A few days ago, the Ministry of Health and Population issued a message on social media asking agencies concerned, service providers and the general public not to carry out sex selective abortions stating that they are illegal and a punishable crime.

Officials say the message was issued after data suggested a widening gap between male and female births.

According to the data, the boys-to-girls birth ratio in Nepal has been increasing every year, raising alarm over the looming gender imbalance.

However, agencies concerned are not taking any significant measures to prevent sex-selective abortions, which could have deleterious long term consequences, and even bring disasters to society, experts warn.

Alarmingly, sex-selective abortions are extremely high not only in areas with low education but also in big cities, where more people are educated.

“We are headed towards disaster. If we fail to check sex-selective abortions, this trend could lead to long-term social and demographic consequences,” said Dr Uddhab Puri, associate professor at the Tribhuvan University, who has carried out multiple researches on the birth rate in Nepal.

“No agency is working to prevent sex selective abortions and as per the law our law enforcement agencies do not do anything unless complaints are lodged or accidents take place,” said Puri.

According to data provided by the Ministry of Health and Population, 383,205 babies were born in fiscal year 2024-025 across the country. Of them 206,374 were boys and 176,831 girls. The difference is 29,543. The figure shows the girls’ ratio is 16.71 percent lower than boys, meaning boys outnumbered girls, markedly.

Experts say the natural sex ratio at birth should be about 105 boys per 100 girls.

“Not only the government data, several other studies also suggest that Nepal is heading towards a serious gender imbalance,” said Puri. “Educated people often talk about gender equality but the birth ratio shows they are not serious about women’s empowerment, and gender equality.”

Data show a more alarming picture at the province level. According to the Health Ministry, of 36,622 babies born in Sudurpaschim province 20,344 were male and remaining 16,278 were female. The disparity is around 25 percent—the highest among all seven provinces. Sudurpaschim province is followed by Madhesh, which recorded 86,901 births, of which 48,117 are male and 38,784 are female. The male-to-female birth gap is over 24 percent.

Experts say the high gap between male and female birth ratio means sex selective abortion is unchecked in those provinces.

Karnali province reported 26,452 births—14,275 boys and 12,177 girls, and the boys-to-girls gap is 17.23 percent. Bagmati province reported 73,639 births—3,918 boys and 34,451 girls, and the gap is 13.75 percent.

Likewise, Lumbini reported 79,032 births—41,931 boys and 37,101 girls; the gap is over 13 percent. Koshi recorded 61,796 births, of which 32,663 were male and 29,133 female, for a gap of over 12 percent.

Gandaki province reported 1,762 births—9,855 boys and 8,907 girls; and the boy-to-girl gap is 10.64 percent, the lowest in the country.

Experts say preference for boys to girls is not new in Nepal, but it has increasingly led to sex-selective abortions in recent decades.

Several studies, including a report by the National Statistics Office, show a widening gap that is especially high in big cities and districts bordering India. These areas, with the largest gender disparities, have easy access to healthcare facilities that provide foetal sex identification tests.

Doctors suspect that parents whose firstborn is a son, tend to not opt for a second child and if their firstborn is a daughter then many first determine the sex of the foetus of their next baby. They often opt for abortion if it is a girl child.

Demographers warn that a widening gap in the number of boys and girls could create gender imbalances. Despite rising education and empowerment among women in Nepal, the illegal practice continues.

Experts say several factors drive the trend. A strong preference for sons, combined with discrimination in care for girls, which increases female mortality, plays a key role. The rising trend of marrying late and delayed motherhood have also encouraged families to have only one child, and many opting for a boy.

The rising costs of living, health and education is also the reason for having a single child and leading to sex-selective abortions.

Both testing of the sex of a foetus and sex-selective abortion are banned in Nepal. The Safe Maternity and Reproductive Health Act, 2018 states that pregnant women should not be coerced into identifying the sex of the foetus through intimidation or terror, or by improper influence and deception.

Under the National Criminal Code, 2017, parents and service providers can face one to five years in prison, along with fines between Rs10,000 and Rs50,000.

But no one has been sentenced or fined for committing such crimes in Nepal.

Doctors say easy access to ultrasound services in urban areas, including in Kathmandu, may have enabled the termination of female foetuses. Another challenge is easy access to the Indian cities, where one can easily travel and know the sex of the foetus.

Multiple doctors told the Post that sex-selective abortion has persisted in the country for years and the practice may be increasing.

Abortion was legalised in Nepal in 2002, a milestone development for women’s reproductive rights, empowerment, and right to bodily autonomy. With legalisation, the practice of prosecution and jail terms for women who terminated unwanted pregnancies ended, and unsafe abortions decreased dramatically.

In the last fiscal year, 105,099 women terminated their pregnancies—through surgical or medical means —at government-authorised health facilities. But it is estimated that thousands of abortions, carried out either by medicines or surgery, do not enter government records. Pills for medical abortion can be purchased over the counter in Nepal.