Intended for healthcare professionals

Feature Fetal sex determination

India’s problem with girls

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4149 (Published 29 August 2013) Cite this as: BMJ 2013;347:f4149
  1. Dinsa Sachan, freelance journalist, New Delhi
  1. dinsasachan{at}gmail.com

A study has found that the ratio of boy to girl babies is higher in wealthy families than in poorer ones. Dinsa Sachan considers the implications of a surplus of boys and how this is being tackled

Between 2001 and 2011, census data show that female literacy rose 12% in India—but that the number of girls born for every 1000 boys dipped from 927 to 914.1 2 A study published in May 2013 in the Journal of Epidemiology and Community Health confirms what others have shown in the past few years: better education and socioeconomic status are associated with the births of proportionally fewer girls.

Researchers at the All India Institute of Medical Sciences, led by Anand Krishnan, additional professor of community medicine at the institute, studied data on 12 517 children born between January 2006 and December 2011 in the Ballabgarh block of Faridabad district in Haryana, a state that ranks high in imbalance between the sexes.3

They found that the ratio of girls to boys born tended to be lower, and that neonatal death rates tended to be greater for girls than boys, in families with higher socioeconomic status or with more educated parents. The sex ratio at birth was 745 girls for every 1000 boys born to the group with the most literate parents; the group with the least literate parents had a sex ratio of 886 girls for every 1000 boys.

Cocktail of factors

Sex determination technology is readily available to parents with higher socioeconomic status, Krishnan told the BMJ. “The poor, especially in rural areas, do not have means to afford expensive ultrasound techniques,” he said.

Some experts including Krishnan have said that India’s family planning programme might encourage sex selective abortion. The sex ratios of second born babies support this hypothesis. A 2011 study in …

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