Making Every Baby Girl Count
China is ramping up a program that addresses the sociological factors behind an alarming trend: the country’s rising sex ratio at birth
CHAOHU, CHINA—When Bao Tiezhu and Li Qing married in 2002, they did everything backward. Instead of settling in his hometown, as most Chinese newlyweds would, Bao moved to Li’s ancestral village and relinquished the right to inherit his family’s land. When Li gave birth to two children in 5 years, they took her surname, not his. And—most importantly for the Chinese government workers who were watching the couple closely—the children are girls.
In discarding centuries of tradition, Bao and Li became the face of the new Chinese family: foot soldiers in a desperate program, called Care for Girls, to narrow China’s gaping sex ratio at birth, among the highest in the world at 120 boys for every 100 girls. Care for Girls, which was developed by a team of social scientists following years of fieldwork in the Chinese countryside, has a variety of carrots and sticks at its disposal, including financial incentives, strict punishment for sex-selective abortion, and radical social restructuring.
In 1980, China, concerned about a population explosion, adopted a one-child policy— and enforced it through compulsory sterilizations and abortions. The policy clashed with the country’s patrilineal tradition, in which sons carry on the ancestral line and care for elderly parents. Many families went to great lengths to ensure that their sole child was a boy. Confronted with a spike in the sex ratio and widespread resistance to coercive methods, Communist Party leaders relaxed the one-child policy in 1984. Most provinces subsequently allowed rural couples with one girl to try again, an exception sometimes termed the “1.5-child policy.” But the change coincided with the introduction of ultrasound machines to rural China, which enabled couples to determine the sex of a fetus and abort females. The country’s sex ratio continued to rise.
China is not the only country grappling with a skewed sex ratio. Across Asia, policy-makers are scrambling to come up with ways to stem a tide of “missing girls.” In India, the state of Haryana began paying parents for having girls in 1994, and last year the national government extended a similar plan to seven other states.
But the powerful National Population and Family Planning Commission of China—the same body that enforces the one-child policy—may, ironically, be critical to bringing sex ratios back into biological harmony. “If [China] really focuses on it, they have the grassroots organizers who are capable of doing this,” says Monica Das Gupta, a demographer at the World Bank who studies sex ratios. “They have a lot of information on the parents, and if they’re going to punish people, they can.”
Chaohu, in rural Anhui Province, is the pilot for Care for Girls. In 1999, local Family Planning Commission volunteers began augmenting their routine of birth monitoring and contraception distribution with the oversight of doctors operating ultrasound machines. The program also features micro-credit grants to women and social security payments for parents of girls—Bao and Li received a small sum, $29, upon the birth of their first daughter—along with measures designed to change social customs.
Bao and Li are one of four couples in their 600-person village to have espoused uxorilocal marriage, or living with the wife’s family. Couples in some regions have opted for this lifestyle throughout Chinese history, but the practice is typically stigmatized. By rewarding daring couples with land and public praise, Care for Girls aims to remove the stigma. Bao says it worked: “People don’t discriminate against you now.”
Unnatural selection
Down the street in Chaohu, a poster hanging in the entryway of Yang Chuanfeng’s home shows a smiling couple embracing a young girl next to the slogan “Let gender equality prevail.” That is exactly the take-home message the family-planning volunteer and mother of two girls hopes to impart to women on house visits. “If it’s a boy, have a boy,” she says. “If it’s a girl, have a girl. They’re the same.” To make her point, she hands out brochures in red bags emblazoned with “New Culture of Marriage.” One pamphlet explains the concept of sex ratio at birth.
Such materials are the result of Zhu Chuzhu’s decades of research. Following China’s 1982 census, Zhu, a tireless 76-year-old demographer at Xi’an Jiaotong University’s Population Research Institute, noticed a spike in mortality among girls aged 1 to 4—the first sign something was wrong—and quietly began researching the causes.
Zhu didn’t have funding to conduct extensive studies on child mortality until the mid-1990s, when the Ford Foundation backed fieldwork in rural Shaanxi Province. In a 2-year survey, she and Xi’an Jiaotong colleague Shuzhuo Li began investigating China’s sex ratio at birth, which had jumped abruptly from a biologically stable level of 107 boys for every 100 girls in 1982 to 111 in 1990. (In the most recent census and in sample surveys, the sex ratio has continued to climb.) Son preference is ingrained in China, but Zhu and Li, a young star with postdoctoral experience at Harvard and Stanford universities, set out to see whether they could discern and combat the underlying causes.
In a study on infant mortality, the duo found that parents were more likely to avoid seeking medical help for sick girls who were second or third in birth order or only had sisters. The pattern mirrored other scholars’ findings on sex ratio at birth. In countries with high sex ratios—including China, India, and, most recently, the Caucasus Mountains nations—the proportion of boys born rises significantly with birth order, presumably because mothers abort female fetuses.
The demographers realized that reversing the trend would require a major cultural shift. Undermining the patrilineal order, they suspected, might do the trick. With Marcus Feldman, an evolutionary biologist at Stanford, Zhu and Li surveyed two counties in China where a historically loose clan structure had led to a high percentage of men living with their wives’ families. Both uxorilocal counties had a normal sex ratio at birth and low female child mortality. Moreover, matrilineality seemed to provide the same benefits as patrilineality: “We found that daughters provided economic and emotional support to their parents equal to that of sons,” Li says.
Through fieldwork in rural China, Zhu and Li developed a framework that would make having girls economically and socially acceptable. At a national meeting in 1998, they approached the Family Planning Commission with their findings. The commission was moving away from coercive methods, repositioning itself as an arbiter of reproductive health, and Li and Zhu convinced Commissioner Zhang Weiqing to incorporate their findings into an upcoming gender-equality campaign. Still, the sex-ratio issue was sensitive because of its connection to the one-child policy—so much so that the demographers had trouble finding a pilot area for Care for Girls. In the end, Li says, they selected Chaohu simply because officials here agreed.
Some scholars question whether the Family Planning Commission, which continues to slap fines on parents who exceed the one or “1.5” child policy, is the best entity to tackle China’s skewed sex ratio. Wang Feng, a demographer at the University of California, Irvine, says the issue would be better addressed by scrapping birth limits entirely. “The Family Planning Commission is … curing the disease by treating the symptoms rather than the root cause,” he says. “They’re evading the more difficult, and the more fundamental, part, which is the [one-child] policy.” Other scientists point out that sex ratios have risen concurrently across Asia in countries that do not limit the number of children a couple can have. And proponents stress that the Family Planning Commission has an army of workers—a nationwide network of 300,000 volunteers—to help engineer rapid social change.
Li is among a group of demographers pushing for a further relaxation of the one-child policy. But he and Zhu argue that the policy exacerbates, but doesn’t directly cause, China’s high male-to-female sex ratio. “The essential problem is culture. And Chinese culture can be changed,” says Zhu, who remembers hearing of infant girls being drowned in buckets of water while growing up in the 1930s and 1940s.
Deeper in Chaohu, in a fishing village at the end of a dirt road, 66-year-old Yang Peihua represents the most intransigent part of that culture. Sitting on a bench in her mudwalled home, Yang recalls how she felt when her daughter-in-law gave birth to a second girl. “It was like I was dropped into a tub of ice cubes,” she says. Under Care for Girls, Yang was required to attend a training session for elderly women, at which she says she learned, “Boy or girl, leave it to nature.” But her attitude underscores the challenge facing China. “It’s a very powerful cultural norm that they’re addressing,” says Feldman.
Against the grain
When Bao told his family he would move to his wife’s hometown, he recalls, “at first my parents were opposed. But I told them the environment in this village is more comfortable. And this kind of land is difficult to get otherwise.” He gestures to the couple’s courtyard home and its prime location on a busy road—a reward from the village government for their unconventional marriage.
As Bao tells his story, Shuzhuo Li looks on approvingly, satisfied that over a decade of work is paying off. The results of the trial here were promising. According to Family Planning Commission data and independent surveys, Chaohu’s sex ratio dropped from 125 in 1999 to 114 in 2002. The next year, the Chinese government scaled up the program to 24 districts around the country. Results were similarly encouraging, with the sex ratio in those places declining from 134 in 2000 to 120 in 2005. In 2006, Care for Girls rolled out nationwide.
Li and Zhu concede that the program’s short-term gains may be the result of a crackdown on sex selection, not deeper cultural change. Further progress could be elusive: “The closer you get to a normal sex ratio, the more difficult it is,” says Zhu. But unborn girls may get a boost from urbanization, which some scholars credit for a recent decline in South Korea’s sex ratio. The flow of migrant workers to wealthy cities in eastern China raises women’s earning power and introduces new ideas to the countryside. “Urban culture values sons and daughters more equally,” Li says. As the sex ratio continues its upward march, China needs all the help it can get.