Female Feticide

1. SEX SELECTION: IMPLICATIONS & CURRENT STATUS Lt Col A S Kushwaha Dept of Community Medicine 3/7/2011 1 Lt Col A S Kushwaha

2. NATURE Statistically speaking, there are 51 boys born for every 49 girls. For every 100 females about 104-106 boys are expected. 3/7/2011 2 Lt Col A S Kushwaha

3. HUMAN: MALE BABY OBSESSION 330 BC, Aristotle – Tying left testicle Chinese conception chart Wheelan method- timing of intercourse Shettles Method – position Urban Legends – diet, drugs, age 3/7/2011 3 Lt Col A S Kushwaha

4. Urban Legends Change your diet to include lots of red meat, salty snacks, and cola soft drinks. Legend says if the man climaxes first, you'll conceive a baby boy. Schedule your lovemaking sessions for odd numbered days of the month. Have sex at night, preferably when there's a quarter moon in the sky. Have as much sex as possible, since many people believe more boys are conceived during the "honeymoon" phase of a relationship. Have the man drink coffee before sex, since this causes the sperm with Y chromosomes to become more active. 3/7/2011 4 Lt Col A S Kushwaha

5. Yatra naryestu pujjyante , ramante tatra devata ’  - Ancient Indian scriptures Having a daughter is like watering a flower in the neighbour's garden . Tamil proverb ( In Kannada : ‘ maga manege ; magalu pararige ’ ) ‘Having a daughter is a punishment for the sins committed in previous life’. - According to one dalit women, 3/7/2011 5 Lt Col A S Kushwaha

6. "The unholy alliance between tradition (son-complex) and technology is playing havoc with Indian Society” The Technologies cloning genetic screening sex selection artificial placentas gene therapy post-menopausal motherhood GOOD BAD UGLY 3/7/2011 Lt Col A S Kushwaha

7. TECHNODOCS OPINION providers of NRTs 64% - against sex selective abortions, 10 % - of them stated that too were against it but they had to do it, 24% - approved of sex selective abortions . A  CEHAT  study 3/7/2011 Lt Col A S Kushwaha

8. July 23, 2007 In a shocking discovery, the Orissa police recovered as many as 30 polythene bags stuffed with female fetuses and the body parts of new-born babies from a dry well near a private clinic in Nayagarh , close to Bhubaneswar . Police have arrested the manager of the clinic. 3/7/2011 8 Lt Col A S Kushwaha

9. , ‘Had these clinics were available 30 years ago, many of us would never have seen this world!’ As narrated by a literate woman in Village M 3/7/2011 9 Lt Col A S Kushwaha

10. SEX SELECTION What is it? How it is done? Where? Why? How we can measure? Current status? What will it lead to? What we can do? 3/7/2011 10 Lt Col A S Kushwaha

11. What is sex selection? Human sex selection is the attempt to control the sex of the offspring to achieve a desired sex . 3/7/2011 11 Lt Col A S Kushwaha

12. METHODS OF SEX SELECTION PRE-IMPLANTATION Sperm sorting - by flow cytometry . Pre-implantation genetic diagnosis (PGD) POST-IMPLANTATION Prenatal diagnosis & sex-selective abortion (Double illegality) 3/7/2011 12 Lt Col A S Kushwaha

13. POST-BIRTH Sex-selective infanticide Sex-selective child abandonment Sex-selective adoption Differential stopping behaviour 3/7/2011 13 Lt Col A S Kushwaha

14. SEX SELECTION What is it? How it is done? Where? Why? Current status? How we can measure? What will it lead to? What we can do? 3/7/2011 14 Lt Col A S Kushwaha

15. WHERE? Globally SEAR countries -China India Punjab, Haryana, Delhi 3/7/2011 15 Lt Col A S Kushwaha

16. WHERE? Poor - Rich Illiterate - Educated Rural - Urban Orthodox families - Modern BIMARU states – DEMARU states 3/7/2011 16 Lt Col A S Kushwaha

17. SEX SELECTION What is it? How it is done? Where? Why? How we can measure? Current status? What will it lead to? What we can do? 3/7/2011 17 Lt Col A S Kushwaha

18. WHY? SOCIAL DEMOGRAPHIC COMMERCIAL LOGISTIC 3/7/2011 18 Lt Col A S Kushwaha

19. SOCIAL Women empowerment Expression of reproductive rights Minimize violence against women Conserve property of family 3/7/2011 19 Lt Col A S Kushwaha

20. Son Preference and Daughter Aversion Economic progress has not necessarily changed the traditions of gender discrimination - dowry family name property last rites old-age support Patrilocal Patrilineage Patriarchal 3/7/2011 20 Lt Col A S Kushwaha

21. SOCIAL ATTITUDES 3/7/2011 21 Lt Col A S Kushwaha

22. SOCIAL PERCEPTIONS 3/7/2011 22 Lt Col A S Kushwaha

23. WHY? SOCIAL DEMOGRAPHIC COMMERCIAL LOGISTIC 3/7/2011 23 Lt Col A S Kushwaha

24. DEMOGRAPHIC Family balancing Prevented occurrences of unintended pregnancy and abortion, Population stabilization- TFR & NRR Small family Norm 3/7/2011 24 Lt Col A S Kushwaha

25. WHY? SOCIAL DEMOGRAPHIC COMMERCIAL LOGISTIC 3/7/2011 25 Lt Col A S Kushwaha

26. SEX SELECTION & SEX SELECTIVE ABORTION Rs . 1,000 crore industry (US$ 244 million) Easy & Quick money 3/7/2011 26 Lt Col A S Kushwaha

27. WHY? SOCIAL DEMOGRAPHIC COMMERCIAL LOGISTIC 3/7/2011 27 Lt Col A S Kushwaha

28. LOGISTIC /ADMINISTRATIVE Easy access to medical facilities Ability to pay the doctor and abortionist for the test and abortion A good network of roads to cut down the cost and time of travel Unholy alliance of traditional thoughts as reflected in the ‘son complex’ and easily available technological advances for sex-determination in utero 3/7/2011 28 Lt Col A S Kushwaha

29. SEX SELECTION What is it? How it is done? Where? Why? How we can measure? Current status What will it lead to? What we can do? 3/7/2011 29 Lt Col A S Kushwaha

30. MEASUREMENTS M:F Sex Ratio Sex Ratio at Birth Child Sex Ratio (0-6 Yrs) Abortion rate & facilities Sex-selective abortion, Differential foetal mortality, Unreported female infanticide Excess female mortality Index of Son preference =100 (E/C) (Where, E =the excess number of sons over daughters considered ideal) 3/7/2011 30 Lt Col A S Kushwaha

31. SEX RATIO Overall sex ratio Trend of sex ratio SRB (Sex Ratio at Birth) CSR (Child sex ratio) Females/1000 males (Female deficit) e.g. SR of 933/1000 Males/100 females (Male surplus) = 107/100 3/7/2011 31 Lt Col A S Kushwaha

32. SEX SELECTION What is it? How it is done? Where? Why? How we can measure? Current status What will it lead to? What we can do? 3/7/2011 32 Lt Col A S Kushwaha

33. CURRENT STATUS ECONOMIST - “Where are the 100 million missing women?” - Amartya Sen Sen A. Development as Freedom. New York: Anchor Books; 1999 3/7/2011 33 Lt Col A S Kushwaha

34. MTP ACT 1971 Law that turned against females for whom it was designed. MTP Act + USG = Sex selective abortion PNDT Act 1994 PCPNDT 2003 3/7/2011 34 Lt Col A S Kushwaha

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36. SEX RATIO Country Sex Ratio India 933 China 944 USA 1029 Indonesia 1004 Brazil 1025 Pakistan 938 Bangladesh 951 Japan 1041 Russian Fed. 1140 Source:World Pop. Prospects, mid year estimates, 1998 3/7/2011 36 Lt Col A S Kushwaha

37. Sex Ratio: India Year No. of Females 1901 972 1911 964 1921 955 1931 950 1941 945 1951 946 1961 941 1971 930 1981 934 1991 927 2001 933 3/7/2011 37 Lt Col A S Kushwaha

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40. Child Sex Ratio Census Total Rural Urban 1981 962 963 931 1991 945 948 935 2001 927 934 903 SRB/ 2003 883 888 866 3/7/2011 40 Lt Col A S Kushwaha

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42. INDIA CHILD SEX RATIO IN AGE GROUP 0-6 1991 2001 3/7/2011 42 Lt Col A S Kushwaha

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46. Excess Female Mortality OR 3/7/2011 46 Lt Col A S Kushwaha OR

47. CURRENT STATUS Since 1991, 80% of districts in India have recorded a declining sex ratio New Delhi , Punjab, Haryana and Uttar Pradesh. have recorded a more than 50 point decline in the child sex ratio in 10 years . CSR in Punjab stood at a mere 775 females per 1000 males . India - deficit of 3.5 crore women when it entered the new millennium. 3/7/2011 47 Lt Col A S Kushwaha

48. STATUS REPORT 2002-2003- every ninth household in the state acknowledged sex selective abortion. (According to the Chandigarh-based Institute for Development and Communication ) More than 100,000 sex-selective abortions in India every year (Arnold et al. 2002). 3/7/2011 Lt Col A S Kushwaha

49. Money –Sex selective abortion link CSR WEALTH 3/7/2011 Lt Col A S Kushwaha

50. PROVING THE NEXUS Sex selective abortion & USG The evidence of substantial sex-selective abortion in states such as Punjab, Haryana, Delhi, and Maharashtra is consistent with the high rates of use of ultrasound and amniocentesis ( Retherford and Roy 2003). 3/7/2011 50 Lt Col A S Kushwaha

51. Pregnancies with an Ultrasound Percent of pregnancies in the past 5 years Residence Wealth Index Education WHO GOES FOR USG 3/7/2011 Lt Col A S Kushwaha

52. USG & PREGNANCY Undergone USG :20.1% Who asked :Doctor (53.2%) Where :Govt. facility (52 %) :Private (20%) Why Abnormality :2.6 % Fetal position :15.6 % Age 35+ : 6.5 % Sex Determination : 26 % 3/7/2011 52 Lt Col A S Kushwaha

53. ARE ULTRASOUNDS BEING CONDUCTED FOR SEX-SELECTION? There is evidence of sex selection, when the sex ratio at birth deviates from the normal of about 960-970 girls per 1,000 boys Thus, the question can be answered by examining the sex ratio at birth for births that result after a pregnancy with an ultrasound 3/7/2011 53 Lt Col A S Kushwaha

54. USG- SEX RATIO LINK NO USG USG 100 3/7/2011 54 Lt Col A S Kushwaha

55. Are ultrasounds being conducted for sex-selection? Girls per 1,000 boys born in the past 5 years (for pregnancies with an ultrasound) 1 child 3 children 2 children 3/7/2011 Lt Col A S Kushwaha

56. IMPLICATIONS 3/7/2011 56 Lt Col A S Kushwaha

57. Implications By 2020 there could be more than 35 million young "surplus males" in China and 25 million in India. Resurgence of practices such as polyandry, infanticide? Trafficking ? Violence against women and girls 3/7/2011 57 Lt Col A S Kushwaha

58. The ‘shortage’ of women does not lead to their increased value, but to greater restrictions and control placed over them. 3/7/2011 58 Lt Col A S Kushwaha

59. Ethical Concerns –designer babies Demographic concerns – gender imbalance Legal concerns -Of the 36 countries with laws or policies on sex selection: 0 explicitly permit it 5 prohibit sex selection for any reason China India Israel New Zealand UK 31 prohibit it for social or “non-medical” reasons 3/7/2011 59 Lt Col A S Kushwaha

60. SATA PRATHA JAISALMER/JAIPUR: Padam Mali (30) is unable to find a suitable bride for himself neither from his own caste nor from others. The reason: his sister is a minor and therefore, not yet ready for marriage. It may sound far-fetched, but the skewed sex ratio in the desert district of Jaisalmer has led to parents marrying off their daughters in families from where they can get a bride for their son.   3/7/2011 60 Lt Col A S Kushwaha

61. A Silent National Emergency 3/7/2011 61 Lt Col A S Kushwaha

62. Sex selection is a key social issue Rooted in patriarchal value of son preference Indicative of a gender divide in society which is not in tune with the development aspirations of the country Also responsible for the demographic divide in the country as it encourages large families in anticipation of an elusive son 3/7/2011 62 Lt Col A S Kushwaha

63. It is time to bring in a social movement Falling sex ratio should be declared a national emergency and adequate resources should be allocated for the same . It is also important to build a national consensus on the issue and mobilize all the stakeholders to stop the practice of sex selection 3/7/2011 63 Lt Col A S Kushwaha

64. In 1995, the Fourth World Women’s Congress passed the Declaration of Beijing, and Action Plan, which have become major principles for promoting gender equality internationally 3/7/2011 64 Lt Col A S Kushwaha

65. It is time ---- to change the perceptions and values to create a positive image of the girl child 3/7/2011 65 Lt Col A S Kushwaha

66. GOVT INITIATIVES National Support & Monitoring Cell Inspection Committee – visits Computerization of the records Community awareness – IEC campaign Training modules Medical curriculum Sex ratio indicators – RCH/NRHM 3/7/2011 Lt Col A S Kushwaha 66

67. ELEVENTH PLAN Develop targets & indicators- SRB, CSR Target: CSR 0-6 Yrs to 935 by 2011-12 and 950 by 2016-17 Gender budgeting in health Resource transfers Data for tracking PHC level enumeration – routine Independent auth at district level 3/7/2011 Lt Col A S Kushwaha 67

68. Sex Selection Never… Commit Condone or Remain silent 3/7/2011 68 Lt Col A S Kushwaha

69. 3/7/2011 69 Campaign Against Sex Selective Abortions DOWN WITH DISCRIMINATION SAY “NO” to FEMALE EXTERMINATION Eliminate Inequality, not Women”. “Destroy Dowry, not Daughters”. Daughters are not for slaughter. Say “NO” to Sex Determination Say “YES” to Gender Justice

70. "A son is a son till he takes a wife A daughter's a daughter the rest of her life." 3/7/2011 70 Lt Col A S Kushwaha

71. Women Achievers ????? MANY MORE ELIMINATED BEFORE THEY COULD ………. 3/7/2011 71 Lt Col A S Kushwaha

72. 3/7/2011 72 Lt Col A S Kushwaha Thank You