'Girl deficit' grows in India

HYDERABAD, India -- Rajitha Kunchala, the mother of three girls, aborted her fetus more than a year ago after a doctor using ultrasound images found abnormalities, but Kunchala said she would have gotten an abortion anyway -- because she was going to have a girl.

''We really wanted a boy," she said one day last week, her hands around her abdomen. She was six months pregnant. ''Now I'm worried again -- we still want a boy. A boy would take care of his parents, not leave the house, and there is no dowry payment" to be made when a boy marries, as there is for females.

In recent years, according to several specialists in India, Indian women have aborted uncounted numbers of female fetuses simply because the family wanted a boy. The practice is made easier by the the proliferation of ultrasound machines, which after 14 to 16 weeks of gestation can usually determine the gender of the fetus.

The British-based medical journal The Lancet published a study yesterday quantifying the phenomenon: The report estimated that Indian women aborted a stunning 10 million girls in the two decades leading up to 1998. The study, analyzing data from a national survey of 1.1 million households, calculated that 500,000 female fetuses were aborted each year in India.

The ''girl deficit," as the study labeled it, was more prevalent among educated women and did not vary according to religion, the study found.

''What surprised me was that the data suggest it is a problem right throughout society, particularly among the elites, who have more access to ultrasound equipment and have more spending money," Dr. Prabhat Jha of St. Michael's Hospital at the University of Toronto, one of the study's authors, said in a telephone interview from New Delhi. ''You would think that maybe this happens in more repressive states toward women, but it is happening everywhere in India."

Health specialists have been aware of the problem of sex selection before birth in India, China, and several other Asian countries since the 1980s, when the technology to do so became more available. But no study has used such detailed data to determine the impact in India, a country of 1 billion people.

Boys are preferred in many Asian countries largely because they provide more financial insurance for aging parents, often living in their parents' homes after marriage and supporting them. Girls, on the other hand, almost always leave their parents' home after marriage, and are not expected to lend financial assistance to their parents. And in these strongly patriarchal societies, boys retain the family's name as well as inheritance rights.

According to India's 2001 census, there were 932 girls for every 1,000 boys under the age of six, but in some parts of India the ratio is even more skewed toward boys. In Daman & Diu state, north of the city of Mumbai, for instance, the ratio of girls to boys was 710 to 1,000, according to the 2001 census.

The study published in The Lancet also found that in families where the preceding child was a girl, the ratio of girls to boys for the next birth was 759 to 1,000. In families where the two preceeding children were girls, the ratio of girls to boys in the next birth dipped even lower: 719 to 1,000.

In an attempt to cut down on the practice, India passed a federal law in 1994 that made it illegal for ultrasound operators to tell families the gender of the fetus. The law also requires that a health professional request the ultrasound test only for specific reasons, which include the mother's age, a woman's history of spontaneous abortions, and possible chromosomal abnormalities in the fetus.

Enforcement of the law has been extremely lax in much of the country. The most aggressive district in the country in trying to stop abortions based on gender is Hyderabad, a south-central city known globally for its high-tech centers. The progress on abortions is attributed largely to the efforts of Arvind Kumar, the top district government official in the city, according to activists working on the issue throughout India.

''It's horrifying," said Kumar. ''We are trying to do everything in our power to stop this sex selection that leads to fewer girl children."

In Hyderabad, Kumar said that when he started his job in September 2004, there was very little oversight of the city's 389 ultrasound operators, and the problem was worsening. In the 1991 census, the ratio of girls to boys was 963 to 1,000, and the 2001 census found 942 girls for every 1,000 boys. In one ward, there were just 838 girls to 1,000 boys that year.

In his second month on the job, he invited the city's ultrasound operators for a daylong workshop on the law, during which he warned them that the rules would now be enforced. But when he asked for the operators to register with his office, just 245 of the 389 complied at first. After several more months of cajoling the operators, 53 were still refusing to register. ''So we told them they were committing a crime and we would enforce the law."

A few months later, he suspended the licenses of 91 centers that had only partially complied or refused to comply. His workers seized 72 ultrasound machines. And just last month, he brought charges against four centers. ''We are trying to send the message out very clearly -- they should follow the law, and that means not telling women the sex of the fetus," he said.

Sabu George, a New Delhi-based public health researcher specializing on gender-selective abortions, said other districts could easily copy Hyderabad's efforts and bring charges against non-compliant operators. But he said the root causes of the problem will take a long time to reverse.

''We live in a very unequal society," he said. ''Women are not equal on any level. . . . In our society, we also accept violence against women. Violence in America is very open. In India, the violence is often within families. It is socially sanctioned to kill our girls."

The declining ratio of girls to boys also has begun to lead to societal changes, several health officials said. In some areas, young men wishing to marry have had to travel far from home to tribal areas and propose to women of lower castes. And in some cases, the tradition of a bride's family paying a dowry to the groom's family now is reversed: Many grooms pay the wedding price.

As the campaign in Hyderabad against gender-selective abortions gains momentum, there are signs of progress.

At a preschool nursery in one middle-class Hyderabad neighborhood, Rajitha Kunchala, 24, the pregnant mother, said she does not know the gender of her fetus this time. ''Doctors are not allowed to tell us," she said. ''We would like to know, but it's illegal."

Sitting next to Kunchala was another mother, Sandhya Yangal, 22, who held in her arms her sleeping 2-month-old girl, Yasasvini. It was her second girl. Several months before she was due to give birth, women in her neighborhood told her that they could tell she was carrying a girl. Yangal, her husband, and her husband's family considered an abortion.

But Yangal also sought out a local educator, Kadari Anitha, 29, herself a mother of two girls, for advice. ''I told Sandhya that boys and girls are equal," Anitha recalled one day last week. ''I said that these days girls are getting more rights, so keep the girl."

The educator said she visited the home every day for two weeksuntil finally the family relented and chose birth, not abortion.

''At first I wanted an abortion, but she convinced me," Yangal said of the educator. ''I am very happy to have my daughter, but when she was born there was a sadness that I did not give birth to a boy."

John Donnelly can be reached at donnelly@globe.com