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Discrimination Begins in the Womb: Evidence of Sex-Selective Prenatal Investments


  • Prashant Bharadwaj
  • Leah K. Lakdawala


This paper investigates whether boys receive preferential prenatal treatment in a setting where son preference is present. Using micro health data from India, we highlight sex-selective prenatal investments as a new channel via which parents practice discriminatory behavior. We find that mothers visit antenatal clinics and receive tetanus shots more frequently when pregnant with a boy. Preferential prenatal treatment of males is greater in regions known to have strong son preference and among women whose previous children are female. We address other mechanisms such as selective recall, medical complications that might cause male fetuses to receive greater prenatal care in general, son preference-based fertility stopping rules and biases due to sex-selective abortions. Our calculations suggest that sex-selective prenatal care in maternal tetanus vaccination explains between 2.6–7.2 percent of excess female neonatal mortality in India.

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  • Prashant Bharadwaj & Leah K. Lakdawala, 2013. "Discrimination Begins in the Womb: Evidence of Sex-Selective Prenatal Investments," Journal of Human Resources, University of Wisconsin Press, vol. 48(1), pages 71-113.
  • Handle: RePEc:uwp:jhriss:v:48:y:2013:i:1:p:71-113

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    References listed on IDEAS

    1. Seema Jayachandran & Ilyana Kuziemko, 2011. "Why Do Mothers Breastfeed Girls Less than Boys? Evidence and Implications for Child Health in India," The Quarterly Journal of Economics, Oxford University Press, vol. 126(3), pages 1485-1538.
    2. Aparna Lhila & Kosali Simon, 2008. "Prenatal health investment decisions: Does the child’s sex matter?," Demography, Springer;Population Association of America (PAA), vol. 45(4), pages 885-905, November.
    3. Osmani, Siddiq & Sen, Amartya, 2003. "The hidden penalties of gender inequality: fetal origins of ill-health," Economics & Human Biology, Elsevier, vol. 1(1), pages 105-121, January.
    4. Silvia Helena Barcellos & Leandro S. Carvalho & Adriana Lleras-Muney, 2014. "Child Gender and Parental Investments in India: Are Boys and Girls Treated Differently?," American Economic Journal: Applied Economics, American Economic Association, pages 157-189.
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    6. Luojia Hu & Analía Schlosser, 2015. "Prenatal Sex Selection and Girls’ Well‐Being: Evidence from India," Economic Journal, Royal Economic Society, vol. 125(587), pages 1227-1261, September.
    7. David S Loughran & Ashlesha Datar & M. Rebecca Kilburn, 2004. "The Interactive Effect of Birth Weight and Parental Investment on Child Test Scores," Working Papers 168, RAND Corporation.
    8. Silvia Helena Barcellos & Leandro Siqueira Carvalho & Adriana Lleras-Muney, 2010. "Child Gender and Parental Investments in India Are Boys and Girls Treated Differently?," Working Papers WR-756, RAND Corporation.
    9. Monica Das Gupta & Jiang Zhenghua & Li Bohua & Xie Zhenming & Woojin Chung & Bae Hwa-Ok, 2003. "Why is Son preference so persistent in East and South Asia? a cross-country study of China, India and the Republic of Korea," Journal of Development Studies, Taylor & Francis Journals, vol. 40(2), pages 153-187.
    10. Orley Ashenfelter & Cecilia Rouse, 1998. "Income, Schooling, and Ability: Evidence from a New Sample of Identical Twins," The Quarterly Journal of Economics, Oxford University Press, vol. 113(1), pages 253-284.
    11. Douglas Almond & Bhashkar Mazumder, 2005. "The 1918 Influenza Pandemic and Subsequent Health Outcomes: An Analysis of SIPP Data," American Economic Review, American Economic Association, vol. 95(2), pages 258-262, May.
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    Cited by:

    1. Douglas Almond & Janet Currie & Valentina Duque, 2017. "Childhood Circumstances and Adult Outcomes: Act II," NBER Working Papers 23017, National Bureau of Economic Research, Inc.
    2. Bahadir Dursun & Resul Cesur & Inas Rashad Kelly, 2017. "The Value of Mandating Maternal Education in a Developing Country," NBER Working Papers 23492, National Bureau of Economic Research, Inc.
    3. repec:kap:ejlwec:v:45:y:2018:i:1:d:10.1007_s10657-017-9562-7 is not listed on IDEAS
    4. repec:eee:deveco:v:127:y:2017:i:c:p:269-282 is not listed on IDEAS
    5. Edward N. Okeke & Amalavoyal V. Chari, 2015. "Can Institutional Deliveries Reduce Newborn Mortality? Evidence from Rwanda," Working Papers WR-1072, RAND Corporation.
    6. Milazzo, Annamaria, 2014. "Why are adult women missing ? son preference and maternal survival in India," Policy Research Working Paper Series 6802, The World Bank.
    7. Palloni, Giordano, 2017. "Childhood health and the wantedness of male and female children," Journal of Development Economics, Elsevier, vol. 126(C), pages 19-32.
    8. Libertad González, 2016. "Sex Selection and Health at Birth among Indian Immigrants," Working Papers 886, Barcelona Graduate School of Economics.
    9. Milazzo, Annamaria, 2014. "Son preference, fertility and family structure : evidence from reproductive behavior among Nigerian women," Policy Research Working Paper Series 6869, The World Bank.
    10. Bhalotra, Sonia R. & Chakravarty, Abhishek & Gulesci, Selim, 2016. "The Price of Gold: Dowry and Death in India," IZA Discussion Papers 9679, Institute for the Study of Labor (IZA).
    11. repec:spr:jopoec:v:31:y:2018:i:2:d:10.1007_s00148-017-0668-6 is not listed on IDEAS
    12. Josef Montag, 2013. "Is Pro-Labor Law Pro-Women? Evidence from India," MENDELU Working Papers in Business and Economics 2013-40, Mendel University in Brno, Faculty of Business and Economics.

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