A 35-year-old woman from Sindhuli district is expecting her third child in November. Despite having two daughters already—one 12 years old and the other eight—the woman and her husband said that they need another child—a ‘son’ and they are sure they will have one this time around.

“My friend told me that she and her husband decided to have a third child, as the ultrasound confirmed a male child this time,” the woman’s colleague told the Post, requesting anonymity. “My friend and her husband both are educated, but education did not work in the case of preference for a son.”

Preference for boys to girls is not a new thing in Nepal, but the tendency has been leading to sex-selective abortions, which have become rampant in recent decades.

Several studies, including a report by the National Statistics Office, show a widening gap in the girls-boys ratio, especially in big cities and in the districts bordering India.

According to the report, Dhanusha district comes at the top in the girls-boys ratio gap with 137 males for every 100 females at birth, followed by Siraha with 132 males, Saptari 128, Arghakhanchi 124, Kanchanpur and Kailali 122, Parsa and Mahottari 121, Parbat and Doti 120, Dadeldhura 119, and Baitadi 118 males.

Likewise, 117 boys are born for every 100 girls in Dolakha, Sarlahi, Darchula and Ramechhap districts, 116 in Jumla, Chitwan, Nawalparasi-East and Bhaktapur districts, and 115 in Tanahun, Palpa, Banke, Surkhet and Kathmandu districts.

All of these districts either border India or are big cities with healthcare facilities providing sex identification tests.

In the aforementioned case too, the woman and her family have been residing in Kathmandu and had their prenatal foetal sex identification test at a private clinic.

Doctors say the ‘natural’ sex ratio at birth is around 105 boys for every 100 girls. The census report shows the gap, but is silent on the causes behind the declining number of girls.

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’s a girl child.

Demographers in Nepal warn that a widening gap in the number of boys and girls could create gender imbalances in the long run.

“More women have been educated and empowered of late in Nepal, but this has not stopped the practice of sex-selective abortion, which is illegal in our country,” said Yogendra Bahadur Gurung, professor and head of the Central Department of Population Studies at the Tribhuvan University. “We are talking about the report of a study carried out two years ago and the gap could widen in coming years, if intervention measures are not taken.”

Preferences for boys might have led to sex-selective abortions. Second, discrimination in care for girls increases female mortality. The increasing trend of late marriage and late motherhood also has promoted the trend of a single child and such parents prefer sons.

The rising cost of living and education, an issue on which no one is talking about but most are affected, is also the reason for having a single child which has led 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 (2075 BS) 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.

The National Criminal Code (2074 BS) allows one to five years of imprisonment of parents and service providers, depending on the stage of pregnancy, and a penalty ranging from Rs10,000 to Rs50,000.

However, no one has been sentenced or fined so far for committing such a crime in Nepal.

Due to easy access to ultrasound services, which can determine the sex of the foetus, doctors say people in urban areas, including in the Capital, may have been terminating female foetuses. Another challenge is easy access to the Indian cities, where one can easily travel and know the sex of the foetus, doctors say.

“The main reason for the high gender gap ratio of girls and boys at the time of birth in the bordering districts is their easy access to the Indian cities,” said Gurung. “We can see a high gap in the birth ratio of male and female children in Arghakhanchi district from where thousands of people go to India for jobs and health care services.”

Multiple doctors the Post talked to, said sex-selective abortion has persisted in the country for years and the practice might have picked up pace of late.

“Sex-selective abortion, which is illegal and prohibited by the law can be stopped by making women more empowered and making them aware that there is nothing wrong in having a daughter,” said Bandana Rana, a member of the United Nations Committee on Convention of the Elimination of all forms of Discrimination against Women. “Female foeticide cannot be stopped without first changing the people’s mindset. Apart from launching awareness drives, the agencies concerned should also make monitoring mechanisms that are effective to prevent wrong practices.”

Abortion was legalised in Nepal in 2002, which is considered to be a milestone 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.

Every year, around 100,000 women across the country receive abortion services—surgical or medical—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, although it is illegal.