India Steps Up Effort to Halt Abortions of Female Fetuses

October 26, 2003

FATEHGARH SAHIB, India - India's "son complex" is visible
in this prosperous market town on the rich plains of the
Punjab. Girls, by the thousands, are missing.

For the last 20 years, local parents in search of a son, a
prize in Indian culture, have taken advantage of a mixture
of technology and tradition to bear their child of choice.
They have used ultrasound machines to determine the sex of
the fetus growing in the mother's womb. If the fetus is
male, the parents keep it, census figures suggest. If it is
female, they often abort it.

J. K. Banthia, the Indian census commissioner, estimates
that several million fetuses have been aborted in India in
the last two decades because they were female.

Interpreting census figures of the last century showing
widening divergences in the ratio of females to males, he
estimates that as many as 25 million female fetuses and
babies have been killed before, during or after birth in

In 1996 India banned the use of ultrasound machines for sex
determination. But the government only began to take broad
action after the 2001 census figures appeared. They showed
927 girls for every 1,000 boys under age 6, a precipitous
decline from 962 girls 20 years earlier.

Since the latest census, some states have mounted
stepped-up enforcement campaigns that include public
education, inspections and edicts from religious leaders.
But Mr. Banthia, the Indian census commissioner, said he
believed that the government had only slowed the spread of
the practice. "I wouldn't say it has decreased," he said.

The greatest disparity exists in this prosperous
agricultural district of 500,000 people in northern India,
where middle-class farmers work fertile land reminiscent of
the American Great Plains. This district had only 754 girls
for every 1,000 boys.

"The people in this part of the country, they prefer boys,"
said Benjamin Mathew, the principal of a private school
here that has 473 boys and 292 girls, a ratio that also
reflects families' unwillingness to pay for a girl's

Abortion is legal in India, but it is illegal to abort a
fetus because of its sex, and so the determination tests
are banned.

The country's health minister, Sushma Swaraj, recently
proposed that the government begin an advertising campaign
warning that there would not be enough women for men to
marry if the trend continued, a situation that some say
already exists here in northern India.

Officials are also considering paying families a supplement
if they have a girl.

Public health officials say that in the last two years they
have registered 21,072 ultrasound machines, which are legal
as long as they are not used to determine the sex of the
fetus. The authorities have seized 199 of the machines and
charged 405 doctors with performing illegal tests. No
figure was available for the number of doctors convicted.
Pregnant women who seek tests are generally not charged.

Health officials say they have some signs of success.
Sprawling billboards and splashy newspaper advertisements
that once openly offered sex determination ultrasound tests
and mysterious preconception sex determination techniques
have mostly disappeared here. Some gynecologists, who value
their medical licenses as well as their images, are
declining to perform sex determination tests.

"The people who are good guys, they have actually stopped,"
said Dr. Mira Shiva, director of women's health and
development for the Voluntary Health Association of India,
a nonprofit group that has campaigned against the practice.
"They don't want to ruin their reputation."

Both economic and cultural forces drive the desire for
boys, public health officials said.

In the traditional South Asian family, a son is expected to
live with his parents, earn an income, inherit property,
care for his forebears in their old age and light their
funeral pyre.

When a daughter marries, the bride's family pays the
bridegroom's family a dowry and she moves in with her
husband's family, leaving her parents with nothing or even
a debt.

Baidyanath Sahu, a 37-year-old bicycle rickshaw driver in
the city of Chandigarh, said he wanted sons. "He earns for
the family," he said. "The daughter wouldn't earn

Dr. Baljit Singh Dahiya, the director general of health
services in the state of Haryana, said it would take
decades to change time-honored attitudes that led to some
mothers being demeaned if they failed to bear boys.

New television and radio advertising campaigns in Haryana,
Punjab and other states are trying to change attitudes,
declaring "daughters are our pride" and "female feticide is

"We are just putting drops in the ocean," Dr. Dahiya said.
"That's how huge the problem is."

On a recent morning, two of Dr. Dahiya's inspectors drove
to Ambala, a city of 350,000 in the northern state of
Haryana to show off new tactics they are using to stop the
sex tests. Haryana has the second most extreme ratio of
girls to boys of any state in India, with 820 girls for
every 1,000 boys under 6. Neighboring Punjab state has the
worst, with 793 girls for every 1,000 boys.

Both states are among the most prosperous in the nation.
New Delhi, the Indian capital, also has a low rate, with
865 girls for every 1,000 boys.

Public health officials in Ambala told the inspectors, Dr.
Gulshan Saluja and Girbhari Singal, that three women had
asked for sex tests in a government hospital that morning.

The inspectors decided that after telling the women that
the tests were illegal, they would ask the three to serve
as decoys. A health department driver would pose as a
husband, and together, they would ask a local clinic for
the test.

Almost immediately, the plan unraveled. Two of the women
refused to cooperate. The driver got cold feet. In the end,
Paramjeet Singh, a 30-year-old maid, went into the clinic
alone. "I asked for the sex of the baby," Ms. Singh said
after having an ultrasound performed. "She didn't reveal

Public health officials say that may indicate how
practitioners have become increasingly shrewd.

In some areas, doctors perform the test only if the patient
is accompanied by an agent the physician knows. In others,
officials say, they use hand signals, like a "V for
victory" sign, or code words, like the name of a candy, to
indicate a boy.

Some expensive fertility clinics will even implant male
embryos instead of female ones if asked, public health
officials said.

In India, middle-class women who already have one or two
daughters are among the most likely to abort, officials
said. Eager for a small family, like many Indians today,
they have the resources for the test and an abortion, which
together cost up to $200. India's average annual per capita
income is $450.

Doctors, meanwhile, complain that the campaign against the
testing is overzealous. After the failed raid in Ambala,
inspectors revoked the clinic's ultrasound certificate
because the office did not have a proper referral form for
4 of the 98 ultrasound tests it performed in September.

"All of the doctors are becoming clerks," said Dr. Namrata
Madan, who runs the clinic and who refused to perform the
ultrasound test on the decoy.

Here in Fatehgarh Sahib, the top local health official, Dr.
Parshotam Lal Goel, said he had closed two clinics for
improper recordkeeping, but said he did not use decoys. M.
P. Arora, the district's No. 2 government administrator,
questioned the validity of the census figures showing that
the district had the greatest gender imbalance in the

"There must be some technical error in the figure," Mr.
Arora said.

On a recent afternoon, a young Indian woman working as an
interpreter for The New York Times walked into the Sood
medical clinic on one of Fatehgarh Sahib's main
thoroughfares. She asked about sex determination tests.

Instead of telling her the tests were illegal, a male and
female employee quizzed the young woman about where she was
from and why she was asking. After several minutes of
questioning, the man suggested the young lady return to the
clinic in a few hours.

"Come later," he said. "We can talk later."