A few years ago, somewhere in Quetta lived a beautiful young woman with her two girls and a husband renowned across the city as among the best sonologists. The couple decided to have a third baby in the hopes of having a boy this time round.
A few months into the pregnancy, however, it dawned on the woman that her life is not as precious as the foetus inside her womb. The baby on the way was a boy and things had changed for the mother.
It was almost as if she had ceased to exist. Doctors routinely take an oath to preserve life and to renew it. But in this case, the sonologist threw caution to the wind. Some months in, the woman’s consultant gynaecologist warned the family that continuing with the pregnancy would be risky for the mother.
In fact, the mother-to-be threatened to abort the pregnancy herself if her doctor’s advice was not heeded. But the sonologist insisted on forging ahead, come hell or high water. But the woman’s health did deteriorate over time. A few weeks before she was due, she was rushed to the hospital for an ultrasound.
Doctors detected neither foetal movement nor a heartbeat; they advised an induced abortion to save the mother’s life and that too immediately. But the husband wanted to seek a “second opinion” – it was, after all, a male foetus.
The couple returned home that day only to return the next morning. But the woman succumbed to the unnecessary delay; her body was too frail to resist the toxins being released from the dead foetus a day more. Amid the sobs of her girls, she passed away, holding her peace and with it, her dreams and ambitions and perhaps those of her daughters too.
“It was outright murder and I believe her consultant was equally responsible in the crime, for she let her patient go home because of what her husband wanted,” says Dr Agha Xaher Gul, Head of Business Strategy at Marie Stopes. Dr Gul was completing his house job at the time; he says the incident shook Quetta. But then again, thousands of women have succumbed to their husband’s maddening pursuit to have a son.
This case was no different. Of late, the trend of aborting a pregnancy if it’s a girl has caught on across Pakistan. Although data on abortions because of the sex of the foetus remains scant, the Population Research Institute, a non-profit research group, released some worrying statistics: of the 24 million sexselective abortions performed during 2000-2014 across the world, more than 1.2 million were estimated to have been carried out in Pakistan.
To put it simply: over 15 years, approximately 219 pregnancies were terminated every day on the basis of their sex. While many doctors shrug off this statistics claiming it to be untrue and unsubstantiated, veteran gynaecologist Dr Shershah Syed expresses the likelihood of its legitimacy, adding however that some might have been done as family planning. “Sex-selective abortions are not uncommon and most likely these numbers are correct,” says Syed.
“Nobody can give exact figures but educated and uneducated people both try to find out about the sex of the foetus and go for an abortion if it is not a boy. The picture is grim as far as the girl child is concerned. Nobody cares about them and they are the cause of tension in families.”
In the heart of the Karachi, in an old building, philanthropist Sarim Burney is sitting with a married couple. The woman is pregnant with her third daughter; they have just had an ultrasound done to confirm the sex.
The couple is there to inform Burney that they will abandon their baby after birth if indeed it is a girl. In case the ultrasound sex prediction proves inaccurate, they will keep the newborn. Burney tries to reason with the man not to discriminate between a boy and a girl. But the man insists he cannot afford another daughter due to lack of resources.
“The couple returned to the trust after a few months with an adorable baby girl,” recalls Burney. “We offered an adequate monthly stipend to keep their daughter at home with them but they left the baby at the trust. Had we forced him to take the daughter back, the father would have dumped her or sold her off somewhere. We felt it was better to keep her with us.”
The fact that the majority of babies recovered from garbage dumps are girls, the fact that most of the babies left in Edhi cradles, hospitals and maternity clinics are girls, the fact that less girls are born in Pakistan than boys and the fact that the primary and secondary school participation of girls is small in number in contrast to boys, is not just mere coincidence.
They are all tied together and point to the mindset of our society – the obsession to have sons, and the savagery and discrimination that results as its consequence. Of course, this is not the phenomenon of every Pakistani household – some are content with the children they have.
There are some who avoid a family with no son, and then there are those who nip the problem in the bud to maintain their ideal family.
They all are part of this society. Our society runs on a skewed gender valuation system in which sons enjoy pre-eminence as they are economic resources, support for elderly parents and, most importantly, prolong the family’s patrilineal lineage.
Those considered the best kinds of people are parents with daughters whom they raise to be sons, but no one raises their sons to be their daughters. But is the desire for survival so intense that people would dump and dispose of their flesh of blood?
Faisal believes that people are “exploiting” ultrasound technology to determine the sex of the child before birth and choose whether or not to bring a girl child to this world. Those who do not get a chance to abort the pregnancy throw them in garbage dumps, offering them as food to street animals and leaving them to die a cruel death.
It was for this reason that Abdul Sattar Edhi had begun a cradle service, encouraging people with “unwanted” babies to let those newborns have a lease on life. Without legal oversight into the health sector, parents dumping their babies into trash dumps evade charges of second-degree murder. But when it came to the Edhi Foundation’s cradle service, they came under attack for encouraging people to have kids out of wedlock.
Of all the deserted babies found alive in the country, claims Faisal, about 90-95 percent were baby girls. He also notes that for every newborn boy left in an Edhi cradle, there are seven newborn girls.
And yet, the Edhi Foundation claims to receive a drastically lower number of babies from their cradles across the country as they did a decade ago. But if you think that this indicates things are getting better, think again.
“Babies are now being sold in the name of adoption,” claims Faisal Edhi, alleging that some NGOs and welfare organisations are also involved in it. This mafia lures the parents into selling their babies instead of dropping them in cradles. Then they sell these children on further for hefty amounts to adoptive parents. “Sometimes a third-party agent or a middleman is involved too,” explains Faisal. “They are not unwanted children. They are planned babies, brought to this world to make money, often by families stricken with poverty.”
Faisal Edhi recalls the smuggling of newborn infants to Malta in the early 2000s and how millions were allegedly earned by selling Pakistani babies abroad. Bilquis Edhi also speaks about how an educated couple adopted a child from the Edhi Centre and sold the child on later. “The incidence of baby boys being sold is twice as much as baby girls,” states Bilquis Edhi.
Every gynaecologist, at some time in their career, has witnessed prenatal and postnatal discrimination against newborn baby girls. One such doctor is Dr Mahjabeen Khan. She discusses a case where a husband stood outside the labour room, threatening his wife of divorcing her if she delivered a girl.
“The baby was not even completely out when the patient sat up to check its gender. She had given birth to her eighth daughter and went in shock soon after,” recalls Dr Khan. “It was a normal case till then but suddenly complications arose because of the husband and his desire to have an heir. I can still hear echoes of him screaming. It was quite traumatic.”
Discrimination can also be weighed with the amount of risk parents are willing to take to deliver their unborn child. “Most parents do not take a risk if they know they are having a boy. Even if there is no need for a C-section, they insist to go for it to ensure zero threat to their unborn son’s life,” Dr Parveen says. “But many parents resist a C-section to deliver a baby girl despite doctors’ recommendations to the contrary.”
The senior gynaecologist also highlights that if two patients of the same name deliver babies at the same time, a boy and a girl, both families would be willing to claim the boy.
Pakistan’s sex ratio at birth (SRB) is fairly skewed. Typically the sex ratio at birth usually oscillates around 105 male births per 100 female births. In Pakistan, it is estimated to be 109.9. In other words, around 110 male births per 100 female births; this is close to India which is infamous for sex-selective abortions.
An in-depth analysis of the data from all five censuses conducted in Pakistan since 1951 also reveals that the male population has constantly dominated female population in numbers. As of the 1998 census, Pakistan’s overall sex ratio was 108.5 males per 100 females or 925 girl babies per 1,000 boy babies. When classified further, the distortion is found worse in Balochistan (114.6) and Sindh (112.2).
Although gender imbalances at birth are attributed to a set of local factors in each country, they are generally observed in regions with persistence of patriarchal norms and son preference. These are typically countries where people have easy access to sex-detection technologies and pregnancies are terminated on the basis of gender.
This practice is known as female foeticide and is quite common in China and India. Pakistan, however, doesn’t have as skewed a SRB as its two neighbouring countries, but researchers suspect the problem is alarming because of the inordinate delay in carrying out the population census.
Somewhat similar to female foeticide is female infanticide, when parents neglect their female child deliberately and let them die (of starvation or thirst), resulting in their premature deaths. Researchers have observed higher rates of malnutrition in girls because of being weaned off breast milk earlier, either to feed the baby boy or in trying to get pregnant again in pursuit of a male child. This denial of breast milk/ sufficient food often results in the loss of many innocent lives.
“A female sweeper of our hospital delivers twins, a boy and a girl. As time passes by, the baby boy continues to gain weight while the girl grows frail and dies within four months. She is starved to death gradually, in front of my eyes, as the mother found it more important to breastfeed the boy,” recalls Dr Gul.
Female foeticide and infanticide, when combined together along with the number of females who died as a result of unequal opportunities or access to resources, lead to the “missing women” epidemic – a term coined by Nobel Laureate Amartya Sen to indicate the difference between the women present on the planet and those that would have been here had the sex ratio been “natural” worldwide.
The picture is gloomy, but a ray of hope is flickering on the dark horizon. Speaking about the preference of adoptive parents, Sarim Burney and Dr Mubina Agboatwalla, chairperson of HOPE, both agreed that trends have been changing.
“Adoptive parents are really desperate to adopt a baby. Nowhere have I seen any discrimination,” argues Dr Agboatwalla. “Even if they have already adopted a baby girl they will still go for the baby girl if available.”
She confirms, however, that around 70 percent of the abandoned babies left at the HOPE hospital and maternal clinics are girls. Burney adds that prospective parents prefer girls because boys are no more considered a support system for parents in their old age.
Indian social scientist and feminist activist Kamla Bhasin describes the patriarchal system as a war of resources where the man is the ‘sun (the resource)’ and women are ‘planets’ dependent on him to sustain life.
But perhaps, the stars will only align for girls if women are no longer financially dependent on anyone; and instead others are reliant on them.