Factors affecting child gender desirability

Objective To evaluate the dynamics influencing child’s gender desirability among expecting females and ascertain the major determinants. Methodology This cross-sectional, observational study included 100 pregnant females, chosen via simple random sampling, at the OBGYN outpatient department of the Liaquat University Hospital, Hyderabad. Data was collected via structured interview based questionnaires from 1st December 2014 to 10th February 2015 after taking the verbal informed consent. SPSS v. 19.0 and Microsoft Excel were used to analyze the obtained data. Results Four main aspects were observed to affect the child gender desirability by the parents, namely the family structure of the expecting mother, socioeconomic circumstances of the expecting mother, locality of the expecting mother and the order of the expected child. The expecting females living in a rural vicinity, having deprived socioeconomic status and a combined family structure have a greater desire for giving birth to a male child. Furthermore, they also desire their first 3 children as a minimum to be born a male child. Conclusion On the roots of our results it has been accomplished that the desire of having a male child is a social taboo of our people and society and it has been recognized as one of the key reasons of domestic cruelty and brutality on women breathing in our society. This matter requires appropriate direction, advice, guidance and counseling.


Introduction
Ever since the Beijing Conference on Women and the Girl Child in 1995 and the Cairo International Conference on Population and Development in 1994, equality of gender has been a prime area of demographic research. In the South Asian setting, researchers have predicted that there are hundreds of thousands' of females "absent" from the population, leading to an oddly high proportion of males and females (Agnihotri, 1995, Coale, 1991, Griffiths, 2000and Das, 1987. In some countries with a strong gender desirability, couples stop having children once they are contented with the gender composition of their family (Pradhan, 1997) specially, after the birth of a male child. Therefore, the gender ratio of child last-born (last birth gender ratio) can be a lot greater than the biological constant of 106 sons per 100 daughters ever born. For instance, in Punjab, a region in Northwest India known to have high levels of gender bias (United Nations, 1998), the sex ratio at last birth is 184 (Choe, 1998).
Preference and desire for a male child is largely viewed as a bias that is determined socially: In a patriarchal society, parents would rather raise a child who has the culturally accepted status, features and economic potential which sadly is not associated with the fairer sex. This desirability often affects behavior and may lead to gender biases that adversely affect welfare, health and survival of the fairer sex. Thus, desirability may lead to discrimination. (Clark, 2000).
The desire for a son may be a direct contributing factor, through shortened birth intervals after the birth of girls (Agnihotri, 1995, Coale, 1991, Griffiths, 2000and Das, 1987 and the neglect of the younger daughters in large families of girls in which parents are still hoping for a boy . Son preference may also promote more extreme forms of discrimination, such as infanticide and feticide of females. . Studies conducted in India suggest that sex preference influences not only discriminatory and excess mortality, but also demographic transition (Mutharayappa, 1997). Through the postponement of stopping behavior until the birth of a son, sex preference may exert its strongest effect on fertility during the intermediate stage of demographic transition, thereby slowing fertility decline. However, in Korea and China, where aggregate fertility levels are low, gender bias has persisted through the demographic transition no longer as sex-determined stopping behavior, but as sex-selective abortion. This finding has unsettling implications for women's status. Although the daughters are desired, sons are very highly prized because they continue the family name, can fulfill cultural expectations and are expected to provide support in old age. Usually the patrilineal social structure discourages women from practicing contraception until they have a son.  To our knowledge, no national study has systematically investigated patterns and implications of son preference in Pakistan. In this study, we examine the extent and determinants of sex preference, by measuring levels of various forms of gender bias and identifying factors associated with son preference.

Methodology
This cross-sectional, observational study included 100 pregnant females, chosen via simple random sampling, at the OBGYN outpatient department of the Liaquat University Hospital, Hyderabad. Data was collected via structured interview based questionnaires from 1st December 2014 to 10th February 2015 after taking the verbal informed consent. The questionnaire comprised of 26 questions specifically designed to investigate both qualitative and quantitative aspects of the research. SPSS v. 19.0 and Microsoft Excel were used to analyze the data obtained.

Results
A detailed analysis of the data revealed that four main factors cast effects on the child gender desirability by the parents, namely the family structure of the expecting mother, socioeconomic circumstances of the expecting mother, locality of the expecting mother and the order of the expected child.  It is a well-established fact that socioeconomic status determines many aspects of our life, but the fact that the socioeconomic status can actually determine life is rather unsettling. Our study discovered that socioeconomic status determined the child gender desirability and probably the ultimate gender ratio. The Figure 2 graphically represents the observed phenomenon below. The locality in which an individual is brought and currently resides has an effect on the ones thought process, desires and decisions. The child gender preference too was found to be different among expecting mothers from different localities. Figure 3 explains the differences we observed.

Figure 3: Our results dictate that male child desirability among females belonging to rural areas is seen more dominant (66.7%) as compared to females belonging to urban areas (50.6%). Women from both types of localities preferred male children. The former more than the latter.
The order of the child also emerged as a factor in the analyzed data. The desire for a male child decreased if the couple had already had male children before. Figure 4 depicts the trend below. Figure 4: 57% of the expecting mothers desired for their first three born to be male and an additional 48% desired for their later three children too to be male. Female born, regardless of the first three or later in order were desired less than males.

Discussion
The expecting females considered their gender favoritism justified. Some called it a matter of personal choice while others defended their bias as necessary for their families given the present cultural norms and requirements, be it the economic reason where the male child is needed to earn, be it the social aspect where the male child is considered to reinforce the family and its status or be it the religious point of view like in Hindu communities where male children are considered to be the one to do the funeral rituals.
Although times are changing and old stereotypes too are withering away, but the older generation is still holding on to the old values and desires and thus expecting mothers living in joint family set-up with the elders are pressured for a male child and the need for a male child sets foot in their subconscious mind and eventually gives birth to a conscious desire. While the nuclear counterparts are independent to form their opinions somewhat free from the influence of the elders and thus they are seen to be less biased towards male children. This belief is substantiated by the results of our research that shows that to-be mothers living in nuclear families have a greater desire for child to belong to the fairer sex 58% as compared to those living in a joint family (43%). While those living in joint families longed more for baby boys (57%) than their nuclear counterparts (42%).
In a developing country such as Pakistan, where the culture dictates strict rules for each gender and define clear roles. The males are the bread earners while the females are largely staying-at-home members of the family. It is natural for the society to extend for more bread earners, and hence more males in the family. In addition to that, socioeconomically less privileged families, consider female children as a burden because it is believed that the female child would be of no importance economically and socially and due to the society we are breathing in where the dowry system is on its peak, it is not possible for the poor parents to afford a good and prosperous life for their female child. Our results give strength to the above said beliefs and gives clues about the desire of male child among females in the lower class and middle class societies as it is seen that the probability for the desire of a male child is 59% in lower class families as compared to girls which is 35%. Whereas for middle class families the probability stands at 65% for girls and 41% for boys.
The locality in which an individual is brought and currently resides has an effect on the ones thought process, desires and decisions. The child gender preference too was found to be different among expecting mothers from different localities. The societal drawbacks and traditional set-backs are stronger in rural areas and thus the desire for a male child is expected more in expecting mothers that come from rural localities. While in urban areas expecting women come across a wide array of modern stimuli and thus become more susceptible towards the ideas of the gender equality and feminism. Our results dictate that male child desirability among females belonging to rural areas is seen more dominant (66.7%) as compared to females belonging to urban areas (50.6%). Women from both types of localities preferred male children. The former more than the latter. The order of the child also emerged as a factor in the analyzed data. The desire for a male child decreased if the couple had already had male children before 57% of the expecting mothers desired for their first three born to be male and an additional 48% desired for their later three children too to be male. Female born, regardless of the first three or later in order were desired less than males. Another idea we can obtain from our results is that the desire for a male child stems from the love of a male child and not from any dislike towards a female child and thus once the desire for a male child is fulfilled, a greater acceptance of a female child is achieved.

Conclusion
On the roots of our results it has been accomplished that the desire of having a male child is a social taboo of our people and society and this matter requires appropriate direction, advice, guidance and counseling. It should be kept in mind that everything is interlinked and although we have established that the factors we talked about influence gender desirability, it must also be noted that the existence of son preference in a region will have implications for future population and socioeconomic development. Which makes this matter of great public importance.

Competing Interests
All the authors disclose that there are no competing interests in the preparation of this article.