Sex selection and health at birth among Indian immigrants

Parental gender preferences over three centuries: Evidence from Argentina

In this paper I examine the evolution of parental gender preferences in Argentina (i.e., parents who prefer a certain gender composition in their children). To do this, I use census microdata that spans the 19th, 20th, and 21st centuries. The estimation strategy exploits the plausibly random assignment in the gender of children. The results show a persistent preference for a mixed gender composition (i.e., having at least one boy and one girl) instead of children of the same gender. This translates into an increase in the probability of having a third child, conditional on already having two children of between 9%-23% for those couples who have children of the same gender -in relation to couples with children of opposite genders-. These preferences are heterogeneous over time and have important implications in terms of fertility (i.e., the reduction of these mixed gender preferences -in favor of greater gender-neutrality- could contribute to reducing the number of children per couple). In addition, the findings of this work support the empirical literature that uses the gender composition of the first two children as an instrumental variable to study the impact of fertility on labor participation.

Sex ratios and 'missing women' among Asian minority and migrant populations in Aotearoa/New Zealand: a retrospective cohort analysis

OBJECTIVES

Recent research from the UK, USA, Australia and Canada point to male-favouring sex ratios at birth (SRB) among their Asian minority populations, attributed to son preference and sex-selective abortion within these cultural groups. The present study conducts a similar investigation of SRBs among New Zealand's Asian minority and migrant populations, who comprise 15% of the population.

SETTING AND PARTICIPANTS

The study focused on Asian populations of New Zealand and comparisons were made with NZ European, Māori, Pacific Island and Middle-Eastern, Latin American and African groups. Secondary data were obtained from the New Zealand historical census series between 1976 and 2013 and a retrospective birth cohort in New Zealand was created using the Stats NZ Integrated Data Infrastructure from 2003 to 2018.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measure was SRBs and sex ratios between the ages 0 and 5 by ethnicity. A logistic regression was conducted and adjusted for selected variables of interest including visa group, parity, maternal age and deprivation. Finally, associations between family size, ethnicity and family sex composition were examined in a subset of this cohort (families with two or three children).

RESULTS

There was no evidence of 'missing women' or gender bias as indicated by a deviation from the biological norm in New Zealand's Asian population. However, Indian and Chinese families were significantly more likely to have a third child if their first two children were female compared with two male children.

CONCLUSION

The analyses did not reveal male-favouring sex ratios and any conclusive evidence of sex-selective abortion among Indian and Chinese populations. Based on these data, we conclude that in comparison to other western countries, New Zealand's Asian migrant populations present as an anomaly. The larger family sizes for Indian and Chinese populations where the first two children were girls suggested potentially 'soft' practices of son preference.

Sex ratios at birth in Australia according to mother's country of birth: A national study of all 5 614 847 reported live births 1997-2016

Objectives

Son preference and sex selective practices have resulted in a deficit of girls in several countries, primarily across Asia. Emerging evidence indicates that son preference survives migration to Western high-income countries. The objective of this study was to assess male-to-female (M/F) ratios at birth per mother’s country of birth in Australia 1997–2016, in total and by parity, and by states/territories and over time.

Methods

Data for this national population-based cross-sectional study were obtained from the National Perinatal Data Collection (NPDC) and included all live births in Australia 1997–2016 (N = 5 614 847). M/F ratios with 95% Confidence Intervals were estimated.

Results

The M/F ratio for births to Australian-born mothers was within the expected range (1.03–1.07) regardless of parity and time period. M/F ratios were elevated above the expected range for births to mothers born in China in the total sample (M/F ratio 1.084, 95% confidence interval 1.071–1.097) and at parity 2 (1.175, 1.120–1.231), and for births to mothers born in India at parity 2 (1.146, 1.090–1.204). Parity 2 births were the most consistently male-biased across time. Across states, elevated M/F ratios were identified for both groups in New South Wales (China parity 2: 1.182, 1.108–1.260; India parity 2: 1.182, 1.088–1.285), for births to Chinese-born mothers in Victoria (total births: 1.097, 1.072–1.123; parity 1: 1.115, 1.072–1.159) and Australian Capital Territory (total births: 1.189, 1.085–1.302) and births to Indian-born mothers Western Australia (parity 2: 1.307, 1.122–1.523).

Conclusions

Son preference persists in some immigrant communities after migration to Australia. The consistent pattern of elevated M/F ratios across the larger states indicates that sex imbalances at birth are largely independent of restrictiveness of local abortion laws. Drivers and consequences of son preference in Western high-income settings should be explored to further promote gender equality, and to strengthen support for women who may be vulnerable to reproductive coercion.

Perinatal health among 1 million Chinese-Americans

The literature on "missing girls" suggests a net preference for sons both in China and among Chinese immigrants to the West. Perhaps surprisingly, we find that newborn Chinese-American girls are treated more intensively in US hospitals: they are kept longer following delivery, have more medical procedures performed, and have more hospital charges than predicted (by the non-Chinese gender difference). What might explain more aggressive medical treatment? We posit that hospitals are responding to worse health at birth of Chinese-American girls. We document higher rates of low birth weight, congenital anomalies, maternal hypertension, and lower APGAR scores among Chinese American girls - outcomes recorded prior to intensive neonatal medical care and relative to the non-Chinese gender gap. To the best of our knowledge, we are the first to find that son preference may also compromise "survivor" health at birth. On net, compromised newborn health seems to outweigh the benefit of more aggressive neonatal hospital care for girls. Relative to non-Chinese gender differences, death on the first day of life and in the post-neonatal period is more common among Chinese-American girls, i.e. later than sex selection is typically believed to occur.

Sex selection and non-invasive prenatal testing: A review of current practices, evidence, and ethical issues

Non-invasive prenatal testing (NIPT) can determine the sex of the fetus very accurately and very early in gestation. There are concerns that the ease, timing, and accuracy of NIPT sex determination will facilitate sex-selective termination of pregnancy (TOP). Here, we review current practices, the evidence for a link between NIPT and sex-selective TOP, and associated ethical issues. Sex-selective TOP, usually motivated by son preference, has had serious demographic consequences in countries such as India and China. Currently, ultrasound is the primary method by which parents determine the sex of the fetus. The diffusion of ultrasound technology has had a direct impact on the rates of sex-selective TOP. Although NIPT is currently more costly, it is feasible that increased uptake of this technology could have a similar effect. Partly because NIPT is a relatively recent development in prenatal screening, there is little data on the impact of NIPT on sex selection practices. Evidence that NIPT is playing a role in sex-selective TOP remains largely anecdotal. Further research is required to assess and quantify TOP resulting from NIPT sex determination. The use of these technologies for sex selection raises a number of ethical issues, in addition to practical demographic consequences.