Indian sex ratio tilt shows up in US, Canada, debate ultrasound

Toronto, February 6: Not just in Punjab or Haryana and not just about boy versus girl economics - female foeticide seems to travel with some Indian parents. A recent editorial in the Canadian Medical Association Journal (CMAJ) talks of female foeticide via selective abortion in Canada’s Asian immigrant communities, sparking off a debate about the prevalence of this practice among Indians in North America.

The CMAJ editorial, by the journal’s outgoing interim editor-in-chief Rajendra Kale, cited studies to show that female foeticide in Canada and the US occurs in large enough numbers to distort male-female ratios in some immigrant groups, including ethnic Indians and Chinese.

Kale, a physician, recommended that “health care professionals should not reveal the sex of the foetus to any woman before, say, 30 weeks of pregnancy because such information is medically irrelevant and in some instances harmful”. After about 30 weeks, an unquestioned abortion would be “all but impossible”, he pointed out.

A working paper for the US National Bureau of Economic Research in 2009 showed that the sex ratio for first births among Indians in the US was close to the norm of 105 boys for every 100 girls. But the ratio got increasingly skewed for subsequent births if the previous children were girls. In cases where the first 2 children were girls, the sex ratio for third births among Indians was found to be nearly 190 boys for 100 girls.

Another study published last year and led by Sunita Puri, a physician at the University of California in San Francisco, looked at 65 Indian immigrant women in the US who had opted for foetal sex selection between September 2004 and December 2009. The paper found 40% of those women had previously aborted female foetuses, and 89% of women carrying girls during the period of the study went on to abort them. The women came from a diverse range of income and education levels, and from different Indian states.

Kale’s opinion has drawn sharp reactions. A nationwide poll by the agency Angus Reid, conducted after the editorial was published, found that 60% of the Canadians, including two-thirds of women, supported laws governing the use of abortion as a means of sex selection.

But several health care experts, both in Canada and the US, have argued against withholding information from parents. The Society of Obstetricians and Gynaecologists of Canada said that while it does not condone pregnancy termination for non-medical reasons, under Canadian standards of care, “it is the right of the patient to be informed of the gender of their foetus”.

It also pointed out that biochemical testing available in the market now can help determine the sex of a foetus with a high degree of accuracy as early as 8 weeks, right at home, and Kale’s solution would be irrelevant in such instances.

“There should not be any barriers in the way of women being able to access legitimate ultrasound tests,” said Prabhat Jha, Director of the Centre for Global Health Research at the University of Toronto. “The response must be commensurate to the scale of the problem, which I suspect is very small in the US and Canada.”

Jha is the author of a well-known study published in 2006 in The Lancet that estimated that India had lost over 10 million girls to female foeticide in the 2 preceding decades. He estimates that even now about 600,000 female foetuses are aborted in India every year.

According to him, the problem among Indians worldwide is less one of discrimination against girls than the desire to have at least one boy, as studies show parents did not abort their first born children even if they knew it was a girl. But if a family was going to have only 2 children and they already had a girl, they would try to ensure the second child was a boy. “It’s a subtle nuance, but it’s relevant,” said Jha. (Courtesy: IE)