child norm as was the case in China is not entirely correct because the Indian government has always had an aggressive population policy which in some form or the other attempts to control the fertility of women under the garb of providing for the unmet need for contraception and small families. The study cautions that the selective abortion of first-order girls might increase if fertility levels dropped further, particularly in urban areas.

For instance, Haryana had recorded a decadal population growth of 19.90 per cent in 2001-11 compared with 28.43 per cent in the previous decade. Most of India's population, the study noted, lived in States where selective abortion of girls was common.

One redeeming feature was that the rate of increase in sex-selective abortion had declined in comparison with the decade between 1991 and 2001. This, the study says, can be attributed to the improvement in States such as Haryana (which recorded the highest sex ratio of 877 females per 1,000 males since 1901), Punjab and Gujarat, which, incidentally, would not account for the highly populous States in the country. One catchy headline in a newspaper said: Though India's worst, Haryana's sex ratio is best in 110 years.

The easy availability of ultrasound technology, the lowered fertility rates of the Indian woman that the government takes a lot of pride in, the relative ability of families to get the tests done, and the easy access (most families owned motorcycles, which helped faster commuting between the village and the testing and abortion centres) had facilitated the elimination of the female foetus.

The authors looked at the data produced by the NFHS and derived birth histories and child mortality rates for 1990-2005. They interviewed every woman covered under the NFHS and recorded her birth history, mortality of all her children, education level and religion. The authors are of the opinion that overall sex ratios camouflage any estimation of sex-selective abortions because they mask conditional sex ratios at higher order birth. For this reason they relied on their main statistic, which was the conditional sex ratio of the second-order births after the firstborn girl.

Considering 950-975 per 1,000 boys as the natural variation of the sex ratio on the basis of the ranges reported from high-income countries where social pressures for fewer girls do not exist, they calculated the expected number of girls with this particular sex ratio at birth, taking into account the annual mortality rates for girls and boys at ages 0 to 1.

The study also demolished the link between high education levels and a high sex ratio as the surveyors found that the conditional sex ratio for second-order births if the firstborn was a girl fell for mothers with 10 or more years of education but was unchanged for mothers with no education. Therefore, education by itself being an agent of emancipation for women in a situation where all other things were unequal (property rights, for instance) was probably not going to work. This probably also underscored the fact that even educated women had little or no reproductive rights and were not given the right to decide the number of children.

What the study does not emphasise enough is that it is not so much the factor of education but that of rising incomes and affordability among a certain section that had made it easier for people to gain access to medical technology.

In Jhajjar, villagers told Frontline that information about easy abortions (information that was let out in both overt and covert forms) was easily accessed through newspaper and television advertisements (the local cable operator played a role in advertising) and that everyone in the village knew were testing was done.

Obviously, it was a certain section that had access to television and cable connection, with the educated in it having a better advantage of utilising that information and circulating it among their social and economic peers.

The poor were left out in more than one sense. The poorer families, such as those of the landless and agricultural workers, who might also have a son preference because of the dominant values in their environment, were either unable to gain access to information and, or unable to make use of the sex determination technology (as most of their monthly incomes would be roughly equivalent to the costs of a single ultrasound test).

The study does refer to NFHS 3, which concluded that son preference varied little by education or income but selective abortions were more common in educated or richer households. It also quotes a World Bank study that recent increases in literacy and per capita income may have contributed to the increased selective abortion of girls.

The study found that conditional sex ratios fell sharply in the 20 per cent of the richest households, declined slightly in urban regions, and did not differ between Hindu and Muslim households. The study does not throw much light on sex ratios among different caste groups in Hindu households.

The analysis included going through district census data and comparing the data on child sex ratios (CSRs) provided in the 2001 and 2011 Censuses. The number of districts with CSRs greater than 950 girls per 1,000 boys fell from 260 to 155. Of the 563 districts common to both the Censuses, 405 districts showed a decline in the CSR and 278 showed declines higher than the national average decline of 1.4 per cent. As many as 158 districts showed no change or increase in the CSR. The overall picture was pessimistic even though some people preferred to draw solace from the improvements in some States that are notorious for their low CSRs.

The authors claim that their study is the first of its kind to assess trends in selective abortions of girls in India at the national level using nationally representative data. There is no doubt that such studies will help policymakers understand how they should go about dealing with the declining CSR and alter their established ideas of how to bring about a change in the mindsets of people, which cannot happen when other things in society are constant. The obsessive preference for the boy child in particular regions of the country to the extent of eliminating the female foetus cannot be dealt with by homilies of changing the mindset and imposing huge fines on offenders, as has been the case in the latest intervention of the Ministry of Health and Family Welfare.

There are larger questions of political economy linked to what is being perceived as a social evil; it cannot be eliminated by a stringent Act alone. The tragedy is that the issue is still not being taken up with the kind of seriousness it deserves, notwithstanding the excellent efforts of independent researchers and others to understand the problem with all its ramifications.