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Sex-selective abortion and infanticide

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Sex-selective abortion and infanticide

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, especially in parts of People's Republic of China, India, Pakistan, and the Caucasus.[1][2] Sex-selective abortion can affect the human sex ratio—the relative number of males to females in a given age group.[3][4] A marker of countries with significant sex-selective abortion is their human sex ratio. The normal range is 105-107 males to females, as more male embryos are formed than female embryos.[5] Countries with significant practices of sex-selective abortion usually have higher human sex ratios, typically 110 and above. See list of countries by sex ratio.

Prenatal sex discernment

The earliest post-implantation test, cell free fetal DNA testing, involves taking a blood sample from the mother and isolating the small amount of fetal DNA that can be found within it. When performed after week seven of pregnancy, this method is about 98% accurate.[6][7]

Obstetric ultrasonography, either transvaginally or transabdominally, can check for the sagittal sign as a marker of fetal sex. It can be performed between 65 and 69 days from fertilization (week 12 of gestational age), where it gives a result in 90% of cases—a result that is correct in approximately 3 out of 4 cases, according to a study from 2001.[8] Accuracy for males is approximately 50% and for females almost 100%. When performed later, after 70 days from fertilization (at week 13 of gestational age), it gives an accurate result in almost all cases.[8]

The most invasive measures are chorionic villus sampling (CVS) and amniocentesis, which involve testing of the chorionic villus (found in the placenta) and amniotic fluid, respectively. Both techniques typically test for chromosomal disorders but can also reveal the sex of the child and are performed early in the pregnancy. However, they are often more expensive and more dangerous than blood sampling or ultrasonography, so they are seen less frequently than other sex determination techniques.[9]

Process of abortion

Main article: abortion

If an induced abortion is desired, suction-aspiration and vacuum aspiration are the most common early-pregnancy (up to fifteen weeks) techniques.[10] These techniques involve the manual or electrical removal of the fetus (or embryo), placenta, and membranes. From the 15th to the 26th week, more invasive techniques must be used. The most common is dilation and evacuation (D&E), which involves the opening of the cervix and surgical removal of the fetus and related tissues. After week 26, induced abortions require labor induction by drugs, intact dilation and extraction, or a hysterectomy abortion. Various injections and medications are also available, dependent upon gestational age, availability, and cost. Due to lack of resources (monetary, physician, transportation, etc.) and emotional factors (such as fear or shame), performing unsafe abortions is a significant global issue. Of the estimated 44 million abortions per year, it is estimated that just below half are performed unsafely. These unsafe abortions lead to approximately 70,000 maternal deaths annually.[11][12]

India

Abortions have been a popular medical procedure in India for quite some time, but the first law regarding abortion was not passed until 1971. This law, the Medical Termination of Pregnancy Act of 1971, made abortion legal in most states, but specified “acceptable” reasons for abortion, physicians who can provide the procedure, and the facilities they can be performed.[13] Since the act was passed, more abortions have been performed illegally than legally for a variety of reasons, including cost, availability, “incorrect” reasons, desire for secrecy, etc. In 1996, Khan, Barge, and Philip estimated that of the 5-6 million abortions performed per year in India, 90% were performed illegally.[14] India’s second National Family Health Survey (NFHS-2), which compiled data from 1998-1999, found that, nationally, 2% of pregnancies ended in induced abortion, with higher rates in 25 of 26 states from the first survey.[15] However, many studies of the survey hypothesize that this number is a low estimate, as the full number of induced abortions was probably not reported (because of the number of abortions performed illegally). A sign that the figures being reported were not entirely accurate was that the NFHS-2 showed higher rates of spontaneous abortion than NFHS-1. However, spontaneous abortions are primarily biologically and environmentally based, so they should not increase significantly over time. As a result, researchers have created higher estimates; Arnold, Kishor, and Roy believe that approximately 4.7% of Indian pregnancies ended in induced abortion in 2002.[16] Techniques for determining sex prenatally first became available in the early 1970s and quickly gained popularity.[17] These techniques spread through most of the country very rapidly and today are typically available from mobile units (such as traveling ultrasound vans), although they have been banned for the purposes of sex determination since 1995.[18] Sudha and Rajan (1999) found that sex determination techniques are sometimes packaged together with abortions and are often marketed as being cheaper in the long run, saving the family from a large dowry in the future, should the fetus be female.[19] Although the Indian government and various female advocacy groups have tried to prevent sex selection, it remains a significant issue nationwide. There is evidence that such bans are rarely enforced[20] and that numerous dedicated sex selection clinics operate in many regions of India.[21] India’s prime minister has stated that gendercide is a national shame and its secretary of health and family welfare has acknowledged that the country has not been aggressive enough in combating it. Women's rights activists allege that the laws are not being enforced because the police and judiciary believe in and may even practice gendercide themselves.[22] Moreover, there has been significant debate within India regarding the morality of sex selection. For example, there are arguments for sex selection which say that prenatal discrimination is more humane than postnatal discrimination,[23][24][25] though there is little evidence that prenatal discrimination has any positive effect on postnatal discrimination; women are not necessarily held in higher regard if they are fewer in number.[26]

India’s 2001 census revealed a national sex ratio of 107.8, up from 105.8 in the 1991 census. Because this number is an average, it masks even more dramatic numbers in certain states—Punjab’s ratio was 126.1 (up from 114.3 in 1991), Haryana’s ratio was 122 (up from 113.8 in 1991), and Gujarat’s ratio was 113.9 (up from 107.8 in 1991). Arnold, Kishor, and Roy hypothesize that this rapid increase was due to increased availability of sex determination techniques.[16] In fact, Ganatra et al. (2000) found that ⅙ of all reported abortions followed a sex determination test.[27] However, this alone does not show causation between sex determination testing and high sex ratios. Researchers also analyzed sex ratios in women who had undergone an induced abortion in the pregnancy just before their most recent live birth. This revealed a sex ratio of 158.0 in Punjab, Haryana, and Gujarat, significantly higher than rates elsewhere in the country. Moreover, these states have very high ultrasonography use and women in these states with no sons are more likely to have an ultrasound than women with at least one son. In Haryana, the sex ratio for babies born from mothers who had ultrasounds performed is 186.3, pointing to widespread sex determination among this population.[16] This shows correlation between induced abortion and high sex ratios, probably pointing to the use of sex determination techniques.

India’s 2001 census found that the majority of southern states have a sex ratio at or approaching 105, the widely accepted “natural ratio.” In general, wealthier southern states have had sex ratios closer to 105 for quite some time. Gujarat, one of the states of interest with very high sex ratios in 2001, now has a child sex ratio around 112.8, an improvement since 2001 but not since 1991.[28] Punjab, another state of interest, now has a child sex ratio of approximately 118.2, a small improvement since 2001.[29] Finally, Haryana’s 2011 child sex ratio was 120.4, reflecting little improvement since 2001.[30]

Overall, it is estimated that 6.4% of pregnancies with a female fetus are aborted, leading to a loss of approximately 106,000 female infants per year.[16]

China

When sex ratio began being studied in China in 1960, it was 106 males to 100 females, still within the normal range. However, it climbed to 111.9 by 1990 and 118 by 2010. [31] [32]Researchers believe that the causes of this sex ratio imbalance are increased female infant mortality, underreporting of female births and sex-selective abortion. According to Zeng et al. (1993), the most prominent cause is probably sex-selective abortion, but it is difficult to prove that in a country with so little reliable data because of the hiding of “illegal” births. [33] Therefore, there is extensive underreporting of female infants. However, they are eventually accounted for, as they must be registered for immunizations, education, etc. To avoid the issue of underreporting, many studies use the sex ratio for those age 20 and younger.

Traditional Chinese techniques have been used to determine sex for hundreds of years, many with unknown accuracy. It was not until ultrasonography became widely available in urban and rural China that sex was determined scientifically. In 1986, the Ministry of Health posted the Notice on Forbidding Prenatal Sex Determination, but it was not widely followed. [34] Three years later, in 1989, the Ministry of Health outlawed all sex determination techniques, except for their use in diagnosing hereditary disease. [35] However, many people still have personal connections to medical practitioners and strong son preference still dominates culture, leading to the widespread use of sex determination techniques. [31] According to Hardy, Gu, and Xie (2000), ultrasound has spread to all areas of China, as evidenced by the spread of the high sex ratio throughout the country. [36]

What’s more, Hardy, Gu, and Xie argue that if it’s available everywhere, sex-selective abortion will be more prevalent in rural China because son preference is so much stronger there. [36] Urban areas of China, on average, are moving toward greater equality for both sexes. However, rural China tends to follow more traditional views of gender. For example, while sons are always part of the family, daughters are only temporary, going to a new family when they marry. Additionally, if a woman’s firstborn child is a son, her position in society moves up, while the same is not true of a firstborn daughter. [31]

In years past, when families wanted a son, many would keep having children until they did, resulting in a normal sex ratio. [31] However, the combination of financial concerns and the One-child policy (discussed further below) have led to an increase in gender planning and selection. Even in rural areas, most women know that ultrasonography can be used for gender discernment. For each subsequent birth, Junhong found that women are over 10% more likely to have an ultrasound (39% for firstborn, 55% for second born, 67% for third born). Additionally, he found that the sex of the firstborn child impacts whether a woman will have an ultrasound in her subsequent pregnancies: 40% of women with a firstborn son have an ultrasound for their second born child. For women with firstborn daughters, this number jumps to 70%, pointing to a strong desire to select for a son if one has not been born yet. [31]

Unfortunately, Junhong also found that many women don’t see a female child as a burden, but rather are pressured to produce a male son. Additionally, 85% of women would try to have two children, ideally one boy and one girl, if there were no restrictions on children. Most women will take steps to ensure their second child is a boy, if the first is a girl. However, they will not take steps to ensure their second child is a girl if the first is a boy, as it is too expensive. [31]

Because of the lack of data about childbirth, a number of researchers have worked to learn about abortion statistics in China. One of the earliest studies by Qui (1987) found that according to cultural belief, fetuses are not thought of as human beings until they are born, leading to a cultural preference for abortion over infanticide. [37] In fact, infanticide and infant abandonment are rather rare in China today. [31] Junhong (2000) found that 27% of those surveyed had an abortion. Additionally, he found that if a family’s firstborn was a girl, 92% of known female would-be second born fetuses were aborted. [38] In a 2005 study, Zhu, Lu, and Hesketh found that the sex ratio for those ages 1-4 was highest overall, and only two provinces, Tibet and Xinjiang, had sex ratios within normal limits. Two provinces had a ratio over 140, four had ratios between 130-139, and seven had ratios between 120-129. [39] There are three types of provinces, which vary in restrictive nature of their childbearing laws. Type one is the most restrictive, where only 40% of couples are allowed a second child, and only if their firstborn is a girl. These provinces tend to be wealthier and more educated, and many parents have a pension to take care of them, eliminating the need for a son. [39] Therefore, they have medium sex ratios and Winckler (2002) that traditional gender preferences are changing toward more equality. [40]In type two provinces, everyone with a firstborn daughter is allowed a second child. Additionally, parents who have a documented hardship (as determined by a local official) are allowed a second child. These provinces tend to have more traditional structure and agriculturally-based economy, causing a need for a son. Therefore, sex ratio is highest in type two provinces. [39] Finally, type three provinces always allow a second child, regardless of the firstborn’s gender, and sometimes allow a third. These provinces are often poor and underpopulated and neither have a preference for sons nor believe in abortion, resulting in the lowest sex ratios. [39] Based on the relationship between type of province and sex ratio, many researchers believe making type two provinces into type one or three could dramatically lower the sex ratio. [39]

Families in China are aware of the critical lack of female children and it’s implication on marriage prospects in the future; many parents are beginning to work extra when their sons are young so that they will be able to pay for a bride for them. [31] Because of the rising awareness of the imbalance in China’s sex ratio, measures to lower it are beginning to take place. For example, in 2000, the Chinese government began the “Care for Girls” Initiative. [41] The sex ratio among firstborn children in urban areas from 2000-2005 didn’t rise at all, so there is hope that this movement is taking hold across the nation. [31]

United States

Like in other countries, sex-selective abortion is difficult to track in the United States because of lack of data. However, based on the sex ratios in the United States, it is certainly rare for the population overall. Abrevaya (2009) found that among firstborn children in the U.S., the sex ratio is the normal 102-106 males per 100 females. However, he also found that among some Korean, Chinese, and Indian parents with one daughter, the sex ratio is 117 and when they have two daughters, the ratio is 151. [42]

While the majority of parents in United States do not practice sex-selective abortion, there is certainly a trend toward male preference. According to a 2011 Gallup poll, if they were only allowed to have one child, 49% of men and 31% of women would prefer a son. [43] When told about prenatal sex selection techniques such as sperm sorting and in vitro fertilization embryo selection, 40% of Americans surveyed thought that picking embryos by sex was an acceptable manifestation of reproductive rights. [44] These selecting techniques are available at about half of American fertility clinics, as of 2006. [45]

Because of this movement toward sex preference and selection, many bans on sex-selective abortion have been proposed at the state and federal level. In 2010 and 2011, sex-selective abortions were banned in Oklahoma and Arizona, respectively. Legislators in Georgia, West Virginia, Michigan, Minnesota, New Jersey, and New York have also tried to pass acts banning the procedure. [44]

Other countries

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 Armenia and Azerbaijan. 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][46] 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.[47] 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.[48]

Reasons for sex-selective abortion

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] Demographers argue that perceived gender imbalances may arise from the underreporting of female births, rather than sex-selective abortion or infanticide.[49][50]

Cultural preference

The reason for intensifying sex-selection abortion in China and India can be seen through history and cultural background. Generally, before the information era, male babies were preferred because they provided manual labor and success the family lineage. Labor is still important in developing nations as China and India, but when it comes to family lineage, it is of great importance. 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.[51] Furthermore, in some cultures sons are expected to take care of their parents in their old age.[52] 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.[51]

Sexual discrimination

The role of many women in nations that are prone to sex-selection abortion is to stay home, do house chores, and raise children. She is mutely banned to work in the society, pressured by family and discouraged by society. Lower salary, working in temporary or non-regular jobs, and lower status at work is often the case even for women who do work. In these societies, mothers are compelled to assist their husbands and raise their children, sparing no time for self-development. All in all, in cultures that practice sex-selective abortion, women are prone to sexual discrimination and are viewed as inferior to men.

One-child policy

The 1960s scare for overpopulation led governments to implement laws to control birth rate such as the one-child policy. Accordingly, it led to consequence where parents highly value boys over girls; even to a point were words such as "infanticide" come into existence. Infanticide has come to be known as the "Holocaust for baby girls". What’s more, her child will follow the husband’s surname and is restricted to visit her parents whenever she wishes. These kinds of cultural practice mixed with the government implications of one-child policy have caused one-daughter parents to become ‘’childless’’ after the marriage. As a result, these parent no longer have a financially supporting or lineage successor. Thus, for parents to ensure financial dependence and hereditary successor, a boy must be born. In this regard, the pervasion of male dominant culture and one-child policy heightens the sex-selective abortion.

Trivers–Willard hypothesis

The Trivers–Willard hypothesis argues that available resources affect male reproductive success more than female and that consequently parents should prefer males when resources are plentiful and females when resources are scarce. This has been applied to resource differences between individuals in a society and also to resource differences between societies. Empirical evidence is mixed with higher support in better studies according to Cronk in a 2007 review. One example, in a 1997 study, of a group with a preference for females was Romani in Hungary, a low status group. They "had a female-biased sex ratio at birth, were more likely to abort a fetus after having had one or more daughters, nursed their daughters longer, and sent their daughters to school for longer."[53]

Genetic

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.

Societal effects

Demography issues and wifeless men

The strong preference on boys over girls will bring about a serious problem: millions of wifeless men. In years to come, the skewed ratio of men and women could cause men to have difficulty finding brides. There are reports of women from Vietnam, Myanmar, and North Korea systematically trafficked to mainland China and Taiwan and sold into forced marriages.[54] In South Korea and Taiwan, high male sex ratios and declining birth rates over several decades have led to cross-cultural marriage between local men and foreign women from countries such as mainland China, Vietnam and the Philippines.[55]

Measures being taken

NGOs such as the Gendercide Watch and Population Research Institute have been created to address the issue of sex-selective abortion and female infanticide.

In Punjab, India, government and NGO networks have set up orphanages to shelter the unwanted girls.[56]

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".[57] In 2011 the resolution of PACE's Committee on Equal Opportunities for Women and Men condemned the practice of prenatal sex selection.[58]

In Canada, a group of MPs led by Mark Warawa are working on having the Parliament pass a resolution condemning sex-selective pregnancy termination.[59][60]

The United States Congress has debated legislation that would outlaw the practice.[61] The legislation ultimately failed to pass in the House of Representatives.[62]

On the state level, laws against sex-selective abortions have been passed in a number of US states;[63] the law passed in Arizona in 2011 prohibits both sex-selective and race-selective abortion.[63][64][65]

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.[66]

See also

References

External links

  • MSNBC - No Girls Please - In parts of Asia, sexism is ingrained and gender selection often means murder
  • Surplus Males and US/China Relations
  • - An analysis of various studies of the lopsided sex ratios in Asian countries
  • Case study: Female Infanticide in India and China
  • Working paper by Emily Oster linking sex ratio imbalances to hepatitis B infection
  • S2 China Report - China: The Effects of the One Child Policy
  • UNESCAP document
  • A collection of essays on sex selection in various Asian countries by Attané and Guilmoto
  • Five case studies and a video on sex selection in Asia by UNFPA
  • Book Review: Unnatural Selection - The War Against Girls / WSJ.com

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