New research from Vietnam shows that not only do girls risk being aborted because of their sex but that they to a greater extent than boys are delivered at home, without qualified midwives or access to emergency surgery.
‘At the same time a disproportionately large part of planned Caesarean sections are performed on mothers expecting boys, which risks subjecting these children and their mothers to complications and unnecessary suffering’, says Mats Målqvist, physician and researcher at the Department of Women’s and Children’s Health at Uppsala University.
In the current study from the Quang Ninh province of Vietnam, which was recently published in journal Gender Medicine, the research group at Uppsala University together with colleagues in Vietnam have studied delivery care utilisation. They found that a larger proportion of girls were born at home while boys to a larger extent were born through Caesarean sections at hospitals. The statistic used is Sex Ratio at Birth, SRB, which is the number of boys per 100 girls born. SRB is normally between 103 and 107 boys per 100 girls, since there are more boys born than girls naturally. In India, China and the countries in South-east Asia, however, it is not uncommon with a clearly elevated SRB; for instance in China values of up to 122/100 have been reported.
In the current study SRB was at 109/100, only slightly above the normal level, but there turned out to be large differences depending on where and how the children were born. Among births at home, which made up 10 per cent of all childbirths, SRB was only 94/100.
‘That means that a significantly larger proportion of girls than boys don’t get access to available delivery care and that the knowledge about the foetus’s sex is a determining factor when choosing place of delivery’, says Mats Målqvist.
The proportion of boys born through Caesarean sections was substantially elevated with an SRB of 135/100. It was mainly the planned Caesarean sections at district hospitals that contributed to this strongly skewed sex ratio. A widespread notion that Caesarean sections are safer and better for the child, and common ideas that certain times are better for giving birth than others, drives this development according to the researchers.
The study shows that gender discrimination starts even before birth, not just through sex-selective abortions but also through choice of delivery method and place. But the gender discrimination goes both ways; girls are neglected through choice of delivery place and mothers of boys are to a higher degree subjected to unnecessary surgery.