Friday, 20 January 2012

Should the sex of a fetus be kept secret?

Sex ratio is the ratio of males to females with respect to population. In humans the sex ratio was commonly assumed to be 106 boys to 100 girls. This number is also reported as the male proportion of total births or 106/206 = 0.514 = 51.4% are born as boys. The CIA estimates that the current world wide sex ratio at birth is 107 boys to 100 girls. In 2010, the global sex ratio was 986 females per 1,000 males and is believed to have been reduced to 984 per 1,000 males in 2011.

Combining all the years studied, older mothers (40 to 44 years of age and 45 years and up) have the lowest total sex birth ratios 1,038 boys to 1,000 girls and mothers 15 to 19 years of age had the highest sex birth ratio 1,054 boys to 1,000 girls. The more children a woman has, the more likely she is going to give birth to an equal number of boys and girls.

For all available years combined, Chinese had 1,074 boys to 1,000 girls and Filipino mothers had 1,072 boys to 1,000 girls. These two races had the highest differences between the number of boys born versus girls, while non-Hispanic black mothers had 1,031 boys to 1,000 girls and American Indian mothers had the lowest where the ratio was 1,031 boys to 1,000 girls.

Most recently, public health scientists in Canada have reported a sharp drop in the sex ratio of a First Nation community (Chippewa) near Sarnia, Ontario, a heavily industrialized region in the province. In fewer than 10 years, the ratio dropped from the norm, around 50:50, to roughly one-third boys, two-thirds girls. The cause of this decline has not been identified, but the pattern is very strong.

But not all parents have more boys than girls. The sex of children born to parents exposed to dioxin in the 1976 dioxin accident in Seveso, Italy, is one reason. It was discovered that the father's exposure level was the best predictor of sex of offspring. Higher dioxin exposure of the father decreased the likelihood of having sons compared to daughters. Fathers exposed at a young age (younger than 19) were significantly more likely to have daughters than sons if their exposure to dioxin was relatively high.

Even with more boys than girls being born, women still outnumber men in the United States. For example, in 2003, the Census Bureau estimated a total of 144,513,361 females of all ages, compared to 138,396,524 males. I think that can be explained. More men are prone to being killed at work and at war than women are. Also, men are more reckless than women.

But why are more boys in some countries born than girls are?

The sobering answer is that in the vast nation of China, now the world's fastest-growing economy, is confronting a self-perpetuated demographic disaster that some experts describe as gendercide—the phenomenon caused by millions of families resorting to sex-selection abortions and infanticide to make sure their only one child is a boy. The age-old bias for boys, combined with China's draconian but necessary one-child policy imposed since 1980, has produced what Gu Baochang, a leading Chinese expert on family planning, described as the largest, the highest, and the longest gender imbalance in the world.

I can appreciate why China passed the law that said that couples should only have one child. China was becoming over populated. But surely the Chinese government must have foreseen gendercide as a consequence. For centuries, Chinese families without sons feared poverty and neglect. The male offspring represented continuity of lineage and protection of their parents in their parent’s old age.

After the Communists took power in 1949, Mao Zedong rejected traditional Malthusian arguments that population growth would eventually outrun food supply, and firmly regarded China's huge population as an asset which by then had an annual birth rate of 3.7 percent. Without a state-mandated birth control program, China's sex ratio in the 60's and 70's remained normal.

Then in the early '80s, China began enforcing an ambitious demographic engineering policy to limit families to one-child, as part of its strategy to fast-track economic modernization. The policy resulted in a slashed annual birth rate of 1.29 percent by 2002. This brought about the prevention of some 50 million births either by abortion of the fetuses or by parental neglect after the female babies were born. The Chinese government is hoping that the current population which is close to 1.3 billion won’t increase dramatically.

From a relatively normal ratio in China of 108.5 boys to 100 girls in the early 80s, the male surplus progressively rose to 111 in 1990, 116 in 2000, and then in 2004, it was close to 120 boys for each 100 girls according to a Chinese think-tank report. This abnormal imbalance is a direct result of parent’s choices either before birth or after birth. This means that there are 32 million more men in China than there are women.

The loss of female births in China due to illegal prenatal sex determination and sex-selective abortions and female infanticide will affect the true sex ratio at birth and at young ages, creating an unbalanced population sex structure in the future and resulting in potentially serious social problems. The Chinese Academy of Social Sciences estimates that by the year 2020, there will be 24 million men in China who will be unable to find a woman to marry.

China isn’t the only country that is facing that problem of an unbalanced population sex structure. There are mothers around the world who are predetermining what the sexes of their fetuses are so that they can have an abortion if their fetuses are girls. Because of this, there are another 50 million female fetuses in other countries in Asia besides China that are aborted or alternatively, who die by parental neglect after the female babies are born.

A fetus's gender should not be revealed until after 30 weeks of pregnancy, according to an editorial in the Canadian Medical Journal. “This change in procedure for a fetal ultrasound, where the sex is usually disclosed to parents at 20 weeks, would help prevent female feticide,” says Rajendra Kale, editor-in-chief of the CMJ. I totally agree with him.

In Canada, doctors rarely perform abortions after 22 weeks of pregnancy unless the baby has a lethal fetal abnormality or the mother's life is in danger because of the pregnancy. But sex-selection abortions are still occurring in Canada. The euphemism is ‘family balancing’ which is brought about by couples who already have a boy or a girl and want their next child to be of the opposite sex.

Kale says that in countries such as India, China, Korea and Vietnam, female fetuses are commonly aborted because of a preference for sons. He also said that though it is by no means widespread, the practice is carried out by some immigrants who come to Canada.

His editorial cites a small U.S. study of about 65 immigrant East Indian women of which 40 per cent had terminated earlier pregnancies and 89 per cent pursued abortions in their most recent pregnancies after learning they were having girls. Previous Canadian research has suggested that sex selection is occurring in Canada in certain groups when families have had girls and are seeking a son. The practice has created a gender imbalance in these communities.

“A pregnant woman being told the sex of the fetus at ultrasonography at a time when permissible abortion is possible is the starting point of female feticide from a health-care perspective,” writes Kale.

A study done in Canada found a distorted ratio of male to female births in the Indo-Canadian community, particularly among couples that already have two daughters. That being the case, it is clear that female feticide is happening, especially at the time when the third child is a female.

Kale wants to see gender disclosure policies at 30 weeks adopted by the provincial colleges that govern doctors. He said, “Such clear direction from regulatory bodies would be the most important step toward curbing female feticide in Canada.”

The Society of Obstetricians and Gynecologists of Canada said Kale's proposal is inconsistent with their policy, which states that “a patient's request for disclosure should be respected, either directly or in a report to the referring health professional.” In an email to CBC News, the obstetricians group said it believes it is the right of the patient to be informed of the gender of the fetus.

The editorial however did not consider tests on the market that give expectant parents a fetal sex determination of high accuracy as early as eight weeks into a pregnancy. People will always try to get around regulations but that's no reason not to have regulations.

The obstetricians group says it doesn't condone abortions based on non-medical reasons such as the gender of the fetus. I find that them making that statement rather silly when you consider the fact that it is meaningless to those parents who upon learning that the fetus is a female, demand that the fetus be aborted.

"The SOGC feels strongly that it is the cultural values and norms in specific segments of the Canadian population that must change to ensure that females are not confronted with procedures and intolerant environments before or after they are born," the association said. That is another foolish statement that is also meaningless to those parents who want the fetus aborted if it is a female.

Couples can go to clinics in the U.S. that advertise early sex determination in Indian newspapers. Cultural factors such as dowry and the belief a boy is needed to carry the family name, are the main causes.

Dr. Samuel Soliman of the New Life Fertility Centre in Mississauga said some patients have told him they've had abortions after having a girl or two. “I think it is part of the whole spectrum of violence against women, which starts from inside the uterus to the outside and the value of women,” says Soliman. “While the rule against disclosing gender might work in Canada, it would not apply in the U.S.,” Soliman notes.

Although this problem of sex-selective abortions and female infanticide has been known for a long time, it has been selectively put out of most people’s minds. You know the adage—out of sight, out of mind. Particularly notable for their lack of concern is the abortion-rights community in the West which appears to sacrifice literally millions of little girls in the service of the abortion licence. As far as I am concerned, the practice of female feticide is barbaric.

My wife and I had hoped for a boy. My wife recognized that most men like to have a boy that they can relate to. We ended up having two girls. I cannot imagine either my wife or me wanting to abort either one of them. They are grown up and are both professional women with university degrees and both have given us grandchildren which we love dearly.

When we learned that my wife was going to give birth to girls, we were just as excited even if they weren’t boys. But at the same time, I understand the concerns that the parents in India have when they discover that their children are going to be girls. This means that the parents will have to provide the dowry for their girls to be married (even though dowries in India are illegal) and the girls will not remain behind to help on the farm when they grow up and get married or care for their aged parents when the latter are unable to care for themselves.

But at the same time, the slaughter of female fetuses really is quite disturbing. To deny life to that which you have created is a terrible thing to do if the motive is merely to have a boy instead of a girl.

When the baby comes out, the first question the parents ask is, “Is it a girl or a boy?” I say this to prospective parents, “If you really want a child, you don’t need to be inquisitive about what’s between their legs. Be grateful that the child is born normal.” It is ironic when you think about it. If our mothers had been aborted, none of us would be alive today.

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