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15 January 2014

Q&A – Sex ratios and abortion

What is the basis for the Independent's extraordinary claim that the ‘commonplace’ practice of sex selection abortion has led to ‘between 1,400 and 4,700’ missing girls in Britain?

1) What is the claim?

The UK Independent on 15 January makes the startling claim that ‘The illegal abortion of female foetuses solely to ensure that families have sons is widely practised within some ethnic communities in Britain and has resulted in significant shortfalls in the proportion of girls’. This newspaper further argues:

‘The practice of sex-selective abortion is now so commonplace that it has affected the natural 50:50 balance of boys to girls within some immigrant groups and has led to the “disappearance” of between 1,400 and 4,700 females from the national census records of England and Wales.’

There are two claims being made here. The first is that there is an imbalance in the sex ratio among some immigrant communities in Britain. The second is that this provides evidence of the practice of sex-selection abortion. Both claims are wrong.

2) What is the sex ratio?

The sex ratio of a society is the proportion of males to females in a given population, usually expressed as the number of males per 100 females. (This is also referred to as the ‘gender ratio’; however, as ‘sex’ is generally understood as a biological feature and ‘gender’ as a social category, we use the term ‘sex ratio’ here.)

It is widely understood (apart from by the Independent) that the normal sex ratio is not a ‘50:50 balance’ but is generally skewed, with slightly more boys being born than girls. A report published by analysts from the British Department of Health (DH) in 2013 stated: ‘The gender ratio at birth is the subject of numerous academic articles, with general consensus that a male to female birth ratio of around 105 (male births per 100 female) is normal.’ In the UK, the sex ratio at birth is ‘105.1 male births to 100 female and is well within the normal boundaries for populations.’

3) Why is the sex ratio skewed?

The sex ratio at birth differs between countries, and the sex ratio within populations changes with age. So while there are usually slightly more males born than females, by the time that cohort reaches the age of 50 or over, the balance tends to skew in the other direction, with more older women alive than older men. For example, the CIA’s World Factbook shows that in the UK, by the age of 55-64, there are 97 men to every 100 women, and by age 65 and over, there are 80 men to every 100 women. The sex ratio of the total population is 99 men to every 100 women. This indicates that differences within the sex ratio at birth tend to ‘even out’ over the course of a cohort’s lifetime.

The Department of Health analysis states that ‘Evidence suggests a number of factors can influence the sex of a child. These include paternal and maternal age, coital rates, number of children and sex of previous children.’ In other words: both natural and cultural factors can influence whether a woman falls pregnant with a girl or a boy.

It is often speculated that the disparity in the sex ratio at birth ‘may be evolution’s way of evening things out overall’, as boys are historically more likely to die younger than girls. Individual factors, such as maternal or paternal age, may have a biological effect on the sex of the fetus. Beyond this, cultural factors can interact with individual behaviour to affect whether couples have girls or boys.

The relationship between culture and individual behaviour is a complex one. The literature suggests that one feature that appears true in a range of different cultures is that couples who have two children of the same sex (girls or boys) are more likely to have a subsequent child than couples who have ‘one of each’. This can be accounted for either by a wider cultural preference to have ‘boy children’, or by a personal preference to have a girl and a boy.

Couples’ attempts to plan their families according to the sex of their existing children are not a feature of modern ‘family planning’ methods, but go back centuries. Well before modern contraception and abortion – and in societies today that lack access to these methods – couples have able to plan the number and spacing of their children; most obviously by abstaining from intercourse.

4) Why the concern with the sex ratios?

It is widely recognised that individuals plan their families in different ways, according to their personal and cultural circumstances; and when it comes to the sex of their children, this has little wider significance. However, when these personal decisions result in an apparent skewing of society’s sex ratio, this is seen to represent a problem, born out of a wider cultural preference for boy children over girl children. As the DH explains, ‘many consider ratios above 108 and below 103 as unlikely to occur naturally other than as a product of the random variability associated with small numbers of births.’

The focus of concerns about the sex ratio has been on countries such as China and India, where a cultural preference for boys has coexisted with widespread poverty and, in the case of China, the ‘One Child Policy’, through which the authorities attempted to restrict couples to having only one baby. However, even in these countries, claims about the numbers have been contested, and there are complex factors and regional variations that need to be taken into account.

Amartya Sen, the Indian-born economist and Nobel laureate, famously wrote in the 1980s that there are large numbers of ‘missing women’ in the world ‘as the result of the differences in mortality rates between men and women’. Since then, Sen has warned of ‘growing numbers of selective abortions of female foetuses’ in China and India. Yet, as he writes in the Independent, there are variations within those countries:

‘All the northern and western states, from Punjab and Uttar Pradesh to Gujarat and Maharashtra have much lower female-male ratios at birth than in the European countries, whereas all the states in south and the east, from Kerala and Tamil Nadu to West Bengal and Assam have female-male ratios well within the   European range’.

In developed countries such as Britain, the sex ratio is completely within normal range. The recent study by the Department of Health emphasised that this was also the case for babies born to mothers who were born outside the UK. ‘Only one country’, Sri Lanka, was found to have a birth ratio ‘significantly different from the figure of 105.1 for the UK as a whole’, and this was because there were fewer boys being born than girls: ‘Mothers born in Sri Lanka have a birth ratio of 99.2, or 99 male children for every 100 female children’.

So on what has the Independent based its extraordinary claim that the ‘commonplace’ practice of sex selection abortion has led to ‘between 1,400 and 4,700’ missing girls in Britain?

5) How did the Independent find its ‘missing women’?

The so-called investigation by the Independent appears to be based on a convoluted attempt at statistical manipulation. This is what the newspaper did:

‘The Independent commissioned a series of tables from the Office for National Statistics (ONS) showing the numbers of families with dependent children who were registered in the March 2011 census, broken down by country of birth of both the mother and father.
We concentrated on the numbers and genders of second-born children within these families to see whether families whose first child was a daughter were more likely to have a son as their second child…
We found that in two-child families of some first-generation immigrants, having elder daughters significantly increases the chances of the second child being male – an imbalance in the sex ratio that should not occur naturally.
To double-check our analysis, we asked professional statisticians to analyse the data in more detail. They confirmed that the effect is statistically significant and that there are only two plausible explanations, which are not mutually exclusive – either gender-based abortion or the practice of women continuing to have children until a son is born.
The latter phenomenon might explain most of the gender imbalances we observed in two-child families, said Christoforos Anagnostopoulos, a lecturer in statistics at Imperial College London. However, it could not explain some sex-ratio anomalies that persisted across families of all sizes, notably for mothers who were born in Pakistan, Bangladesh and Afghanistan.’

Translated into plain English, this seems to mean that the Independent looked at the second child born to immigrant couples and decided that there were more boys being born than should normally be the case. This only appeared to be ‘statistically significant’ (which, we should remember, means something different to socially significant) in relation to mothers born in Pakistan, Bangladesh and Afghanistan; and the Independent decided that this probably meant that mothers from these countries had been ‘aborting female foetuses in the hope of getting pregnant again with a boy’.

The claim about the sex ratio directly contradicts findings by the DH, which analysed the UK birth ratios for mothers born in all countries, over the period 2007-2011. The DH’s analysis shows clearly that, first, we are looking at small numbers, from which it is surely difficult to draw too many firm conclusions; and second, that the sex ratios for all of these groups were within normal range. The birth ratio for mothers born in Pakistan (95,829) was 104.3; for mothers born in Bangladesh (43,723) it was 102.6; and for mothers born in Afghanistan (13,373) it was 105.4.

Given the small numbers of women, how was it possible for the Independent to arrive at the startling claim that ‘the selective abortion of female foetuses is taking place on a big enough scale to account for between 1,400 and 4,700 “missing girls”’? Here, that newspaper seems to have employed yet more statistical chicanery.

The Independent’s argument is that a number of other ethnic groups -‘Indian, Chinese, Nepalese and the others)’ - have a preference for boy children, but are revealing this preference partly by moving quickly on from having two daughters to having another child. This takes them out of the ‘two child’ category that the Independent analysed: but, states the paper, we can nonetheless ‘suppose’ that those immigrant families are also practising ‘sex selective’ abortion:

‘The “don’t stop” behaviour and gender selective abortion are not mutually exclusive, and given that we have found significant evidence of sex-selective abortion among some ethnic groups, it seems reasonable to suppose that it may also play a role in the families of parents born in other countries for which we have weaker statistical evidence.
‘In total, the statistics suggest that the selective abortion of female foetuses is taking place on a big enough scale to account for between 1,400 and 4,700 “missing girls” within all these ethnic groups (Pakistani, Afghan, Bangladeshi, Indian, Chinese, Nepalese and the others) living in England and Wales.’

Of course, it may be that Reproductive Review has not grasped the sophistication of the Independent’s analysis here, in which case we will gladly publish a response from that newspaper. But it seems very hard to square this extraordinary claim, both about the anomalies in the sex ratio and the link with abortion, with what we actually know.

6) Is sex selective abortion taking place in Britain?

It is worrying enough that a national newspaper such as the Independent should go to such lengths to target immigrant groups with allegations of having such a strong preference for boy children that it skews the sex ratio within these communities: particularly when official analysis from the Department of Health, which appears far more robust than the Independent’s convoluted number-crunching, has recently shown the contrary.

It is even more worrying that (contested) claims about an imbalance in the sex ratio at birth should be marshalled as evidence of sex-selective abortion, when there is absolutely no evidence that this practice is taking place in Britain. As explained above, there are a number of factors that might affect whether a woman gives birth to a boy or a girl: the sex ratio itself, particularly within small communities, tells us nothing about how a woman has managed to end up with a child of a particular sex.

The idea that a woman must have had a boy child because she has deliberately aborted a female fetus is nothing more than a supposition. And it is a supposition based on a fantasy about what abortions in Britain actually take place. The Independent quotes Sabaratnam Arulkumaran, a Sri-Lankan born gynaecologist and past president of the Royal College of Obstetricians and Gynaecologists, who ‘said he struggled to explain the findings as most abortions in the UK are undertaken prior to 13 weeks, when ultrasound scans to determine gender are unreliable’:

“I am surprised actually, if that is what they have found… I cannot dispute the facts… but the question is: how did it happen?”

A rational response to Arulkumaran’s bemusement would be to recognise that it is simply impossible that between ‘1,400 and 4,700’ abortions of female fetuses are somehow secretly taking place in Britain, when scanning technology does not allow for the identification of fetal sex until much later in pregnancy. But the Independent chooses instead to speculate that couples must be ‘returning to their home countries to have sex-selective abortions, or getting them done illegally in the UK’. This is the stuff of paranoid fantasy, not news.

We should remember that the idea that sex selective abortion has become a problem in Britain was a fantasy cooked up in the first place by a different newspaper, the Daily Telegraph. In 2012, Telegraph journalists visited several clinics requesting an abortion because they were pregnant with a girl or a boy; at most clinics, their request was denied. Only two doctors reluctantly agreed that they could proceed with the abortion; and as it later transpired, the journalists had ‘mixed in’ other arguments, such as chromosomal defects, to make their case.

This desperate attempt by the Telegraph to find evidence of sex-selection abortion in Britain failed miserably. The Independent’s attempt to draw hypothetical conclusions from selectively manipulated statistics is even more pathetic, in that it simply relies on people jumping to the worst possible conclusions about immigrant women and abortion doctors.

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Also read:

Discrimination Against Women Is Not Tackled by Curbing Their Reproductive Rights. By Clare Murphy, Director of External Affairs, British Pregnancy Advisory Service, 15 January 2014.

Campaigns against sex-selective abortion are misogyny disguised as feminism. By Frances Ryan. New Statesman, 16 January 2014

The Indie’s ‘Lost Girls’ may not be what it appears. Ministry of Truth, 15 January 2014