Abstract

The study is directly related to the Sustainable Development Goal 5 on gender equality. It provides insight into the levels and trends of son preference in Pakistan, as reflected through fertility practices. It has direct relevance for policy-makers and NGOs working on the provision of reproductive health services. 

‘Even though Pakistan is a highly patriarchal society, it has not featured prominently in studies focusing on sex-selective abortion and sex ratios at birth. But with fertility declining and existing strong son preference - Pakistan has one of the highest desired sex ratios in the world (Bongaarts 2013) - how do Pakistani families respond?’ (Zaidi 2013). In the pursuit of sons, do they have additional children or resort to sex-selective abortions? Or is there evidence that the pursuit of sons is weakening? 

We use data from three rounds of the Pakistan Demographic and Health Survey (1990/91, 2006/06 and 2012/13), and examine how sex composition of previous children influences the likelihood of intending more children, using contraception and continuing childbearing. To assess the differentials in these outcomes, we produce cross-classifications of each outcome by parity and sex composition of children. We then estimate a series of log-linear models that capture the structure (or systematic variation) in these data.  We choose a preferred model for the data (for each outcome) that captures the association between that outcome and sex composition in a parsimonious way. The preferred model captures the systematic and substantively important variation and provides expected (Exp.) odds ratios that can be compared with the ones calculated from the observed data. Additionally, we test for elevated sex ratios at birth and for significant variation in these sex ratios. We calculate sex ratios at birth and interpret high sex ratios (those significantly higher than 1.06) as ‘unambiguous evidence’ of sex-selective abortions. We assess whether an estimated sex ratio at birth (SRB) differs from normal (106) by determining whether it falls in the confidence interval of a normal SRB for that sample size. Additionally, chi-square tests are used to test whether SRBs vary across a set of subpopulations.

To gain a deeper understanding of women’s reproductive desires and strategies, we conducted in-depth interviews in January 2015with seven women on their aspirations and reproductive decisions as well as the degree to which they face pressure to have sons.  We also conducted in-depth interviews with 2 gynaecologists working in public hospitals in Islamabad about sex determination of pregnancies and the desire for sons expressed by clients. We used the results from these interviews to contextualize our findings. Our results show clear evidence of son preference in fertility intentions, patterns of contraceptive use and parity progression ratios. More specifically, we find pervasive evidence that Pakistanis continue childbearing to have a son, to have more than one son and to have at least one daughter. We do not find consistent and convincing evidence that sex ratios at birth (which indicate sex-selective abortion) are elevated or increasing.  

References

Bongaarts, J. 2013, ‘The Implementation of Preferences for Male Offspring’, Population and Development Review, vol. 39, no. 2, pp. 185-208.

Zaidi, B. 2013, ‘In the Pursuit of Sons: Sex-Selective Abortion and Differential Stopping in Pakistan’, Masters Thesis, Department of Sociology in the College of Arts and Sciences, University of North Carolina at Chapel Hill, USA,

, accessed 21 September 2016.