Abstract

ObjectiveSex-ratio at birth in families with previous girls is worse than those with a boy. Our aim was to prospectively study in a large maternal and child unit sex-ratio against previous birth sex and use of traditional medicines for sex selection.Main Outcome MeasuresSex-ratio among mothers in families with a previous girl and in those with a previous boy, prevalence of indigenous medicine use and sex-ratio in those using medicines for sex selection.ResultsOverall there were 806 girls to 1000 boys. The sex-ratio was 720∶1000 if there was one previous girl and 178∶1000 if there were two previous girls. In second children of families with a previous boy 1017 girls were born per 1000 boys. Sex-ratio in those with one previous girl, who were taking traditional medicines for sex selection, was 928∶1000.ConclusionEvidence from the second children clearly shows the sex-ratio is being manipulated by human interventions. More mothers with previous girls tend to use traditional medicines for sex selection, in their subsequent pregnancies. Those taking such medication do not seem to be helped according to expectations. They seem to rely on this method and so are less likely use more definitive methods like sex selective abortions. This is the first such prospective investigation of sex ratio in second children looked at against the sex of previous children. More studies are needed to confirm the findings.

Highlights

  • According to the last census, there are only 933 women for every 1000 men in India [1]

  • Neglect of girls and women resulting in early death [3,4,5], female infanticide [6,7] and more recently, antenatal sex determination and female feticide [8], all contribute to it

  • While the Nobel laureate Amratya Sen believes that the pattern of gender inequality shifted from ‘mortality inequality’ to what he calls ‘natality inequality’ due to female feticide after the facility for antenatal sex determination became available [11,13], others suggest that parents are not substituting pre-natal for post-natal discrimination against girls, but combining the two strategies [14]

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Summary

Introduction

According to the last census, there are only 933 women for every 1000 men in India [1]. Neglect of girls and women resulting in early death [3,4,5], female infanticide [6,7] and more recently, antenatal sex determination and female feticide [8], all contribute to it. While the Nobel laureate Amratya Sen believes that the pattern of gender inequality shifted from ‘mortality inequality’ to what he calls ‘natality inequality’ due to female feticide after the facility for antenatal sex determination became available [11,13], others suggest that parents are not substituting pre-natal for post-natal discrimination against girls, but combining the two strategies [14]. The relative contribution of these modes of discrimination, to the unbalanced sex ratio in India, is still unresolved [15]. It is important to resolve this issue so as to target remedies appropriately, before they threaten the stability and security of society [16]

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