Whither Sex Ratios in a Low Mortality Setting

Sex ratio at birth should remain constant in the absence of any manipulation. India has shown a worsening sex ratio over the years. Tamil Nadu has shown a remarkable decline in birth rate as well as infant mortality rate. Knowing trends of sex ratio over the years will help us in formulating policies to reduce discrimination.
Community Health Department of the Christian Medical College has been operating a detailed demographic surveillance system in Kaniyambadi block in Tamil Nadu since 1982. Data was analyzed to provide estimates of sex ratio at birth, juvenile sex ratio and sex specific infant and perinatal mortality.
There has been a decline in the Infant mortality rate from 67.4 per 1000 live births in 1986 to 16.3 per 1000 live births in 2013. But the sex ratio during 2011-2014 is showing an unfavorable trend. The sex ratio for the first child was 845 females/1000 males. The second pregnancy was not unfavorable but every subsequent pregnancy showed an unfavorable sex ratio.
The study has shown the preference for a male child in the Indian society. The sex of the pre-existing child is a powerful predictor for the next child. The role of modern technology needs to be re-examined in order to address this adverse sex ratio.