Thirty-two year old Sanjana Khurana lives in an upmarket New Delhi neighbourhood known for its leafy lanes, quiet parks and swanky homes. At first glance, her life seems perfect–parties at swish restaurants, a large social circle, frequent holidays abroad, and a husband whose textiles business is flourishing.
But she says despite all this there’s still something missing, and right now it’s all she can think about–she desperately wants a son.
Sanjana, in the third trimester of her second pregnancy, already has a five-year-old daughter, Anya. But she says that as adorable as her daughter is, she still can’t escape the enormous social pressure she feels under to have a son this time around.
‘I can’t sleep at night because I keep battling the fear that I’ll have another girl,’ she says. ‘I dread going to family events because this is all my relatives can talk about. They tell me to be prepared in case we’re not blessed with a boy. My in-laws love my daughter but not in the way they love their other grandson. They tell me I don’t know what having a son means because I don’t have one.What if I never do?”
Sanjana, who holds a master’s in fine arts from a prestigious Indian university, is leaving as little to chance as possible this time, and has commissioned a priest to perform elaborate rituals to appease the gods in the hopes that they will bless her with a son.
But such divine blessings, reflected in the popular Sanskrit invocation ‘Sau Putra Vati Bhava’ (May you be the mother of a hundred sons) that is showered liberally on new brides and expectant mothers, is proving to be a double-edged sword for India.
Globally, a typical sex ratio at birth (SRB) would be expected to be about 105 male babies per 100 female babies. India, which measures the SRB in reverse, should therefore have about 950 female births per 1,000 male births.
But a census taken in 2001 underscored the consequences of the pressure felt by mothers such as Sanjana–a dramatic distortion of the ratio, with only 927 girls being counted for every 1000 boys aged between 0 and 6. The figure is down from 945 in 1991 and 962 in 1981.
In the north western states of Delhi, Haryana and Punjab, some of India’s most prosperous, the statistics are even more alarming–the 2001 census showed Punjab had only 798 girls per 1000 boys, while Haryana and Delhi had 819 and 868, respectively.
The reason is that in India, sons are viewed as bankable assets, while girls are more often associated with anxiety, expense and subjugation. Having a daughter get married is hugely costly for parents, and there is little these women can do in return. Boys are also seen as a better investment as they don’t need crippling dowries. And in Hinduism, only a male heir can light the parent’s funeral pyre.
These attitudes are not confined to a specific social class, although there is evidence to suggest that more literate, higher socio-economic groups in India are actually more likely to see an abnormal sex ratio. Indeed, other things being equal, female literacy and other positive economic indicators tend to increase the sex ratio gap.
Forty-two-year old Akhila Singh is a good case in point. A lecturer in political science at a government-run university in Lucknow, in the north of the country, Akhila has two daughters, aged 12 and 10. But she says she frequently argues with her husband, who has pushed for them to try for a third child in the hopes they will have a son. She says her husband doesn’t have any brothers and his widowed mother lives with his family. Akhila says he constantly worries about who they will live with in old age.
‘I used to laugh at him, but now I get a little worried about it too,’ she says. ‘What am I able to do for my parents? Will my daughters be as helpless? We’ve decided to try again, though I don’t know if that’s wise.’
She bristles at the question of what she would do if she had another daughter. ‘That won’t happen. God wouldn’t do that to me.’
UNICEF says about 7000 fewer girls per day are born in India than would normally be expected. An oft-quoted study by leading medical journal The Lancet published in 2006 estimated nearly 10 million girls in India have been dealt a death sentence even before they were born since 1985. The overriding cause, the study says, is the practice of using ultrasound technology to determine foetal sex and subsequent selective abortion of female foetuses.
‘This growing imbalance is foremost an issue of medical malpractice,’ says Dr. A L Sharada, Programme Director of Population First, a Mumbai-based non-profit working on population and health issues.
Population First has been running a major communications campaign called Laadli (Beloved Daughter) to try and change public perceptions. ‘India has been a male-centric, patriarchal society for ages, but technology has given people the luxury of choice, something they never had before,’ Sharada says. ‘Since 1984, when ultrasound was first introduced in India, there’s been a sudden fall in ratio figures.’
‘Family planning programmes have put social pressure on parents to have only two kids. These programmes have been very insensitive to the gender issue. So, people want to ensure they at least have one son,’ she adds.
Although the discrepancy has been more acute in urban areas (with the ratio falling from 959 to 906 between 1981 and 2001) than in rural areas (963 to 934 in the same period), anecdotal evidence suggests access to ultrasound is fairly widespread, even in rural areas, thanks to mobile clinics. Even in remote areas, medical practitioners say there is a high level of awareness about foetal sex determination.
Prenatal sex determination has been illegal in India since 1994, when the country passed the Preconception and Prenatal Diagnostic Techniques Act. However, its implementation has been dismal. Through May 2006, 22 of India’s 35 states had not reported a single violation since the act came into force. In 2003, the act was modified to target the medical profession–the ‘supply side’ of the practice of sex selection. But still, little has changed.
Population First has also been tracking the numbers and says that despite there being 2.7 million illegal sex determination tests a year in India, there has been only a single conviction in the past 15 years.
‘The act isn’t implemented stringently because appropriate authorities consider it an additional burden,’ Sharada says. ‘They don’t want to get sucked into a legal tussle. At most, they take a fine and seal the clinics for a short while.’
And she adds: ‘Sex ratio is a low-priority area for our health administrators. They don’t see it as a public health issue. Many are not willing to listen, to understand, to realise the consequences.’
But while some in the medical community admit they should bear at least part of the blame, they caution that focusing on one factor is too simplistic an approach to the problem.
‘Of course many doctors indulge in these practices. And we have a flourishing mid-wives network that will do anything for small sums of money,’ says Dr. Meena Misra, a senior gynaecologist with the government of Uttar Pradesh, India’s most populous state. ‘But, Indian legislation at its core is very pro-abortion. We have a very liberal abortion regime. And, it’s getting easier to abort.’
Meena says that under the Medical Termination of Pregnancy Act 1971, a woman up to 12 weeks pregnant–and in some circumstances up until 20 weeks–can legally opt for abortion under certain conditions. And the Act even includes contraceptive failure as a reason for abortion, allowing people to use it as a last-resort family planning method. ‘Very few countries have such liberal provisions,’ Meena says.
Medicinal abortion is also widespread in India, and the drugs used–Mifepristone, Misoprostol and other prostaglandin medicines–are easily available over the counter. Indian magazines and television networks, meanwhile, regularly run advertisements for a variety of pills and methods for ending unwanted pregnancies.
‘I’m often surprised by the knowledge even village women have of these pills,’ Meena says. ‘They advise each other to take it with little correct information. I’ve seen women aborting seven and even eight month foetuses.’
The long-term impact of selective abortions on future demographics is hard to predict. But, the Lancet study warns India could be heading down the same road as China, where prenatal sex determination has meant about 40 million men are now unable to find spouses.
‘Evidence is already available that there are social adaptations made to cope with the skewed sex ratio in adult ages, especially in the adversely affected north western states,’ says U S Mishra, a population expert at the Centre for Development Studies. ‘People are marrying across regions despite linguistic barriers and in a few instances brothers share a wife.’
A United Nations Population Fund (UNFPA) study in 2007 said even if the sex ratio at birth were to remain at the ‘normal’ level of 950 girls per 1,000 boys until 2030, India is likely to have a female deficit of 25 million by 2030 in the marriageable age group of 20-49. More realistic studies that have factored in a limited and even further decline in the ratio have suggested the deficit could be anywhere between 29 and 34 million.
The potential consequences of such a development were laid bare in a 2005 headline-grabbing Indo-French production, ‘Matrubhoomi – A Nation Without Women.’ The film, selected by Time magazine as one of its 10 movies of the year, follows the story of a young woman married to five brothers.
Mishra says movies like these do help in raising awareness, a valuable soldier in this ongoing battle. But he also adds that societies are often better at coping with imbalances than they are given credit for.
‘There is much apprehension about the consequences of this imbalance. But societal innovations will always be found to cope with such behavioural aberrations–there’s no need for panic,’ Mishra says. ‘In fact, there even might be a positive within this. Regional imbalances may finally bridge inter-regional differences in cultural practices as people are forced to marry outside their caste, creed and languages.’
A report last year by the Washington-based Population Reference Bureau also struck a more upbeat chord, saying the crisis had stabilized and even improved in most states. In Haryana and Punjab, both of which have a particularly low sex ratio, concerted efforts at rebalancing appear to have had some effect–in Punjab, the sex ratio has improved from 775 in 1999-2001 to 808 in 2004-2006, while in Haryana, it rose from 803 to 837 over the same period.
The Laadli campaign has also set itself a tough task in an effort to help raise awareness–a one million signature campaign. Nearly 35,000 people have already signed up, and the governments of Delhi, Haryana and Madhya Pradesh have co-opted the program into their government schemes.
But campaigners warn there is still little to celebrate. ‘In some regions where the sex ratio was abysmally low, there has been a slight correction. But more and more districts that had not displayed these tendencies earlier are now also showing a skewed sex ratio,’ Sharada says. ‘We need to builder stronger associations, to educate more people, to give the girl child a more expanded role in society. We have our work cut out for us.’