Why Are Adult Women Missing? Son Preference and Maternal Survival in India

This paper is the first to show that excess mortality among adult women can be partly explained by strong preference for male children, the same cultural norm widely known to cause excess mortality before birth or at young ages. Using pooled individual-level data for India, the paper compares the age structure and anemia status of women by the sex of their first-born and uncovers several new findings. First, the share of living women with a first-born girl is a decreasing function of the women's age at the time of the survey. Second, while there are no systematic differences at the time of birth, women with a first-born girl are significantly more likely to develop anemia when young (under the age of 30) and these differences disappear for older women. Moreover, among those in the older age group, they appear to be significantly better off in terms of various predetermined characteristics. These findings are consistent with a selection effect in which maternal and adult mortality is higher for women with first-born girls, especially the poor and uneducated with limited access to health care and prenatal sex diagnostic technologies. To ensure the desired sex composition of children, these women resort to a fertility behavior medically known to increase their risk of death. The observed sex ratios for first births imply that 2.2-8.4 percent of women with first-born girls are 'missing' because of son preference between the ages of 30 and 49.

Bibliographic Details

Main Author:	Milazzo, Annamaria
Language:	English en_US
Published:	World Bank, Washington, DC 2014-03
Subjects:	ACCESS TO HEALTH, ACCESS TO HEALTH CARE, ACCESS TO HEALTH SERVICES, ACCESS TO TREATMENT, ACCIDENTS, ADOLESCENCE, ADULT MORTALITY, ADULT WOMEN, ADULTHOOD, ADVERSE HEALTH, AGE DISTRIBUTION, AMNIOCENTESIS, ANTENATAL CARE, BIOLOGICAL DIFFERENCES, BIRTH ORDER, BIRTH SPACING, BREASTFEEDING, CARDIOVASCULAR DISEASE, CARE SERVICES, CHILD HEALTH, CHILD MORTALITY, CHILDBEARING, CHILDBIRTH, CHILDHOOD, CHRONIC CONDITIONS, CHRONIC MALNUTRITION, CLOSELY SPACED PREGNANCIES, COGNITIVE PERFORMANCE, COMPLICATIONS, CONDOMS, CONTRACEPTION, CONTRACEPTIVES, DEPRESSION, DEVELOPING COUNTRIES, DEVELOPMENT POLICY, DIET, DISABILITIES, DISABILITY, DISCRIMINATION, DISEASES, DOMESTIC VIOLENCE, EARLY DETECTION, EDUCATED WOMEN, EITHER SEX, EMOTIONAL VIOLENCE, EXCESS MORTALITY, FAMILIES, FAMILY HEALTH, FAMILY PLANNING, FAMILY SIZE, FEMALE, FEMALE CHILDREN, FEMALE MORTALITY, FEMALE POPULATION, FEMALE STERILIZATION, FEMALES, FERTILITY, FERTILITY BEHAVIOR, FERTILITY RATE, FERTILITY RATES, FIRST BIRTH, FIRST BIRTHS, FIRST CHILD, FIRST MARRIAGE, FIRST PREGNANCY, FORMS OF VIOLENCE, GENDER, GENDER BIAS, GENDER DIFFERENTIAL, GENDER DISPARITIES, GENDER PREFERENCES, GYNECOLOGY, HEALTH CARE SYSTEM, HEALTH CONSEQUENCES, HEALTH FACILITIES, HEALTH RISKS, HEALTH STATUS, HIV, HIV/AIDS, HUMAN DEVELOPMENT, HUMAN RESOURCES, HUSBAND, HUSBANDS, IDEAL FAMILY SIZE, ILLEGAL ABORTION, ILLEGAL ABORTIONS, ILLNESS, INFANT, INFECTIONS, INFERTILITY, INFORMATION ON WOMEN, INJURIES, INJURY, IRON STORES, JOURNAL OF EPIDEMIOLOGY, KNOWLEDGE OF CONTRACEPTION, LEVELS OF FERTILITY, LIFETIME RISK, LIFETIME RISK OF DEATH, LIVE BIRTHS, MALARIA, MARRIED WOMEN, MATERNAL CARE, MATERNAL DEATH, MATERNAL DEATHS, MATERNAL HEALTH, MATERNAL HEALTH CARE, MATERNAL HEALTH OUTCOMES, MATERNAL MORBIDITY, MATERNAL MORTALITY, MATERNAL MORTALITY RATIO, MATERNAL MORTALITY RATIOS, MATERNAL NUTRITION, MEAT, MEDICAL BULLETIN, METHOD OF CONTRACEPTION, METHODS OF CONTRACEPTION, MILLENNIUM DEVELOPMENT GOAL, MISCARRIAGE, MORTALITY RATES, MOTHER, MOTHERS, NATIONAL FAMILY HEALTH SURVEY, NATIONAL POPULATION, NATIONAL POPULATION POLICY, NEWBORN, NUMBER OF BIRTHS, NUMBER OF CHILDREN, NUMBER OF DEATHS, NUMBER OF WOMEN, NUTRITIONAL NEEDS, NUTRITIONAL REQUIREMENTS, NUTRITIONAL STATUS, NUTRITIONAL SUPPLEMENTS, NUTRITIOUS FOOD, OBSTETRIC FISTULA, OBSTETRICS, OLDER AGE GROUPS, OLDER CHILDREN, OLDER WOMEN, OVERWEIGHT, PELVIC INFLAMMATORY DISEASE, PHYSICAL VIOLENCE, POLICY DISCUSSIONS, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POOR HEALTH, POOR NUTRITION, POPULATION AND DEVELOPMENT, POPULATION STUDIES, PRACTITIONERS, PREGNANCY, PREGNANT WOMEN, PRENATAL CARE, PRENATAL DIAGNOSTIC, PRENATAL DIAGNOSTICS, PROGRESS, PSYCHOSES, PUBLIC HEALTH, PUBLIC SERVICES, RADIO, REDUCING MATERNAL MORTALITY, REPRODUCTIVE HEALTH, REPRODUCTIVE HEALTH CARE, REPRODUCTIVE RIGHTS, REPRODUCTIVE YEARS, RHYTHM METHOD, RISK OF DEATH, RURAL AREAS, SAFE MOTHERHOOD, SECOND BIRTH, SEVERE VIOLENCE, SEX, SEX OF THE CHILD, SEX OF THE FETUS, SEX PREFERENCE, SEX RATIO, SEX RATIOS, SEX SELECTION, SEX-SELECTIVE ABORTION, SEX-SELECTIVE ABORTIONS, SEXUAL VIOLENCE, SOCIOECONOMIC STATUS, SON PREFERENCE, SPACING BETWEEN BIRTHS, SPOUSAL VIOLENCE, SPOUSE, STATUS OF WOMEN, STERILIZATION, SUICIDE, TELEVISION, TERMINATION OF PREGNANCY, UNEDUCATED WOMEN, UNICEF, UNITED NATIONS, UNITED NATIONS POPULATION DIVISION, UNIVERSAL ACCESS, UNSAFE ABORTION, UNSAFE ABORTIONS, URBAN AREAS, VICTIMS, WILL, WIVES, WOMAN, WOMEN WITH EDUCATION, WOMEN'S HEALTH, WORLD POPULATION, YOUNG AGES, YOUNG GIRLS, YOUNGER WOMEN,
Online Access:	http://documents.worldbank.org/curated/en/2014/03/19238584/adult-women-missing-son-preference-maternal-survival-india https://hdl.handle.net/10986/17295
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