Female Feticide

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  • Sex selection is a problem with social, medical, commercial and demographic dimensions. It is rooted deeply in our society due to undue preference for male sex.
  • Since male infants are biologically more fragile, the higher conception rate appears to be nature's way of ensuring an even sex distribution
  • The Shettles Method-have intercourse no more than 24 hours before ovulation to no more than 12 hours past ovulation.The Whelan Method- Chinese Conception ChartUrban Legends
  • Some are unscientific and others out rightly silly.
  • The technology in the field of medicine must advance but sometimes we get results that may be Good, bad and at times Ugly.
  • Are’nt these stories shocking? This is happening in all states of India.
  • Sperm sorting - The separation of X chromosome sperm from Y chromosome sperm by flow cytometry. The resulting sorted sperm are used in either artificial insemination or in-vitro fertilization (IVF) procedures.Preimplantation genetic diagnosis (PGD) - In sex selection cases, embryos resulting from IVF procedures are genetically tested for X or Y chromosomes. The embryos of the desired sex are then implanted.POST-IMPLANTATIONPrenatal diagnosis - Amniocentesis and/or ultrasound is used to determine sex of an offspring, leading to subsequent sex-selective abortion of any offspring of the unwanted sex.
  • To those who do not have the facility for pre-implantation and prenatal sex selection, they practice the same after birth of the offspring.
  • The propertied class do not desire daughters because after marriage of the daughter, the son-in-law may demand a share in the property. The property-less classes dispose off daughters to avoid dowry harassment.
  • Patrilineality, patrilocality and patriarchy determine thedominant status of men in inheriting property, in living arrangements,in continuity of families, and in family power structure, and result inthe lower status of women
  • Female Feticide

    1. 1. SEX SELECTION: IMPLICATIONS & CURRENT STATUS Lt Col A S Kushwaha Dept of Community Medicine5/9/2012 Lt Col A S Kushwaha 1
    2. 2. NATURE• Statistically speaking, there are 51 boys born for every 49 girls.• For every 100 females about 104-106 boys are expected.5/9/2012 Lt Col A S Kushwaha 2
    3. 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, age5/9/2012 Lt Col A S Kushwaha 3
    4. 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, youll conceive a baby boy.• Schedule your lovemaking sessions for odd numbered days of the month.• Have sex at night, preferably when theres 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.5/9/2012 Lt Col A S Kushwaha 4
    5. 5. Yatra naryestu pujjyante, ramante tatra devata’ - Ancient Indian scripturesHaving a daughter is like watering a flower in the neighboursgarden. Tamil proverb (In Kannada : ‘maga manege; magalupararige’ )‘Having a daughter is a punishment for the sins committed inprevious life’. - According to one dalit women,5/9/2012 Lt Col A S Kushwaha 5
    6. 6. BAD GOOD UGLY genetic screening cloning sex selection The Technologies gene therapy artificial placentas post- menopausal motherhood "The unholy alliance between tradition (son-complex) and5/9/2012 technology is playing Col A S Kushwaha Indian Society” Lt havoc with
    7. 7. TECHNODOCS OPINIONproviders of NRTs• 64% - against sex selective abortions,• 10 %- of them stated that too were against it butthey had to do it,• 24% - approved of sex selective abortions. A CEHAT study5/9/2012 Lt Col A S Kushwaha
    8. 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.5/9/2012 Lt Col A S Kushwaha 8
    9. 9. , ‘Had these clinics were available 30 years ago, many of uswould never have seen this world!’ As narrated by a literate woman in Village M 5/9/2012 Lt Col A S Kushwaha 9
    10. 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?5/9/2012 Lt Col A S Kushwaha 10
    11. 11. What is sex selection? Human sex selection is the attempt to control the sex of the offspring to achieve a desired sex.5/9/2012 Lt Col A S Kushwaha 11
    12. 12. METHODS OF SEX SELECTIONPRE-IMPLANTATION1. Sperm sorting - by flow cytometry.2. Pre-implantation genetic diagnosis (PGD)POST-IMPLANTATION1. Prenatal diagnosis & sex-selective abortion (Double illegality)5/9/2012 Lt Col A S Kushwaha 12
    13. 13. POST-BIRTH• Sex-selective infanticide• Sex-selective child abandonment• Sex-selective adoption• Differential stopping behaviour5/9/2012 Lt Col A S Kushwaha 13
    14. 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?5/9/2012 Lt Col A S Kushwaha 14
    15. 15. WHERE?• Globally• SEAR countries -China• India• Punjab, Haryana, Delhi5/9/2012 Lt Col A S Kushwaha 15
    16. 16. WHERE?• Poor - Rich• Illiterate - Educated• Rural - Urban• Orthodox families - Modern• BIMARU states – DEMARU states5/9/2012 Lt Col A S Kushwaha 16
    17. 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?5/9/2012 Lt Col A S Kushwaha 17
    18. 18. WHY?• SOCIAL• DEMOGRAPHIC• COMMERCIAL• LOGISTIC5/9/2012 Lt Col A S Kushwaha 18
    19. 19. SOCIAL• Women empowerment• Expression of reproductive rights• Minimize violence against women• Conserve property of family5/9/2012 Lt Col A S Kushwaha 19
    20. 20. Son Preference and Daughter AversionEconomic progress has not necessarily changed thetraditions of gender discrimination- dowry- family name- property- last rites- old-age support•Patrilocal•Patrilineage•Patriarchal 5/9/2012 Lt Col A S Kushwaha 20
    21. 21. SOCIAL ATTITUDES5/9/2012 Lt Col A S Kushwaha 21
    22. 22. SOCIAL PERCEPTIONS5/9/2012 Lt Col A S Kushwaha 22
    23. 23. WHY?• SOCIAL• DEMOGRAPHIC• COMMERCIAL• LOGISTIC5/9/2012 Lt Col A S Kushwaha 23
    24. 24. DEMOGRAPHIC• Family balancing• Prevented occurrences of unintended pregnancy and abortion,• Population stabilization- TFR & NRR• Small family Norm5/9/2012 Lt Col A S Kushwaha 24
    25. 25. WHY?• SOCIAL• DEMOGRAPHIC• COMMERCIAL• LOGISTIC5/9/2012 Lt Col A S Kushwaha 25
    26. 26. SEX SELECTION & SEX SELECTIVE ABORTIONRs. 1,000 crore industry(US$ 244 million)Easy & Quick money5/9/2012 Lt Col A S Kushwaha 26
    27. 27. WHY?• SOCIAL• DEMOGRAPHIC• COMMERCIAL• LOGISTIC5/9/2012 Lt Col A S Kushwaha 27
    28. 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 utero5/9/2012 Lt Col A S Kushwaha 28
    29. 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?5/9/2012 Lt Col A S Kushwaha 29
    30. 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)5/9/2012 Lt Col A S Kushwaha 30
    31. 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) = 107/1005/9/2012 Lt Col A S Kushwaha 31
    32. 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?5/9/2012 Lt Col A S Kushwaha 32
    33. 33. CURRENT STATUSECONOMIST -“Where are the 100 million missing women?” -Amartya Sen Sen A. Development as Freedom. New York: Anchor Books; 19995/9/2012 Lt Col A S Kushwaha 33
    34. 34. MTP ACT 1971• Law that turned against females for whom it was designed.• MTP Act + USG = Sex selective abortion• PNDT Act 1994• PCPNDT 20035/9/2012 Lt Col A S Kushwaha 34
    35. 35. 5/9/2012 Lt Col A S Kushwaha 35
    36. 36. Country SEX RATIO Sex RatioIndia 933China 944USA 1029Indonesia 1004Brazil 1025Pakistan 938Bangladesh 951Japan 1041Russian Fed. 5/9/2012 1140 Lt Col A S Kushwaha 36
    37. 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 20015/9/2012 933 Lt Col A S Kushwaha 37
    38. 38. 5/9/2012 Lt Col A S Kushwaha 38
    39. 39. 5/9/2012 Lt Col A S Kushwaha 39
    40. 40. Child Sex Ratio Census Total Rural Urban 1981 962 963 931 1991 945 948 935 2001 927 934 903 SRB/ 883 888 866 20035/9/2012 Lt Col A S Kushwaha 40
    41. 41. 5/9/2012 Lt Col A S Kushwaha 41
    42. 42. INDIA CHILD SEX RATIO IN AGE GROUP 0-6 N.A. INDIA N.A. INDIA CHILD SEX RATIO IN CHILD SEX RATIO IN AGE GROUP 0-6 AGE GROUP 0-6 1991 2001 A A A FEMALES PER 1000 MALES A IN AGE GROUP 0-6 800 AND BELOW 801 - 850 851 - 900 901 - 950 951 - 1000 1001 AND ABOVE N.A. DATA NOT AVAILABLE Data Not Available 1991 20015/9/2012 Lt Col A S Kushwaha 42
    43. 43. PUNJAB CHILD SEX RATIO IN AGE GROUP 0 - 6 (DISTRICT) 2001 1991 PUNJAB PUNJAB CHILD SEX RATIO CHILD SEX RATIO IN AGE GROUP 0-6 IN AGE GROUP 0-6 2001 (PROVISIONAL) 1991 Gurdaspur (DISTRICT) Gurdaspur (DISTRICT) 775 878 Hoshiarpur Hoshiarpur 810 Amritsar 884 Amritsar 861 783 Kapurthala Kapurthala 775 879 K K Jalandhar Nawanshahr Jalandhar Nawanshahr 797 810 886 900 Rupnagar Ludhiana Rupnagar Moga Ludhiana 791 Moga 877 884 Faridkot 819 814 Faridkot 867 Fatehgarh 805 Fatehgarh 865 Sahib Sahib 874 754 Firozpur Sangrur Muktsar Sangrur Patiala Firozpur Muktsar Patiala 819 807 Bathinda 873 871 784 770 887 Bathinda 779 858 860 Mansa Mansa 873 P FEMALES PER 1000 MALES IN AGE GROUP 0-6 779 P 800 AND BELOW 801 - 850 851 - 900 901 - 950 951 - 1000 1001 AND ABOVE5/9/2012 Lt Col A S Kushwaha 43
    44. 44. HARYANA CHILD SEX RATIO IN AGE GROUP 0 - 6 (DISTRICT) 1991 2001 Panc hkula Panc hkula 890 837 Ambala 784 Yam unanagar 888 Yam unanagar Ambala 807 888 770 Kurukshetra Kurukshetra 868 Kaithal Kaithal Karnal 854 Sirsa 789 Karnal 808 Fatehabad 818 Fatehabad Sirsa 871 830 873 883 JIN D 807 Jind Panipat His ar 818 Panipat 858 889 His ar 830 864 Sonipat Sonipat 878 Rohtak Rohtak 783 796 868 Bhiw ani Bhiw ani 838 Jhajjar Jhajjar 885 886 805 Gurgaon 895 Mahendragarh Rew ari Faridabad Mahendragarh Gurgaon Rew ari 892 894 884 814 863 814 Faridabad 856 CHILD SEX RATIO 800 AND BELOW 801 - 850 851 - 900 901 - 950 951 AND ABOVE5/9/2012 Lt Col A S Kushwaha 44
    45. 45. DELHI CHILD SEX RATIO IN AGE GROUP 0 - 6 (DISTRICT) 2001 1991 North West North West 854 913 North East North East North 867 North 917 West 870 West 920 858 913 Central Central 902 East 937 East 918 New Delhi 868 New Delhi 882 919 South West South West 845 904 South South 886 912 CHILD SEX RATIO 800 AND BELOW 801 - 850 851 - 900 901 - 950 951 AND ABOVE5/9/2012 Lt Col A S Kushwaha 45
    46. 46. Excess Female Mortality OR OR5/9/2012 Lt Col A S Kushwaha 46
    47. 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.5/9/2012 Lt Col A S Kushwaha 47
    48. 48. STATUS REPORT• 2002-2003- every ninth household in the stateacknowledged sex selective abortion. (According to theChandigarh-based Institute for Development and Communication)• More than 100,000 sex-selective abortions in Indiaevery year (Arnold et al. 2002).5/9/2012 Lt Col A S Kushwaha
    49. 49. Money –Sex selective abortion link CSR5/9/2012 WEALTH Lt Col A S Kushwaha
    50. 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).5/9/2012 Lt Col A S Kushwaha 50
    51. 51. Pregnancies with an UltrasoundPercent of pregnancies in the past 5 years WHO GOES FOR USG 65 62 44 24 16 9 4 Total Rural Urban None 12+ Lowest Highest Residence Education Wealth Index5/9/2012 Lt Col A S Kushwaha
    52. 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 %5/9/2012 Lt Col A S Kushwaha 52
    53. 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 ultrasound5/9/2012 Lt Col A S Kushwaha 53
    54. 54. USG- SEX RATIO LINK NO USG 100 USG5/9/2012 Lt Col A S Kushwaha 54
    55. 55. Are ultrasounds being conducted for sex-selection?Girls per 1,000 boys born in the past 5 years (for pregnancies with an ultrasound) 988 876 908 849 751 665 570 Total 0 sons 1 son 0 sons 2 sons 0 sons 2-3 sons 1 child 2 children 3 children5/9/2012 Lt Col A S Kushwaha
    56. 56. IMPLICATIONS5/9/2012 Lt Col A S Kushwaha 56
    57. 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 girls5/9/2012 Lt Col A S Kushwaha 57
    58. 58. The ‘shortage’ of women does not lead to theirincreased value, but to greater restrictions andcontrol placed over them. 5/9/2012 Lt Col A S Kushwaha 58
    59. 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 1. China 2. India 3. Israel 4. New Zealand 5. UK 31 prohibit it for social or “non-medical” reasons5/9/2012 Lt Col A S Kushwaha 59
    60. 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.5/9/2012 Lt Col A S Kushwaha 60
    61. 61. A Silent National Emergency5/9/2012 Lt Col A S Kushwaha 61
    62. 62. • Rooted in patriarchal value of son preference Sex selection is a key social issue• 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 son5/9/2012 Lt Col A S Kushwaha 62
    63. 63. • Falling sex ratio should be declared a national emergency and adequate resources should be allocated for the same.It is time to bring in a social movement• It is also important to build a national consensus on the issue and mobilize all the stakeholders to stop the practice of sex selection5/9/2012 Lt Col A S Kushwaha 63
    64. 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 internationally5/9/2012 Lt Col A S Kushwaha 64
    65. 65. It is time ---- to change the perceptions and values to create a positive image of the girl child5/9/2012 Lt Col A S Kushwaha 65
    66. 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/NRHM5/9/2012 Lt Col A S Kushwaha 66
    67. 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 level5/9/2012 Lt Col A S Kushwaha 67
    68. 68. Sex Selection Never… • Commit • Condone or • Remain silent5/9/2012 Lt Col A S Kushwaha 68
    69. 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 Justice5/9/2012 69
    70. 70. "A son is a son till he takes a wife A daughters a daughter the rest of her life."5/9/2012 Lt Col A S Kushwaha 70
    71. 71. Women Achievers ????? MANY MORE ELIMINATED BEFORE THEY COULD ……….5/9/2012 Lt Col A S Kushwaha 71
    72. 72. 5/9/2012 Lt Col A S Kushwaha 72

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