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Female foeticide in India

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The practice of female foeticide in India, causing the death of the foetus in the womb because of the gender, has resulted in an all-time high birth sex ratio in India, according to the Ministry of Health and Family Welfare.[1] The Pre-Conception and Pre-Natal Diagnostic Techniques Act (PCPNDT) of 1994 criminalized prenatal sex screening and female foeticide, making it illegal in India to determine or disclose sex of the foetus to anyone. However, there are concerns that PCPNDT Act has been poorly enforced by authorities.[2]

The natural human sex ratio at birth was estimated, in a 2002 study, to be close to 106 boys to 100 girls.[3] Human sex ratio at birth that is significantly different from 106 is often assumed to be correlated to the prevalence and scale of sex-selective abortion. A birth sex ratio impacts a society's overall sex ratio over time, as well the child sex ratio in near term. India's child sex ratio (defined as the ratio of boys to girls in 0-6 year age group) was 108 according to its 2001 census, and 109 according to its 2011 census.[4] The national average masks the variations in regional numbers according to 2011 census — Haryana’s ratio was 120, Punjab’s ratio was 118, Jammu & Kashmir was 116, and Gujarat’s ratio was 111.[5]

High birth sex ratio and implied female foeticide is an issue that is not unique to India. Even higher sex ratios than in India have been reported for the last 20 years in China, Pakistan, Vietnam, Azerbaijan, Armenia, Georgia and some Southeast European countries.[6] There is an ongoing debate as to whether these high sex ratios are only caused by female foeticide or some of the higher ratio is explained by natural causes.[7]

Child sex ratio and foeticide by states of India

2011 Census sex ratio map for the states and Union Territories of India, boys per 100 girls in 0 to 1 age group.[8]

The child sex ratio in India shows a regional pattern. India’s 2011 census found that all eastern and southern states of India had a child sex ratio between 103 to 107,[5] typically considered as the “natural ratio.” The highest sex ratios were observed in India's northern and northwestern states - Haryana (120), Punjab (118) and Jammu & Kashmir (116).[9] The western states of Maharashtra and Rajasthan 2011 census found a child sex ratio of 113, Gujarat at 112 and Uttar Pradesh at 111.[9]

The Indian census data suggests there is a positive correlation between abnormal sex ratio and better socio-economic status and literacy. Urban India has higher child sex ratio than rural India according to 1997 , 2001 and 2011 Census data, implying higher prevalence of female foeticide in urban India.[5][10]

The following table presents the child sex ratio data for India's states and union territories (UT), according to 2011 Census of India for population count in the 0-1 age group.[11] The data suggests 18 states/UT had birth sex ratio higher than 107 implying excess males at birth and/or excess female mortalities after birth but before she reaches the age of 1, 13 states/UT had normal child sex ratios in the 0-1 age group, and four states/UT had birth sex ratio less than 103 implying excess females at birth and/or excess male mortalities after birth but before he reaches the age of 1.

State / UT Boys (0-1 age)
2011 Census[11]		 Girls (0-1 age)
2011 Census[11]		 Sex ratio
(Boys per
100 girls)
National 10,633,298 9,677,936 109.9
Jammu & Kashmir 154,761 120,551 128.4
Haryana 254,326 212,408 119.7
Punjab 226,929 193,021 117.6
Uttarakhand 92,117 80,649 114.2
Delhi 135,801 118,896 114.2
Maharashtra 946,095 829,465 114.1
Lakshadweep 593 522 114.0
Rajasthan 722,108 635,198 113.7
Gujarat 510,124 450,743 113.2
Uttar Pradesh 1,844,947 1,655,612 111.4
Chandigarh 8,283 7,449 111.2
Daman & Diu 1,675 1,508 111.1
Bihar 1,057,050 957,907 110.3
Himachal Pradesh 53,261 48,574 109.6
Madhya Pradesh 733,148 677,139 108.3
Goa 9,868 9,171 107.6
Jharkhand 323,923 301,266 107.5
Manipur 22,852 21,326 107.2
Andhra Pradesh 626,538 588,309 106.5
Tamil Nadu 518,251 486,720 106.5
Odisha 345,960 324,949 106.5
Dadra & Nagar Haveli 3,181 3,013 105.6
West Bengal 658,033 624,760 105.0
Karnataka 478,346 455,299 105.1
Assam 280,888 267,962 104.8
Nagaland 17,103 16,361 104.5
Sikkim 3,905 3,744 104.3
Chhattisgarh 253,745 244,497 103.8
Tripura 28,650 27,625 103.7
Meghalaya 41,353 39,940 103.5
Arunachal Pradesh 11,799 11,430 103.2
Andaman & Nicobar Islands 2,727 2,651 102.9
Kerala 243,852 238,489 102.2
Puducherry 9,089 8,900 102.1
Mizoram 12,017 11,882 101.1

Analysis of data

High sex ratio as abnormal

One school of scholars suggest that any birth sex ratio of boys to girls that is outside of the normal 105-107 range, necessarily implies sex-selective abortion. These scholars[12] claim that both the sex ratio at birth and the population sex ratio are remarkably constant in human populations. Significant deviations in birth sex ratios from the normal range can only be explained by manipulation, that is sex-selective abortion.[13] In a widely cited article,[14] Amartya Sen compared the birth sex ratio in Europe (106) and United States (105) with those in Asia (107+) and argued that the high sex ratios in East Asia, West Asia and South Asia may be due to excessive female mortality. Sen pointed to research that had shown that if men and women receive similar nutritional and medical attention and good health care then females have better survival rates, and it is the male which is the genetically fragile sex.[15] Sen estimated 'missing women' from extra women who would have survived in Asia if it had the same ratio of women to men as Europe and United States. According to Sen, the high birth sex ratio over decades, implies a female shortfall of 11% in Asia, or over 100 million women as missing from the 3 billion combined population of India, other South Asian countries, West Asia, North Africa and China.

High sex ratio as normal

Other scholars question whether birth sex ratio outside 103-107 can be due to natural reasons. William James and others[7][16] suggest that conventional assumptions have been:

  • there are equal numbers of X and Y chromosomes in mammalian sperms
  • X and Y stand equal chance of achieving conception
  • therefore equal number of male and female zygotes are formed, and that
  • therefore any variation of sex ratio at birth is due to sex selection between conception and birth.

James cautions that available scientific evidence stands against the above assumptions and conclusions. He reports that there is an excess of males at birth in almost all human populations, and the natural sex ratio at birth is usually between 102 to 108. However the ratio may deviate significantly from this range for natural reasons such as early marriage and fertility, teenage mothers, average maternal age at birth, paternal age, age gap between father and mother, late births, ethnicity, social and economic stress, warfare, environmental and harmonal effects.[7][17] This school of scholars support their alternate hypothesis with historical data when modern sex-selection technologies were unavailable, as well as birth sex ratio in sub-regions, and various ethnic groups of developed economies.[18][19] They suggest that direct abortion data should be collected and studied, instead of drawing conclusions indirectly from human sex ratio at birth.

James hypothesis is supported by historical birth sex ratio data before technologies for ultrasonographic sex-screening were discovered and commercialized in 1960s and 1970s, as well by reverse abnormal sex ratios currently observed in Africa. Michel Garenne reports that many African nations have, over decades, witnessed birth sex ratios below 100, that is more girls are born than boys.[20] Angola, Botswana and Namibia have reported birth sex ratios between 94 to 99, which is quite different than the presumed 104 to 106 as natural human birth sex ratio.[21] South Korea's historical records suggest a birth sex ratio of 1.13, based on 5 million births, in 1920s over a 10 year period.[22] Other historical records from Asia too support James hypothesis. For example, Jiang et al. claim that the birth sex ratio in China was 116–121 over a 100 year period in late 18th and early 19th century; in the 120–123 range in early 20th century; falling to 112 in the 1930s.[23][24]

Origin

Male to female sex ratio for India, based on its official census data, from 1941 through 2011. The data suggests the existence of high sex ratios before and after the arrival of ultrasound-based prenatal care and sex screening technologies in India.

Female foeticide has been linked to the arrival, in the early 1990s, of affordable ultrasound technology and its widespread adoption in India. Obstetric ultrasonography, either transvaginally or transabdominally, checks for various markers of fetal sex. It can be performed at or after week 12 of pregnancy. At this point, 3⁄4 of fetal sexes can be correctly determined, according to a 2001 study.[25] Accuracy for males is approximately 50% and for females almost 100%. When performed after week 13 of pregnancy, ultrasonography gives an accurate result in almost 100% of cases.[25]

Availability

Ultrasound technology arrived in China and India in 1979, but its expansion was slower in India. Ultrasound sex discernment technologies were first introduced in major cities of India in 1980s, its use expanded in India's urban regions in 1990s, and became widespread in 2000s.[26]

Magnitude estimates for female foeticide

Estimates for female foeticide vary by scholar. One group estimates more than 10 million female foetuses may have been illegally aborted in India since 1990s, and 500,000 girls were being lost annually due to female foeticide.[27] MacPherson estimates that 100,000 abortions every year continue to be performed in India solely because the fetus is female.[28]

Reasons for female foeticide

Various theories have been proposed as possible reasons for sex-selective abortion. Culture is favored by some researchers,[29] while some favor disparate gender-biased access to resources.[28] Some demographers question whether sex-selective abortion or infanticide claims are accurate, because underreporting of female births may also explain high sex ratios.[30][31] Natural reasons may also explain some of the abnormal sex ratios.[7][18] Klasen and Wink suggest India and China’s high sex ratios are primarily the result of sex-selective abortion.[13]

Cultural preference

One school of scholars suggest that female foeticide can be seen through history and cultural background. Generally, male babies were preferred because they provided manual labor and success the family lineage. The selective abortion of female fetuses is most common in areas where cultural norms value male children over female children for a variety of social and economic reasons.[32] 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. Female foeticide then, is a continuation in a different form, of a practice of female infanticide or withholding of postnatal health care for girls in certain households.[33] Furthermore, in some cultures sons are expected to take care of their parents in their old age.[34] These factors are complicated by the effect of diseases on child sex ratio, where communicable and noncommunicable diseases affect males and females differently.[33]

Disparate gendered access to resources

Some of the variation in birth sex ratios and implied female foeticide may be due to disparate access to resources. As MacPherson (2007) notes, there can be significant differences in gender violence and access to food, healthcare, immunizations between male and female children. This leads to high infant and childhood mortality among girls, which causes changes in sex ratio.[28]

Disparate, gendered access to resources appears to be strongly linked to socioeconomic status. Specifically, poorer families are sometimes forced to ration food, with daughters typically receiving less priority than sons (Klasen and Wink 2003).[13] However, Klasen’s 2001 study revealed that this practice is less common in the poorest families, but rises dramatically in the slightly less poor families.[13] Klasen and Wink’s 2003 study suggests that this is “related to greater female economic independence and fewer cultural strictures among the poorest sections of the population.” In other words, the poorest families are typically less bound by cultural expectations and norms, and women tend to have more freedom to become family breadwinners out of necessity.[13]

Lopez and Ruzikah (1983) found that, when given the same resources, women tend to outlive men at all stages of life after infancy. However, globally, resources are not always allocated equitably. Thus, some scholars argue that disparities in access to resources such as healthcare, education, and nutrition play at least a small role in the high sex ratios seen in some parts of the world.[13]

Laws and regulations

A sign in an Indian hospital stating that prenatal sex determination is a crime.

India passed its first abortion-related law, the so-called Medical Termination of Pregnancy Act of 1971, making abortion legal in most states, but specified legally acceptable reasons for abortion such as medical risk to mother and rape. The law also established physicians who can legally provide the procedure and the facilities where abortions can be performed, but did not anticipate female foeticide based on technology advances.[35] With increasing availability of sex screening technologies in India through the 1980s in urban India, and claims of its misuse, the Government of India passed the Pre-natal Diagnostic Techniques Act (PNDT) in 1994. This law was further amended into the Pre-Conception and Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) (PCPNDT) Act in 2004 to deter and punish prenatal sex screening and female foeticide. However, there are concerns that PCPNDT Act has been poorly enforced by authorities.[2]

The impact of Indian laws on female foeticide and its enforcement is unclear. United Nations Population Fund and India's National Human Rights Commission, in 2009, asked the Government of India to assess the impact of the law. The Public Health Foundation of India, an premier research organization in its 2010 report, claimed a lack of awareness about the Act in parts of India, inactive role of the Appropriate Authorities, ambiguity among some clinics that offer prenatal care services, and the role of a few medical practitioners in disregarding the law.[10] The Ministry of Health and Family Welfare of India has targeted education and media advertisements to reach clinics and medical professionals to increase awareness. The Indian Medical Association has undertaken efforts to prevent prenatal sex selection by giving its members Beti Bachao (save the daughter) badges during its meetings and conferences.[10][36] However, a recent study by Nandi and Deolalikar (2013) argues that the 1994 PNDT Act may have had a small impact by preventing 106,000 female foeticides over one decade.[37]

According to a 2007 study by MacPherson, prenatal Diagnostic Techniques Act (PCPNDT Act) was highly publicized by NGOs and the government. Many of the ads used depicted abortion as violent, creating fear of abortion itself within the population. The ads focused on the religious and moral shame associated with abortion. MacPherson claims this media campaign was not effective because some perceived this as an attack on their character, leading to many becoming closed off, rather than opening a dialogue about the issue.[28] This emphasis on morality, claims MacPherson, increased fear and shame associated with all abortions, leading to an increase in unsafe abortions in India.[28]

The government of India, in a 2011 report, has begun better educating all stakeholders about its MTP and PCPNDT laws. In its communication campaigns, it is clearing up public misconceptions by emphasizing that sex determination is illegal, but abortion is legal for certain medical conditions in India. The government is also supporting implementation of programs and initiatives that seek to reduce gender discrimination, including media campaign to address the underlying social causes of sex selection.[10][36]

Given the dismal Child Sex Ratio in the country, and the Supreme Court directive of 2003 to State governments to enforce the law banning the use of sex determination technologies, the Ministry set up a National Inspection and Monitoring Committee (NIMC) in October last. Dr. Rattan Chand, Director (PNDT) was made the convenor of the NIMC. The NIMC under the guidance of Dr. Rattan Chand conducted raids in some of the districts in Maharashtra, Punjab, Haryana, Himachal Pradesh, Delhi and Gujarat. In April, it conducted raids on three clinics in Delhi. In its reports sent to the Chief Secretaries of the respective States, the committee observed that the Authorities had failed to monitor or supervise the registered clinics. [38]

Other recent policy initiatives adopted by many states of India, claims Guilmoto,[6] attempt to address the assumed economic disadvantage of girls by offering support to girls and their parents. These policies provide conditional cash transfer and scholarships only available to girls, where payments to a girl and her parents are linked to each stage of her life, such as when she is born, completion of her childhood immunization, her joining school at grade 1, her completing school grades 6, 9 and 12, her marriage past age 21. Some states are offering higher pension benefits to parents who raise one or two girls. Different states of India have been experimenting with various innovations in their girl-driven welfare policies. For example, the state of Delhi adopted a pro-girl policy initiative (locally called Laadli scheme), which initial data suggests may be lowering the birth sex ratio in the state.[6][39]

Response from others

Increasing awareness of the problem has led to multiple campaigns by celebrities and journalists to combat sex-selective abortions. Aamir Khan devoted the first episode "Daughters Are Precious" of his show Satyamev Jayate to raise awareness of this widespread practice, focusing primarily on Western Rajastan, which is known to be one of the areas where this practice is common. Its sex ratio dropped to 883 girls per 1,000 boys in 2011 from 901 girls to 1000 boys in 2001. Rapid response was shown by local government in Rajastan after the airing of this show, showing the effect of media and nationwide awareness on the issue. A vow was made by officials to set up fast-track courts to punish those who practice sex-based abortion. They cancelled the licences of six sonography centres and issued notices to over 20 others.[40]

This has been done on the smaller scale. Cultural intervention has been addressed through theatre. Plays such as 'Pacha Mannu', which is about female infanticide/foeticide, has been produced by a women's theatre group in Tamil Nadu. This play was showing mostly in communities that practice female infanticide/foeticide and has led to a redefinition of a methodology of consciousness raising, opening up varied ways of understanding and subverting cultural expressions.[41]

The Mumbai High Court ruled that prenatal sex determination implied female foeticide. Sex determination violated a woman's right to live and was against India's Constitution.[2]

The Beti Bachao, or Save girls campaign, has been underway in many Indian communities since the early 2000s. The campaign uses the media to raise awareness of the gender disparities creating, and resulting from, sex-selective abortion. Beti Bachao activities include rallies, posters, short videos and television commercials, some of which are sponsored by state and local governments and other organisations. Many celebrities in India have publicly supported the Beti Bachao campaign.[citation needed]

See also

References

  1. ^ "2006 Handbook on Pre-Conception & Pre-Natal Diagnostic Techniques Act, 1998 and rules with Amendments" (PDF). Indian Ministry of Health and Family Welfare. Retrieved 14 June 2015. Female foeticide or sex selective abortion is the elimination of the female foetus in the womb itself {{cite web}}: line feed character in |title= at position 76 (help)
  2. ^ a b c "UNICEF India". UNICEF.
  3. ^ Grech, V; Savona-Ventura, C; Vassallo-Agius, P (2002). "Unexplained differences in sex ratios at birth in Europe and North America". BMJ (Clinical research ed.). 324 (7344). BMJ, NCBI/National Institutes of Health: 1010–1. doi:10.1136/bmj.324.7344.1010. PMC 102777. PMID 11976243.
  4. ^ India at Glance - Population Census 2011 - Final Census of India, Government of India (2013)
  5. ^ a b c Child Sex Ratio in India C Chandramouli, Registrar General & Census Commissioner, India (2011)
  6. ^ a b c Christophe Z Guilmoto, Sex imbalances at birth Trends, consequences and policy implications United Nations Population Fund, Hanoi (October 2011)
  7. ^ a b c d James W.H. (July 2008). "Hypothesis:Evidence that Mammalian Sex Ratios at birth are partially controlled by parental hormonal levels around the time of conception". Journal of Endocrinology. 198 (1): 3–15. doi:10.1677/JOE-07-0446. PMID 18577567.
  8. ^ Age Data C13 Table (India/States/UTs ) Final Population - 2011 Census of India, Ministry of Home Affairs, Government of India (2013)
  9. ^ a b Child Sex Ratio 2001 versus 2011 Census of India, Government of India (2013)
  10. ^ a b c d IMPLEMENTATION OF THE PCPNDT ACT IN INDIA - Perspectives and Challenges Public Health Foundation of India, Supported by United Nations FPA (2010)
  11. ^ a b c Age Data - Single Year Age Data - C13 Table (India/States/UTs ) Population Enumeration Data (Final Population) - 2011, Census of India, Ministry of Home Affairs, Government of India
  12. ^ Therese Hesketh and Zhu Wei Xing, Abnormal sex ratios in human populations: Causes and consequences, PNAS, September 5, 2006, vol. 103, no. 36, pp 13271-13275
  13. ^ a b c d e f Klausen, Stephan and Claudia Wink. "Missing Women: Revisiting the Debate" Feminist Economics 9 (2003): 263-299.
  14. ^ Sen, Amartya (1990), More than 100 million women are missing, New York Review of Books, 20 December, pp. 61–66
  15. ^ Kraemer, Sebastian. "The Fragile Male." British Medical Journal (2000): n. pag. British Medical Journal. Web. 20 Oct. 2013.
  16. ^ see:
  17. ^ JAN GRAFFELMAN and ROLF F. HOEKSTRA, A Statistical Analysis of the Effect of Warfare on the Human Secondary Sex Ratio, Human Biology, Vol. 72, No. 3 (June 2000), pp. 433-445
  18. ^ a b R. Jacobsen, H. Møller and A. Mouritsen, Natural variation in the human sex ratio, Hum. Reprod. (1999) 14 (12), pp 3120-3125
  19. ^ T Vartiainen, L Kartovaara, and J Tuomisto (1999). "Environmental chemicals and changes in sex ratio: analysis over 250 years in finland". Environmental Health Perspectives. 107 (10): 813–815. doi:10.1289/ehp.99107813. PMC 1566625. PMID 10504147.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  20. ^ Michel Garenne, Southern African Journal of Demography, Vol. 9, No. 1 (June 2004), pp. 91-96
  21. ^ Michel Garenne, Southern African Journal of Demography, Vol. 9, No. 1 (June 2004), page 95
  22. ^ Ciocco, A. (1938), Variations in the ratio at birth in USA, Human Biology, 10:36–64
  23. ^ Jing-Bao Nei (2011), Non-medical sex-selective abortion in China: ethical and public policy issues in the context of 40 million missing females, British Med Bull 98 (1): 7-20
  24. ^ Jiang B, Li S. Nüxing Queshi yu Shehui Anquan (2009), The Female Deficit and the Security of Society, Beijing: Social Sciences Academic, pp 22-26
  25. ^ a b Mazza V, Falcinelli C, Paganelli S; et al. (June 2001). "Sonographic early fetal gender assignment: a longitudinal study in pregnancies after in vitro fertilization". Ultrasound Obstet Gynecol. 17 (6): 513–6. doi:10.1046/j.1469-0705.2001.00421.x. PMID 11422974.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  26. ^ Mevlude Akbulut-Yuksel and Daniel Rosenblum (January 2012), The Indian Ultrasound Paradox, IZA DP No. 6273, Forschungsinstitut zur Zukunft der Arbeit, Bonn, Germany
  27. ^ "BBC NEWS - South Asia - India 'loses 10m female births'". bbc.co.uk.
  28. ^ a b c d e MacPherson, Yvonne (November 2007). "Images and Icons: Harnessing the Power of Media to Reduce Sex-Selective Abortion in India". Gender and Development. 15 (2): 413–23. doi:10.1080/13552070701630574.
  29. ^ 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
  30. ^ 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.
  31. ^ 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.
  32. ^ Goodkind, Daniel (1999). "Should Prenatal Sex Selection be Restricted?: Ethical Questions and Their Implications for Research and Policy". Population Studies 53 (1): 49–61
  33. ^ a b Das Gupta, Monica, "Explaining Asia's Missing Women": A New Look at the Data", 2005 Cite error: The named reference "Gupta_2005" was defined multiple times with different content (see the help page).
  34. ^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1016/j.evolhumbehav.2007.01.004, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1016/j.evolhumbehav.2007.01.004 instead.
  35. ^ "Medical Termination of Pregnancy Act 1971 - Introduction." Health News RSS. Med India, n.d. Web. 20 Oct. 2013.
  36. ^ a b MTP and PCPNDT Initiatives Report Government of India (2011)
  37. ^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1016/j.jdeveco.2013.02.007, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1016/j.jdeveco.2013.02.007 instead.
  38. ^ Small gain for the girl child Front Line)
  39. ^ Delhi Laadli scheme 2008 Government of Delhi, India
  40. ^ Helen Pidd. "Indian campaign confronts prevalence of female foeticide". the Guardian.
  41. ^ A. Mangai, "Cultural Intervention through Theatre: Case Study of a Play on Female Infanticide/Foeticide," Economic and Political Weekly, Vol. 33, No. 44 (Oct. 31 - Nov. 6, 1998), pp. WS70-WS72 http://www.jstor.org/stable/4407327
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