The consequences of son preference

 

Lisanne Denneman

 

Rakhi, married at the age of seventeen, is a young woman living in the Indian state of Rajasthan. Although she was pregnant seven times, she only has one living son. She strangled her first two children right after birth, just because they were girls. Two sons died from child diseases. When she got pregnant again, she aborted the foetuses because they were both female. She says she would do it again, as she hasn’t got the money to pay for a dowry.

Son preference

Already at the beginning of the nineteenth century, the British council discovered that India has an unusually male-predominant population. Throughout history, India has had one of the highest levels of excess child mortality for girls in the world, exceeding child mortality for boys by 43%. For ages gender inequality has been embedded in Indian society. Furthermore, the practice of infanticide - direct killing of an infant shortly after birth - is present in Indian society. Apart from son preference, infanticide is also committed because congenital anomalies or because the mother is unmarried. It is hard to estimate the prevalence of infanticide, as infanticides are often reported as stillbirths or not reported at all.

However, nowadays the main cause of the skewed sex ratio is the application of sex-selective abortions. India is a patriarchal society in which son preference is deeply pervaded. Sons are preferred mainly because of economic reasons: they raise family income and provide financial support to their elderly parents. Moreover, girls are an economic burden because their family is expected to pay a dowry to the family of the groom after which she will belong to the family of her future husband. Besides, social causes play a part as sons provide status and strength to their family. They continue the family line and are the only recipients of inheritance. Finally, some important religious functions can only be performed by sons, like the cremation of deceased parents. In general, women have a low status in most Indian communities, whether Hindu, Sikh or Muslim.  

Sex selective abortions

Although the living conditions for women have been steadily improving over the past decades, new technological developments have offset its potentially stabilizing effect on the sex ratio. The sex ratio fell significantly after 1980, when ultrasound machines for antenatal sex determination became available. This way of determination soon gained popularity due to its non-invasive character, safety and widespread availability. Because abortion had been legalized in 1971, the combination of these techniques soon led to sex-selective abortions. This was promoted by medical doctors, who often considered these early abortions as a prevention of the birth of unwanted children and a method of population control. A lot of Indian families cannot be concerned with ideological objections, as they face the financial consequences of having daughters, especially with regards to the expensive dowries. Health clinics cleverly capitalized on these concerns by advertising with slogans like Pay 500 rupees now, rather than 500 000 later. 

Ultrasound machines are present in even the most remote areas where people do not have access to clean water or electricity. The availability of sex detection methods puts pressure on women to undergo a test, either by family or by dominating social values. Nowadays, one in every seven girls is aborted because of her sex, which means that within five years over a million girls will be eliminated in India annually. 

In reaction to the troubling increase of sex selective abortions, the government of India implemented the Prenatal Diagnostic Techniques (PNDT) Act in 1996. This law prohibits determination of the foetus’ sex and advertising to promote this. However, the Act had little impact on the problem. On the contrary, physicians have continued their practice and doubled their prices, because they now face prosecution. Besides, sex-selection is now being done in a clandestine way, which has caused an increase in unhygienic procedures and in unsafe abortions resulting in at least 20 000 abortion-related deaths each year.  

Unethical medical practice

The question remains what can be done against the practice of sex-selective abortions. Besides measures that limit the possibility of performing antenatal sex determination, including more strict enforcement of the PNDT Act, it is essential that they change their indifferent attitude towards prenatal sex determination and gender inequality. The abuse of ultrasound diagnostics wouldn’t exist without the cooperation of doctors, who now consciously violate human rights (i.e., the right to life). Ethical medical practice is of vital importance to enforce the Act and will promote gender equality. 

Anyhow, treatment should be focused on the disease rather than on the symptoms. As discussed earlier, for a lot of Indian families practical reality overshadows ethical concerns regarding feticide. By pushing back financial obstacles, parents will be able to choose to have daughters as well. However, the scope of the possible effect of this kind of measures is limited. Is India able to change its social attitude towards women resulting in son preference, thus improving the age old devalued status of daughters? After all, the only really constructive antidote against son preference is raising the status of women in patriarchal India by guaranteeing them equal rights to men.

 

 

About the author

Lisanne Denneman is a third year medical student in Amsterdam. Currently she is enrolled in the minor International Development Studies.

Further reading

• Guilmoto, C. 2007. Characteristics of sex ratio imbalance in India and future scenarios. In: UNFPA, 4th Asia Pacific Conference on Reproductive and Sexual Health and Rights. Hyderabad, India. October 29-31, 2007. United Nations: New York. 
• Sharma BR, Gupta N & Relhan N. 2007. Misuse of prenatal diagnostic technology for sex-selected abortions and its consequences in India. Public Health 121(11):854-60.

References

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12. Sharma BR, Gupta N & Relhan N. 2007. Misuse of prenatal diagnostic technology for sex-selected abortions and its consequences in India. Public Health 121(11):854-60
13. Walia, A. 2005. Female Foeticide In Punjab: Exploring the socio-economic and cultural dimensions. IDEA: A journal of social issues 10 (1)

 

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