Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
Parity- and Sex-Specific Factors Related to Sex Selective Abortion Seeking in Nepal
Background: Nepal, like many countries in South Asia, has a tradition of son preference. Abortion has been legal since 2002 and access has been expanded. While much is known about causes and consequences of son preference in other South Asian countries, there are still gaps in understanding about sex selective abortion seeking (predictors and outcomes). Furthermore, past research has been limited in its data and study design.
Methods: We use data from a unique study design to understand parity and sex-composition factors associated with sex selective abortion seeking compared to other types of abortions. Survey was collected from 1,841 women age 15-45 from across Nepal at the time that they were seeking abortion services between April 2019-December 2020 and followed for up to five years. Descriptives and logistic regression models are used to explore socio-economic and demographic factors associated with sex selective abortion. Qualitative in-depth interviews were conducted with a subsample of 43 women. Interviews were audio recorded, transcribed and translated into English and analyzed using thematic approach.
Findings: About nine percent of women report seeking sex selective abortions. Women seeking sex selective abortions were more likely to be denied their abortion (give birth). Having no boy children was associated with increased odds of sex selective abortion seeking, and each additional existing girl child increased the likelihood. We find no evidence of preference for a mixture of boys and girls; women who give birth to multiple daughters face discrimination and neglect from their families.
Interpretation: Sex selective abortion is relatively common in Nepal, with desire for male children still being a main predictor and pressure increasing with parity. Despite advancements in other domains of gender equality, son preference remains strong in this context and sex selective abortion common.
Keywords: son preference, gender discrimination, South Asia
Download This Paper