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In India, Discrimination Against Women Can Start In The Womb

Dr. Nayna Patel performs an ultrasound exam on Rinku Macwan, at a hospital near Ahmedabad, India. It's illegal in India for doctors to reveal a baby's sex during these exams, but many do it anyway.
Sam Panthaky
AFP/Getty Images
Dr. Nayna Patel performs an ultrasound exam on Rinku Macwan, at a hospital near Ahmedabad, India. It's illegal in India for doctors to reveal a baby's sex during these exams, but many do it anyway.

India has lately become infamous for its epidemic sexual violence and discrimination against women. Sexual harassment there is so rampant that it even has a nickname: Eve-teasing.

But mothers may be practicing discrimination, too, in how they treat their daughters in the womb.

Indian mothers were slightly more likely to seek out better prenatal care when carrying a boy than when carrying a girl, economists report in the Journal of Human Resources.

An analysis of more than 30,000 health surveys across India found that women pregnant with boys were 1.8 percent more likely to go to prenatal medical appointments, take iron supplements, deliver the baby in a health care facility (instead of the home) and receive tetanus shots than women pregnant with girls.

The discrepancy rises to 4.6 percent in northern India, where gender discrimination is more prevalent.

The survey didn't ask the women whether they knew the baby's sex before getting the prenatal care. But the study's authors, and Leah Lakdawala, say it's common practice for doctors to share that information with parents.

But even disparities this small between how male and female fetuses are treated harm India's women, they tell Shots.

Access to prenatal care is linked to a 27 percent decrease in infant mortality in India. "And there's a whole wealth of evidence that early childhood health influences outcomes later in life — like educational attainment, income, full-time employment," says Bharadwaj, an assistant professor at the University of California, San Diego.

"Decisions your mother makes early in life can affect whether you make it to age 5 or earn higher wages at age 50," says Lakdawala of Michigan State University.

Of course, women may make decisions about prenatal care unconsciously, especially if they don't know the baby's sex. And it's unclear what exactly could drive this type of gender discrimination. But Bharadwaj thinks it might be connected to social disparities. For instance, if a family knows that a girl is going to earn lower wages, then parents may not want to invest as much in her future.

This idea fits with what the team found in other countries. Women in China, Pakistan and Bangladesh also slightly increased their prenatal care for boys, while those in Sri Lanka, Thailand and Ghana — where sexual discrimination is less of a problem — didn't.

India and China both have populations with many more men than women. To try to reverse the trend, doctors are prohibited from revealing a baby's sex during ultrasound exams. Still, the practice remains common in both countries.

Illicit gender identification is a lucrative business in China. The Global Times recently profiled one Chinese company that was giving women illegal ultrasounds and abortions in the back of vans for about 800 to 1,200 yuan ($128 to $193) and 3,800 yuan ($612), respectively. Another company charged 5,000 yuan ($805) to send blood for a gender test in Hong Kong.

So what about here in the U.S., where knowing the sex of a baby is often a top priority for parents who are expecting?

Even though there's evidence that Americans generally favor sons, a study in 2006 found that parents in the U.S. invest equally in prenatal health care for baby girls and boys. This was true even among first-generation immigrants from China and India.

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Michaeleen Doucleff, PhD, is a correspondent for NPR's Science Desk. For nearly a decade, she has been reporting for the radio and the web for NPR's global health outlet, Goats and Soda. Doucleff focuses on disease outbreaks, cross-cultural parenting, and women and children's health.
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