On sex selection in Ontario

The new Canadian Medical Association Journal paper "Sex ratios among Canadian liveborn infants of mothers from different countries", by Ray, Henry, and Urquia got quite a bit of attention from the Canadian press today. Sex-selective abortions may be occurring among some immigrant communities in ontario.

Women born in India and living in Canada are slightly more likely to have male children than other mothers living in this country, raising the possibility of sex-selective abortions.

But the researchers warn that without any evidence documenting this trend, it’s impossible to conclude that female feticide is the only explanation.

“We need more data … or we have the risk of committing a wrong by filling in the blanks that need to be filled in by data, not assumptions,” said Joel Ray, lead author of the study and a physician and scientist at Toronto’s St. Michael’s Hospital who focuses on obstetrical medicine.

Researchers looked at data for all single (not twins or triplets) live births that took place in Ontario from 2002 to 2007 and categorized mothers based on their country of origin.

They found the ratio of male to female births was even for all women except those from India and South Korea. Women from those countries who had one prior child were much more likely to give birth to a boy. But the trend was much more noticeable for Indian-born mothers with two or more prior children.

The “normal” male to female birth ratio is considered to be 1.05. But the ratio for South Korean- and Indian-born women with one prior child at the time of delivery was 1.20 and 1.11, respectively. For Indian-born women with two children at the time of delivery, the ratio was 1.36, which dropped slightly to 1.25 if the woman had three or more children at the time of delivery.

A couple of ancillary news items have since appeared highlighting this--a Toronto Star report that some hospitals in communities with large South Asian populations, a CBC article describing how an American reproductive clinic has been advertising sex-selection services in an Indo-Canadian newspaper--and the press coverage has, creditably, emphasized the preliminary nature of the conclusions that sex selection is ongoing.

Ray acknowledged that there are gaps in his research — he could not determine the ethnicities of the Canadian-born mothers, for example, and his study also did not examine statistics around abortions, a focus Ray plans on pursuing next.

But the study’s greatest weakness is failing to determine the genders of the women’s previous children, said Prabhat Jha, chair of Disease Control at the University of Toronto. He also works at St. Michael’s Hospital as director of the Centre for Global Health Research.

“To really understand what these stats are, you have to understand what was the gender of the previous children in the family,” said Jha, who has done extensive research on female feticide in India.

“Selection happens at higher birth orders, which means you let nature decide the first child and if you have a girl, then a small number of homes say, ‘Well, we want a boy.’ That’s when they turn to sex-selective abortion.”

Even if this latest study proves that female feticide is happening in Ontario, it would reveal that it is occurring in very small numbers, Jha said.

Using the study’s findings, Jha calculated that there were about 245 “missing girls” for Indian-born mothers with at least two prior children — that’s less than one per cent of the 31,963 babies born to Indian women between 2002 and 2007.

“Important but subtle biases, such as higher migration of women who are about to give birth to a son might well explain this finding and suggest that selective abortion is not the explanation,” Jha said.

The implications of this finding are multiple--Jonathan Kay, writing in the National Post, may be right to expect an impact on Canadian regulation of abortion, for instance. The effects of sustained sex selection on the immigrant communities in question, if it is ongoing, will also be serious: among other things, if young men born into these ethnic communities lack partners in Canada, then either exogamy or the immigration of women from their countries of origin will become more appealing possibilities than celibacy. The impacts of sex-selection abortion on immigration, further, may make immigration unpopular; if immigrants could be framed as viscerally misogynistic, exclusionism could become popular.