Sex selection and abortion of female foetuses by Indian couples living in Canada has been rampant in the last couple of decades. And Indian couples are more likely to resort to selective abortion of female foetuses if it is a third or fourth birth.

As a result, fewer than expected girls were born to these couples across Canadian provinces during the period 1990 to 2011.  This trend was seen even among mixed nativity couples, including those of Canadian-born mothers and Indian-born fathers.

There are 4,472 missing girls in Canada in the last two decades

“It appears that skewed sex ratio among some Indian immigrants to Canada has been present for at least two decades, accruing about 4,472 missing girls,” notes a paper published on April 11 in the journal CMAJ Open. The actual number of missing girls may be much higher given that the calculations based on the ratios did not factor in repeated induced abortions of female foetuses. Luckily, the deficit in the number of newborn girls to Indian immigrants is very small in Canada, around 200 per year.

“It is a woman’s right to undergo an abortion in Canada. No questions are asked regarding the reasons. Induced abortions are legal and free in Canada,” Dr. Marcelo Urquia, the first author from St. Michael’s Hospital, Ontario told me in an email. “Implantation of male embryos are not allowed under Canadian law. However, there is no law preventing women to undergo an abortion for any particular reason, even if it involves sex selection.”

The majority of missing girls occurs at the third birth. The deficit of girls gets bigger among fourth and higher order births than among second order births.

In the case of India, the sex selection starts even at the second-order births. According to a May 2011 study in The Lancet, in India, the sex ratio for second-order births when the firstborn was a girl fell from 906 girls per 1000 boys in 1990 to 836 girls per 1000 boys in 2005. In contrast, there was no significant declines in the sex ratio for second-order births if the firstborn was a boy.

While Canadian couples had a sex ratio of about 103 and 106 boys per 100 girls and showed no change based on the birth order, among Indian-born mothers, the proportion of male children noticeably increased according to the birth order.

For instance, Indian-born mothers, who already had two children, gave birth to 138 boys per 100 girls; it was as high as 157 boys per 100 girls in 2000-2001. But the sex ratio was worse when Indian-born mothers had three children — they gave birth to 166 boys per 100 girls during the period 1990-2011.

Dr. Urquia and others note that the ratio among couples who already had three children improved from 184 boys per 100 girls in 1990-1991 to 145 boys per 100 girls in 2010-2011. But this improvement may not indicate any reduction in sex selection for boys. Instead, a trend towards smaller families was seen during this period among Indian mothers — the proportion of third child born to Indian women decreased from 16.4 per cent in 1990-1991 to 11.3 per cent in 2010-2011.

The study also revealed that the presence of an Indian-born father skewed the ratio towards more boys per 100 girls at the second and higher birth orders immaterial of whether the mother was born in India or not.

Effect of two daughters

According to another paper published by Dr. Urquia and others on April 11 in the journal CMAJ, in Ontario, the sex ratio among Indian-born mothers with two previous daughters was 196 boys per 100 girls overall. “But if they have had at least one induced abortion in between the second and the third birth the sex ratio increased to 326 boys per 100 girls at the third birth. Among those who had more than one abortion before the third birth the sex ratio went up to 409 boys per 100 girls and if they had at least one abortion after 14 weeks of gestation the sex ratio increased to 663 boys per 100 girls,” Dr. Urquia said in an email to me.

“Our findings show that, among some Indian immigrants, the practice of induced abortion is associated with subsequently having a boy, especially at the third birth and among women with two previous girls,” the authors write.

The factors

They were able to find the details about specific factors that may influence sex selection.  The preference for boys during third order births was more common among Indian couples who already had two daughters that those who already had two sons. Two, a third child was much more likely to be a boy after an induced abortion. In the case of a boy born after induced abortion, the practice of sex selection was more in the case of couples who already had two daughters and who carried out the abortion(s) after 15 weeks of gestation.  The sex of the foetus can be accurately determined by ultrasonography when the gestation period was beyond 15 weeks.

“Preceding the live birth of a third child, one quarter of Indian women who had two  daughters underwent at least one induced abortion, and one third of them underwent repeated induced abortions during that interim,” they write. “Lifetime multiple induced abortions have been shown to be detrimental not only to a woman’s health, but also to a subsequent pregnancy, including preterm delivery.” And in these cases, the multiple abortions were carried out in a relatively short time interval before the third live birth took place.

The study examined birth certificate data of 5.8 million births to Canadian-born women and 1,77,990 Indian-born women between 1990 and 2011. The data is provided by provincial Vital Statistics Registrars to the Canadian Vital Statistics Birth Database administered by Statistics Canada.

Published in The Hindu on April 12, 2016