Jaipur (Rajasthan): “Bojha, Aanachhi, Kachri, Nirasha are some popular names given to girls born as a second or third child here,” says Kachri Bai, who lives in the rural outskirts of Jaipur, the capital of the western state of Rajasthan.

Bojha means burden, Aanachhi means unwanted or bad, Kachri means garbage and Nirasha means gloom. Kachri bai is the third girl in the family, after her sisters Roshni and Renu.

Such names are common for unwanted girls, born in a culture where male children are preferred. To avoid having a second or third daughter, families pay for illegal sex determination tests during pregnancy, and abortions if the foetus is female.

When Kachri’s mother was pregnant, she had a sex determination test, and was assured that the foetus was male. “They had, in fact, paid a good amount since the foetus was said to be a boy's,” Kachri said. “I understand their disappointment when they were mentally prepared for something else.”

Last year, when Kachri was 23 and pregnant with her second child, she too got a sex determination test for Rs 55,000 ($670). “My husband paid Rs 25,000 and my father-in-law gave another Rs 30,000. The doctor (she uses the word but doesn’t know the qualification of the person who conducted the test) had asked for Rs 60,000 but gave a discount of Rs 5,000 on request.”

“It is not a big deal here unless you can’t afford it (the test) at all.”

One 2020 study estimates that in India, as a result of sex-selctive abortions, there will be 6.8 million fewer female births between 2017 and 2030 than there would have been otherwise.

In the third part of our series, ‘Trapped In Tradition’, we report on the continuing son preference and female foeticide practised in Rajasthan, with impacts on women’s choice and health.

Preference for sons

Families prefer sons, who for them carry forward the family name. On the other hand, the tradition of dowry for a daughter’s marriage means there is an economic cost of having girls. “While sons offer security to their families in old age and can perform the rites for the souls of deceased parents and ancestors, daughters are perceived as a social and economic burden,” according to a 2022 study of female foeticide in India.

“Female foeticide based on sex-determination testing rose in India some 40 years ago, when ultrasound technology became accessible among upper and middle-class society,” said Shaheena Bano, an Udaipur-based activist, working on this issue since the past 20 years.

India banned sex determination tests in 1994 under the Pre-Conception & Pre-Natal Diagnostic Techniques Act, 1994 (PC-PNDT). It prohibited sex selection, before or after conception, and regulated prenatal diagnostic techniques for detecting genetic abnormalities, metabolic disorders, chromosomal abnormalities or congenital malformations.

But there is a need to implement the Act better, IndiaSpend reported in March 2018 based on a Niti Aayog report. In Rajasthan, crime records show no case has been registered under the Act between 2016 and 2021, based on data provided by the state to the National Crime Records Bureau (see data below).

Neelam Singh, a gynaecologist in Lucknow, who has helped police catch those who conduct sex determination, says it is a misconception that only less educated, poorer families have a son preference. She says many illegal centres run smoothly across the country and involve even senior doctors.

Sex-selective abortions are not just in Rajasthan, but across India, say experts. For instance, just some months ago, said an Accredited Social Health Activist from Uttar Pradesh (UP), a pregnant woman called her home, urgently. “She said she wanted to abort the four-month-old foetus because she and the family had found out it was female, after an ultrasound in UP,” the ASHA worker, who requested anonymity, said. The ASHA worker suggested that they give up the child for adoption when she is born rather than aborting the foetus as a solution but the family said they knew someone who would abort and preferred to do that.

Uttar Pradesh, Rajasthan and Bihar are the worst states to be a woman, IndiaSpend had reported in July 2016. Women in these states were most likely to be aborted in the womb, had the lowest literacy rates, died most frequently while pregnant, bore the most children, had the most crimes committed against them and were least likely to be employed.

Unsafe abortions

Harshinder Kaur, a Punjab-based paediatrician and women’s rights activist who works on the issue of sex-selective abortions, said that couples who cannot afford or access sex-selection, sometimes abort the foetus just because of the fear of having a girl, often in an unsafe manner. Others who abort after a sex-determination test might also not have access to abortion by a medical expert and have unsafe abortions, she added. “Due to lower education level, many women are dragged to faith healers who claim to change the sex of the foetus and if they don't succeed, they suggest abortion through unsafe measures.”

This is often common for women from most marginalised and rural communities, who do not have the right to decide for themselves, Kaur said. She gave the example of a case when a traditional midwife inserted her hand to take the foetus out of the woman, who then kept bleeding and became critical and had to be taken to a doctor.

More than half of the world’s unsafe abortions occur in Asia, most of them in south and central Asia. Unsafe abortions are the third leading cause of maternal mortality in India, and unsafe abortion-related causes kill nearly eight women a day.

“I have treated several women who were rushed to me after unsafe and unhygienic abortions done in the absence of medical experts,” said Singh, the Lucknow gynaecologist.

The discrimination does not stop at birth. Many girls who were unwanted or born when their parents were expecting a boy child, tend to live a compromised life, said Kaur. “They would be given bare minimum education, won’t be involved in decision making and married off at the earliest possible because the sole motive of parents and family members in such cases remains to get rid of her."

Decoy agents to catch illegal sex determination

One method used by the police and non-governmental organisations working to stop sex-selective abortions are decoy operations, in which a pregnant woman poses as wanting to know the sex of the child but is actually a spy for the authorities.

Suman Devi (32), a resident of Jhunjhunun district, has done five such operations in and around Jaipur. Devi did her first decoy while she was pregnant with her fourth child, after taking permission of her parents-in-law and husband. “I had three daughters and was pregnant with the fourth child,” and her parents-in-law agreed to let her be part of the operation, partly because it would help them know the sex of their grandchild too, she said.

The doctor who conducted the ultrasound told her, ‘Buri khabar hai. Chori hai. (Bad news, it’s a girl)’, Suman told IndiaSpend. “He said I had to pay just Rs 15,000 more and he will abort the foetus.” She stepped out on the pretence of talking to her family, and the authorities came in and arrested the doctor and confiscated the ultrasound machine.

Annu Devi (30) joined a special team of police and non-profits when she was pregnant, and paid Rs 35,000 for a sex determination test. She successfully had the doctor arrested in 2016. She says she still received bribes and threats from the doctor’s relatives to take back her testimony.

Sheelawati Meena is project director for PCPNDT in Rajasthan, who says the government has deputy controllers in every district, and works with NGOs that are active at the grassroots. “Rajasthan Government’s Mukhbir Yojana, started in 2019, has been very helpful in favour of the PCPNDT Act. As a part of this, the whistleblower, pregnant woman and her partner in the decoy are given an incentive of Rs 2 lakh from the state government, in three instalments.”

“If and when we get any information on any such centre being run, we are ready for a decoy operation.”

Annu Devi still receives bribes and threats from the doctor who she got arrested in 2006 for conducting illegal sex determination tests.

Reducing female foeticide

Over time, with better implementation of the Act, greater awareness and changing perceptions, with the Beti Bachao, Beti Padhao (Save Daughters, Educate Daughters) campaign, female foeticide has reduced, and the sex ratio at birth for Rajasthan, and India has improved marginally.

It has also become harder to get sex determination tests, and the cost of illegal tests has increased, said Vikas Kumar Rahar, the coordinator of the Shikshit Rojgar Kendra Prabandhak Samiti (SRKPS), who has been a part of over 25 decoy operations.

“Earlier the rates for just knowing the sex of the foetus would be Rs 30,000-40,000 and another Rs 15,000-20,000 for the abortion,” said Rahar, adding that the rates have now increased to Rs 60,000 to Rs 90,000 for the test and Rs 50,000 for an abortion.

Given the difficulty of knowing the sex of the foetus, families who can afford it are choosing to fly abroad where such tests are legal. Sonia* says she and her husband flew to Thailand in October 2022 for the test. “We were excited to be prepared for what the sex of our baby was going to be, so we did it without any bad intentions and came back to deliver here,” said Sonia, who paid Rs 50,000 for the test in Thailand.

“The betterment of sex ratio is the proof that these tests and foeticide have reduced over the years,” said Meena. She said they track the use of sonography through software, and identify women who abruptly stop getting sonographies done. “It could be a miscarriage or abortion in these cases and we reach out to them for details of what had happened.”

Research published in March 2023 too finds a “significant decline in son preference from 40 to 18 percent and an increase in gender-equitable preferences”, between 1992 and 2021, attributed to education, frequent exposure to television, community norms supporting women's employment.

“No doubt that the law has cut down on the number of female foeticides but it still prevails in Rajasthan,” Bano said. But “the law alone cannot wash away the issue of illegal tests, unless there is a social and mental sensitisation of people going after it.”

For Kachri, she hinted that it was lucky the sex-determination test she underwent showed she would have a boy. “I was relieved to find out the sex of our unborn baby for the sake of my in-laws. God knows what I would have gone through otherwise.”

We welcome feedback. Please write to respond@indiaspend.org. We reserve the right to edit responses for language and grammar.