India Steps Up Effort to Halt
Abortions of Female Fetuses
October 26, 2003
By DAVID ROHDE
FATEHGARH SAHIB, India - India's "son
complex" is visible
in this prosperous market town on the rich plains of
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
of technology and tradition to bear their child of
They have used ultrasound machines to determine the
the fetus growing in the mother's womb. If the fetus
male, the parents keep it, census figures suggest. If
female, they often abort it.
J. K. Banthia, the Indian census
that several million fetuses have been aborted 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
estimates that as many as 25 million female fetuses
babies have been killed before, during or after birth
In 1996 India banned the use of
ultrasound machines for sex
determination. But the government only began to take
action after the 2001 census figures appeared. They
927 girls for every 1,000 boys under age 6, a
decline from 962 girls 20 years earlier.
Since the latest census, some states
stepped-up enforcement campaigns that include public
education, inspections and edicts from religious
But Mr. Banthia, the Indian census commissioner, said
believed that the government had only slowed the
the practice. "I wouldn't say it has decreased," he
The greatest disparity exists in this
agricultural district of 500,000 people in northern
where middle-class farmers work fertile land
the American Great Plains. This district had only 754
for every 1,000 boys.
"The people in this part of the
country, they prefer boys,"
said Benjamin Mathew, the principal of a private
here that has 473 boys and 292 girls, a ratio that
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
The country's health minister, Sushma
proposed that the government begin an advertising
warning that there would not be enough women for men
marry if the trend continued, a situation that some
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
as long as they are not used to determine the sex of
fetus. The authorities have seized 199 of the
charged 405 doctors with performing illegal tests. No
figure was available for the number of doctors
Pregnant women who seek tests are generally not
Health officials say they have some
signs of success.
Sprawling billboards and splashy newspaper
that once openly offered sex determination ultrasound
and mysterious preconception sex determination
have mostly disappeared here. Some gynecologists, who
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
a nonprofit group that has campaigned against the
"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
care for his forebears in their old age and light
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
Baidyanath Sahu, a 37-year-old
bicycle rickshaw driver in
the city of Chandigarh, said he wanted sons. "He
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
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
declaring "daughters are our pride" and "female
"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
sex tests. Haryana has the second most extreme ratio
girls to boys of any state in India, with 820 girls
every 1,000 boys under 6. Neighboring Punjab state
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,
865 girls for every 1,000 boys.
Public health officials in Ambala
told the inspectors, Dr.
Gulshan Saluja and Girbhari Singal, that three women
asked for sex tests in a government hospital that
The inspectors decided that after
telling the women that
the tests were illegal, they would ask the three to
as decoys. A health department driver would pose as a
husband, and together, they would ask a local clinic
Almost immediately, the plan
unraveled. Two of the women
refused to cooperate. The driver got cold feet. In
Paramjeet Singh, a 30-year-old maid, went into the
alone. "I asked for the sex of the baby," Ms. Singh
after having an ultrasound performed. "She didn't
Public health officials say that may
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
officials say, they use hand signals, like a "V for
victory" sign, or code words, like the name of a
indicate a boy.
Some expensive fertility clinics will
even implant male
embryos instead of female ones if asked, public
In India, middle-class women who
already have one or two
daughters are among the most likely to abort,
said. Eager for a small family, like many Indians
they have the resources for the test and an abortion,
together cost up to $200. India's average annual per
income is $450.
Doctors, meanwhile, complain that the
campaign against the
testing is overzealous. After the failed raid in
inspectors revoked the clinic's ultrasound
because the office did not have a proper referral
4 of the 98 ultrasound tests it performed in
"All of the doctors are becoming
clerks," said Dr. Namrata
Madan, who runs the clinic and who refused to perform
ultrasound test on the decoy.
Here in Fatehgarh Sahib, the top
local health official, Dr.
Parshotam Lal Goel, said he had closed two clinics
improper recordkeeping, but said he did not use
P. Arora, the district's No. 2 government
questioned the validity of the census figures showing
the district had the greatest gender imbalance in the
"There must be some technical error
in the figure," Mr.
On a recent afternoon, a young Indian
woman working as an
interpreter for The New York Times walked into the
medical clinic on one of Fatehgarh Sahib's main
thoroughfares. She asked about sex determination
Instead of telling her the tests were
illegal, a male and
female employee quizzed the young woman about where
from and why she was asking. After several minutes of
questioning, the man suggested the young lady return
clinic in a few hours.
"Come later," he said. "We can talk