THE BLOG
03/28/2009 05:12 am ET Updated May 25, 2011

Missing Girls ... Missing Women

Ads screaming "Girl or Boy?" are banned in India. Major internet search engines Google, Yahoo, and Microsoft have been put on notice to ensure that they do not provide advertising platforms for sex-determining technology. Yet, efforts by prospective parents to ensure that their baby is a boy -- the so called "son-preference" -- remain a serious problem in India.

With the focus on domestic debates about abortion, many Americans may be unfamiliar with the complicated dynamics in other countries such as India. Recently I was listening to a discussion about women's rights when the facilitator commented, "Everyone here is for women's right to choose in abortion," and saw nods of agreement. Likewise, there was a unanimous call for an end to discrimination against girls.

However, when the facilitator probed further, raising questions about how discrimination and abortion affected each other, commotion ensued. I heard some horrific stories and tapped into a charged debate that highlighted some dangerous implications for women's rights in the country.

Skewed gender ratios have caused justified outrage in India, where there are 927 girls for every 1,000 boys. The picture is even grimmer if one looks at the gender ratio based on birth order -- 250 girls for every 1,000 boys for the third child. The widespread use of sex-determination tests and resulting sex-selective abortions contributes to this disturbing imbalance.

The Indian government is taking some measures to curb the "supply" side of sex-determination. The Parliament passed a law regulating medical professionals' use of sex-determination technology and made it illegal to advertise such services. Most people are in agreement with such an approach.

But many women's rights advocates grow concerned at some of the more blanket measures that have been proposed. "I have sat through many government meetings where officials have advocated a ban on second trimester abortions in practice to prevent sex-selective abortions," a leading women's health activist pointed out. The newspapers carried a story of how a woman who aborted five months into her pregnancy following a sex-determination test was arrested, even as she was bleeding profusely, and imprisoned, along with her sister-in-law, who had helped her.

Many government officials, eager to improve the gender ratios, are informally instructing doctors to curtail women's access to second-trimester abortions. Women with daughters who seek abortions face special scrutiny. In some cases, police apprehend women instead of the doctors who conduct the sex-determination tests.

What might seem like a sensible solution to some in fact poses a grave danger for pregnant women in India. As evidence from other parts of the world demonstrates, curtailing access to abortion could kill more women by driving abortions underground.

The key to eliminating sex-selective abortion is not in the abortion procedure itself, but rather in the motivation for having it. Sex-selective abortion is merely a symptom of the root problem: a deep-seated preference for sons based on social, cultural, economic, and historical factors. Many women in India who seek sex-selective abortions are, in fact, under severe pressure to produce a boy. Some face violence, social exclusion, and expulsion from their homes if they do not.

Sons' traditional roles in providing financial support for their parents in their old age, inheriting and controlling family property, and conducting death rituals as well as the skyrocketing cost of dowries and the low social value placed on daughters underlie the demand for sex-selective abortion. Unless sustained policies and efforts to alter such attitudes are introduced, the demand for sex-selective abortions will not be eradicated.

Curtailing access to safe abortions is only likely to exacerbate women's woes by driving them to unsafe methods. In fact, despite legalizing abortion several decades ago, India continues to lose thousands of women to unsafe abortions every year. A whopping 90 percent of the estimated six million abortions occurring annually are performed illegally. Unsafe abortion contributes to 10 percent of the estimated annual 117,000 maternal deaths in India.

Altogether, India's rank on the 2008 global gender gap index is appalling. Ranked 116 of 130 countries based on a range of indicators, India would be among the winners if there were prizes for the worst country on women's health and survival.

The demand for sex-selective abortions is a telling symptom of this gender gap index, and points to the economic and social disparities that lead families to prefer sons over daughters. To address the unacceptable gulf between births of boys and girls, the Indian government's goal should ultimately be to fight "son-preference" by advancing women's rights and equality.

The government should positively promote the value of women's lives through expanding educational and economic opportunities and encouraging public discussion about traditional attitudes rather than resorting to blunt instruments such as a curtailing women's access to second trimester abortions. Otherwise, India may soon be in running for the gold when it comes to the worst country for women's health and survival.