Falling Sex Ratios and Emerging Evidence of Sex Selective Abortion in Nepal

Abortion was legalised in Nepal in 2002 and the government began providing comprehensive abortion care services in 2004. Prior to that, the sex ratio at birth remained within normal limits, though other indicators suggested high levels of son preference. Changes in the sex ratio at birth since 2004 may indicate the extent to which sex selection has resulted from the introduction of abortion services.
Birth-order specific conditional sex ratios (CSRs) were calculated using data from four Nepal Demographic and Health Survey (NDHS). CSRs were looked at over time as well as for different sub-groups in order to assess trends and see which women were most likely to have sex selective abortions.
During 2007-10 the CSR for second-order births where the first born was a girl was just 742 (girls per 1,000 boys). Before abortion was legalised the same CSR was 1021. The CSR was lowest amongst educated women and richer women, especially in urban areas.
The fall in CSRs witnessed post legalisation indicates that sex-selective abortion is increasing. This change is likely driven by both supply and demand factors. Falling fertility has intensified the need to bear a son sooner, while legal abortion services have reduced the costs and risks associated with obtaining an abortion.