Manisha Sharma | Essays

Gendered Arrangements: India

Girls are considered a burden in Indian society and over seven million have been aborted in the last decade, simply because they were girls.[1] Previous research points at social, cultural and economic factors for the gendered arrangement, but a comprehensive understanding is still missing. The problem is spreading like an epidemic and the impact is felt in various forms in different parts of India. This issue is also known as the “missing girls” phenomenon.[2]

The following infographs are my attempt at a contextual understanding of sex selection and gender imbalance in India.

Biological Gender Ratio

The biological gender ratio at birth is in favor of boys. Fewer girls are born than boys. “There are around 105 or 106 male children for every 100 female children.” [3]

India Gender Ratios

The unnatural gender ratio in India has resulted in a massive gender imbalance. In 2011, there were 940 women and 914 girls per 1000 men and boys respectively.

The imbalance is worse in urban areas, where there are 902 girls per 1000 boys. In rural India, there are 919 girls. Historically, for the last fifty years (1961-2011), the number of women in India has fluctuated between 941 and 940.[3] There were 941 women in 1961 and there are 914 women per every 1000 men today. Though the number of women or the sex ratio in India has improved since 1991, the child sex ratio or the number of children between the ages of 0-6 has been consistently declining since 1961, the fall becoming steeper since 1981. Ultrasound technology was also introduced in India in the 1980s.

International Gender Ratio

In 2011, among the ten most populous countries in the world, India had the least number of women (940) after China (926). Ten years ago, in 2001, India had the lowest number of women (933). The Russian Federation had the most number of women (1161) in 2011, followed by Japan (1055) and the United States of America (1025). [3]


Every year 400, 000 female fetuses are aborted just because they are girls. Sex selective abortion in scholarly discourse refers to the abortion of a female fetus. “There are about 400,000 sex selective abortions per year, …With respect to the “missing girls”, the estimate is that 87 per cent of them are missing due to prenatal selection.” [4]

The number of selective abortions of female fetuses per year in India (400,000) is roughly equal to the entire estimated population of Oakland, CA (400, 740). [5]


Pregnant women, family members, financially able, educated, urbanites, doctors and healthcare technicians, and easy access to sex determination technology, all are factors and major stakeholders that contribute to the imbalanced gender ratio.


Introduced in 1960, ultrasound scan was a major breakthrough in medical imaging. Feticide is a medical procedure that constitutes a very sensitive aspect of late termination of pregnancy. In the field of reproductive technology, ultrasound scan detects foetal abnormalities. This assists doctors and patients to decide if a pregnancy needs to be terminated. [6]

However, largely in India, the combination of ultrasound — introduced in the 1980s — and feticide, has proved to be very fatal. Research, statistics and media reports show that the misuse of ultrasound technology has become a panacea for those Indians who only want boys. Such people may also choose to terminate pregnancy as soon as an ultrasound scan reveals that the fetus is a female.

This abuse of technology has given ‘feticide’ multiple meanings, some of which may be considered ‘politically charged’. [6]


Several studies have suggested that parents are compelled to abort female fetuses because of socio-economic reasons like poverty, dowry, ignorance and illiteracy. The issue of sex selective abortions is made more complex, by equating it with the abortion debate, whereas abortion was legalized in India by the 1972 Medical Termination of Pregnancy Act. [7] “Sex selection is not about abortion, its [sic] about sex determination.” [8] “Existing feminist literature around foetal images is primarily concerned with the rights of women and the way that these are set in opposition to the rights of fetuses.” [9]

While widespread poverty and the demands for dowry in India cannot be disregarded, they are no longer the major players. The number of girls kept falling even as India became economically prosperous and literate. A McKinsey Global Institute report points to the soaring “India’s Urban Awakening”.[10] “Literacy rate has gone up from 64.83 per cent in 2001 to 74.04 per cent in 2011 showing an increase of 9.21 percentage points.” [11]

Irrespective of the reasons behind sex selective abortions in India, the truth is that the current situation of fewer girls is already affecting all sections and sectors of the Indian society and beyond.


What will the future look like if the number of girls in India continues to decline?

Christophe Z Gilmito in “Characteristics of Sex-Ratio Imbalance in India and Future Scenarios,” points to demographic and other changes: “fewer women today translates into fewer births after 20 years”. There will be 47 million more men than women by 2050. [12] Female deficit for marriage is already witnessed in some parts of the country. Rise and increase in social problems and gender violence is on the rise. The December 2012 Delhi gang rape is a testimony. Scholars project major changes in family structures and a demographic disequilibrium that will be felt beyond the Indian borders.


Several steps have been taken to address and correct the issue of sex selective abortion of female fetuses in India. “In order to prohibit sex selection and prevent misuse of technology for preconception and prenatal sex determination, the Government of India enacted the Pre-conception and Pre-natal Diagnostics Techniques (Prohibition of Sex Selection) Act, 1994 (PCPNDTAct).” [13] PCPNDT was amended in 2003. Efforts by the government, NGOs, activists, researchers and awareness campaigns are ongoing. The project, Ultrasafe Ultrasound, uses a “novel ultrasound technology” that “… strives to curb female feticide in developing nations by automatically blurring the genitalia of the fetus in live images produced by ultrasound machines.” [14] ‘Ultrasafe Ultrasound’ is also a semifinalist in the Dell Social Innovation Prize 2013.


In order to better understand the issue of sex selective abortion of female fetuses in India, more reliable data, especially at the regional levels in India is needed (UNFPA). There is an urgent need to “prioritize sex selection” now. [12]


The author would like to acknowledge the support from a SEAD grant by The Institute for Creativity, Arts, and Technology at Virginia Tech. Michelle Gailhac’s ([email protected]) graphic design contribution is very instrumental to this essay. I also thank Hannah Tushara for technical assistance.

1. Prabhat Jha et. all http://cghr.org/wordpress/wp-content/uploads/Trends-in-selective-abortions-of-girls-in-India-2011.pdf

2. Amartya Sen, “More Than 100 Million Women are Missing, The New York Review of Books”

3. Provisional Population Totals Paper 1 of 2011 India, Series 1; Chapter 5

4. Report of the International Workshop on Skewed Sex Ratios at Birth: Addressing the Issue and the Way Forward

5. United States Census Bureau

6. Ruth H. Graham, Stephen C. Robson, Judith M. Rankin, “Understanding feticide: An analytic review” in Social Science and Medicine 66 (2008) 289–300

7. N.L. Pandey, O.P. Gupta Legalization of Abortion in India, US National Library of Medicine, National Institutes of Health

8. Anuradha Vemuri, UNFPA, Presentations made by Resource Persons at the PNDT Workshop

9. Julie Palmer, “Seeing and knowing: Ultrasound images in the contemporary abortion debate”, Feminist Theory, July 8, 2009

10. http://www.mckinsey.com/insights/urbanization/urban_awakening_in_india

11. Census of India: Provisional Population Totals 2011: India: Census 2011

12. Christophe Z Guilmono, UNFPA, “Characteristics of Sex-Ratio Imbalance in India and Future Scenarios,” 4th Asia Pacific Conference on Reproductive and Sexual Health and Rights

13. UNFPA India, Reports. (2012) “Towards a Stronger Implementation of the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act”

14. Ultrasafe Ultrasound

Posted in: India, Politics, Social Good

Comments [3]

This seems a subject with broad social, political and health implications that is not well suited to a poster presentation format. It is quite easy to take many of the same statistics cited by the author and reach very different conclusions. For instance, she dismisses poverty and education as important factors contributing to the skewed sex ratio based on based on a very questionable comparison to statistics about literacy levels in all of India.

A more nuanced view is provided by Sneha Barot of the Guttmacher Institute in relation to some examples of badly imbalanced ratios of female births to each 1000 male births:

"...the northern Indian states of Haryana and Punjab are notorious for their exceedingly disparate ratios, at 830 and 846, respectively, with some districts dipping into the 770s.6 In contrast, south India has normal sex ratios. In this regard, it is worth noting that the status of women in parts of south India is higher than in the rest of the subcontinent; gender discrimination—and thereby son preference—apparently is not motivating women and their families to use the same accessible technology for sex-selection purposes in these regions."

In regard to legal and technological management of the symptoms of the real problem, Barot has this to say:

"An even more compelling argument against sex-selective abortion bans is that restrictions on access to prenatal technologies and to abortions can create barriers to health care for women with legitimate medical needs; scare health care providers from providing safe, otherwise legal abortion services; and force women who want to terminate their pregnancies into sidestepping the regulated health care system and undergoing unsafe procedures. Accordingly, the joint UN statement stresses that 'States have an obligation to ensure that these injustices are addressed without exposing women to the risk of death or serious injury by denying them access to needed services such as safe abortion to the full extent of the law. Such an outcome would represent a further violation of their rights to life and health.'"

A Problem-and-Solution Mismatch: Son Preference and Sex-Selective Abortion Bans
By Sneha Barot

I'm an Indian woman who has directly experienced this issue. I find this article over simplifies the problem, and also tends to generalise the drivers behind the skewed gender ratio. I agree with MikeC, a much more nuanced approach is needed. The problem in fact is deeply cultural and systemic.

For instance, Haryana and Punjab are among the richest states in India, and yet have the highest rates of female feticide. This rules out poverty and concerns about employment as rationale. Further, I grew up in Mumbai, and belong to the upper socio-economic class of society, and I know people in my social circles who have aborted female foetuses.

Secondly, I find highlighting ultrasound in one of the statistics almost implies that it is the main culprit. This is really problematic as prenatal diagnostics are crucial in ensuring the health of the foetus. It should also be noted that sex determination through ultrasound has been classified as illegal in India, thus doctors who agree to carry it out are doing so illegally. The problem here is the way the Indian government has chosen to monitor and enforce the law. Again, proving how complex this issue is.
Amishi Parekh

      For the past 28 years, I have worked on issues such as female child neglect, female infanticide and sex selection in India. Over the intercensal period 2001-2011 India lost seven million girls before birth, more than the number of Jews who were exterminated by the Nazis. The fact that companies like GE did promote ultrasound for foetal sex determination in South Korea and China in the 1980s and 90s has been ignored by the authoritative UN document! The then GE CEO Jack Welch promised in 1993 that GE will not misuse ultrasound when it announced manufacturing of machines in India. However, I had to approach the Supreme Court of India in December 2001 to stop the criminal practices of ultrasound companies like GE.
       Ms. Barot's scholarship sadly has ignored the realities of sex selection practice in India. Could her long association with US family planning and abortion rights organisations have biased her perspective on sex selection in India? Sex selection was introduced into India in 1970 by the American population control lobby (see Mara Hvistendahl's book -'unnatural selection. Choosing boys over girls'). Several of us who have been involved in the campaign against sex selection are not against abortion rights. Any form of limitation of abortion rights is unacceptable. But we certainly believe that “abortion politics” in the US should not be the basis of India's response to this extreme form of violence against women (sex selection). Note the Indian law forbids foetal sex determination, the focus is not on abortion. But regrettably vested interests including powerful medical associations have used “abortion politics” to protect their own financial interests and to scuttle the implementation of the law. Note about one and a half million ultrasound scans are done for sex determination annually. For instance, recently, the Indian Radiological and Imaging Association have told the Delhi High Court that declines in child sex ratios are because of abortions carried out by gynaecologists, deliberately ignoring the massive misuse of ultrasound.
      The claim “In contrast, south India has normal sex ratios” is wrong. Sex ratios are becoming masculine in South India also, caused by misuse of ultrasound. When Salem District in TamilNadu had the lowest child sex ratio in India in the 1991 Indian Census, ultrasound machines which emerged in Salem town and periphery in the late 1980s had a contributory role. North Karnataka Districts and Mandya showed declines in 2001 itself. Andhra has shown the sharpest drop in 2011 Census among South Indian states. Rural Warangal has fallen to low 900s (girls per thousand boys)! Both in 1991 the and 2001 Andhra had better ratios than Tamilnadu and Karnataka. In TamilNadu Ariyalur and Cuddalore had declines in 2011. Tragically, Kerala is witnessing drops in sex ratios at birth. Over two thousand girls are eliminated before birth in Kerala annually in recent years.
      Yes, India should definitely ensure that the social norms and structural issues underlying gender discrimination are addressed. Given the context of genocide happening today can we wait till the Indian society starts loving girls? The relentless promotion of sex selection by the medical profession over four+ decades has to be stopped. Therefore without recourse to the “Pre conceptional and Pre natal diagnostic techniques law” the spread and intensification of sex selection cannot be stopped. Companies including Google which have been advertising sex selection technologies domestically and encouraging sex selection tourism from our country should be held liable for the violation of global human rights conventions and grave violations of Indian law. We cannot allow the UN or global population control lobbies to ignore the history of introducing and promoting sex selection for population control in India. Neither can we forget the ways multi-national corporations have profited from their participation in the genocide of millions of missing Indian girls.
Sabu M George, MA(Johns Hopkins), PhD(Cornell)
sabu george

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