Australian researchers have found compelling indirect evidence suggesting sex-selective abortion practices among parents from migrant backgrounds including China and India.
The study reviewed 2.1 million births across Western Australia and NSW between 1994 and 2005, finding a skewed sex ratio for Australian births to women of Asian origin. The imbalance grew when mothers had two previous daughters.
For mothers from China, the male-to-female ratio hit 1.34 at the third birth when previous births had been female, while mothers from India saw a ratio of 1.31 when all previous births had been girls.
The research team found substantially more induced abortions among Indian and Chinese mothers in early pregnancy, coinciding with the time at which non-invasive prenatal testing (NIPT) became widely available in Australia in 2012.
Pre-natal testing is now routinely available to Australians from as early as 10 weeks’ gestation. While its primary use is screening for common chromosomal abnormalities, can also accurately determine fetal sex.
Writing in PLOS Global Public Health [link here] researchers from Edith Cowan and Curtin universities said it was feasible that the “ease, timing and accuracy” of NIPT could help facilitate sex-selective abortion practices.
Co-author Dr Amanuel Gebremedhin, Edith Cowan University Vice-Chancellor’s research fellow, said the ability to detect fetal sex appeared to be playing a role in skewed sex ratios.
“Often times parents are able to determine the gender of the baby as early as 10 weeks of gestation. Given that abortion on request in many Australian jurisdictions is generally available up to 22-24 weeks of gestation, it allows parents time to consider whether they would want to maintain the pregnancy,” he said.
The analysis found Indian-born mothers in Western Australia had a higher rate of hospital-induced abortions than Australian mothers between 2009 and 2015 (6.7% vs 3.6%), with a greater proportion of early-term abortions prior to 13 weeks (93% vs 84%).
The proportion of early-term abortions among mothers from Indian backgrounds increased from 64.3% in 2010 to 97.7% in 2015.
Demographic imbalances have been associated with various societal harms including increased violence and mental health concerns as well as the reinforcement of gender stereotypes.
The “natural” sex ratio sits around 105 boys to 100 girls, though a skew towards male births has been recorded in China and India in recent decades.
While the evolution of ultrasound technology and genetic testing may provide potential avenues for sex-selective abortion, there is some evidence that sex ratios at birth are evening out across Asia.
As The Economist reported earlier this year [link here], the ratio has fallen from 117.boys per 100 girls in 2006 to 109.8 in 2024, suggesting evidence that social expectations about the role of a son are fading.
Dr Gebremedhin noted the sex-ratio at birth among Australian-born mothers appeared fairly constant.
“[The] markedly skewed sex ratio at birth among certain migrant communities almost certainly point to human intervention,” he said in a statement.
Rethinking fetal sex disclosures through NIPT
The authors said the data suggested patterns of male-biased skewed sex ratios among certain immigrant groups in Australia, but “while this may be indicative of prenatal sex-selection, our study does not establish causality”.
Though it would have been beneficial to have “direct evidence” of sex determination through NIPT on rates of induced abortion, they said they were not aware of any reports tracking the sex of aborted fetuses in Australia at a large scale.
However, they research team emphasised the study has significant clinical and public health implications for Australia and highlights the potential that NIPT has to facilitate sex-selective termination of pregnancy.
The results led the research team to make a strong recommendation in favour of limiting the “non-medical” traits that can be disclosed about a fetus after pre-natal testing, including sex.
“Restricting this information is one of the most feasible approaches to preventing sex-selective abortion and reducing gender-biased reproductive practices,” they said.
Beyond this, culturally-appropriate discussions about reproductive options and public awareness campaigns about the negative effects of sex imbalances are needed.
“Researchers are urged to try to understand how reproductive decision–making occurs in certain cultures, particularly in families from South Asian backgrounds, in a culturally acceptable manner,” the authors said.