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Missing women of China is a widely known phenomenon referring to the unusual shortfall of female population resulting from cultural influences and government policy. ^[1] The term "missing women" was coined by economist Amartya Sen, winner of the 1998 Nobel Memorial Prize in Economic Sciences, to describe a distorted population sex ratio in which the number of males far outweighs the number of females. ^[2] Female disadvantages in child survival throughout China reflects a long pattern of gender based discrimination. Son preferences are common throughout the world due to males ability to carry on family names, their wealth inheritance, and the idea that they are typically ones who care for parents once they are older. Limiting the ability for parents to have numerous children forces them to think of logical and long term reasons to decide between a male or female child. ^[3] Chinese parents are known to have favored large families and have preferred sons over daughters in effort to create more directed family resources. ^[4] The result of the discrimination and male preference is a shortfall of women and an extremely unbalanced sex ratio in the population of China. ^[5]

The one-child policy was designed to control population throughout China, emphasizing limitations for families and creating deprivation among couples. The implications resulted in increased underreporting of female births, female infanticide, sex selective abortion, and the underreported adoption of baby girls. ^[6] Families not only risk their health but are at risk for punishment by law as well as health institutions who participating in sex selective abortion. Increased abandonment of babies, especially females has greatly added to the phenomenon of "missing women" throughout the country. Xuefeng Chen, director fo the Chinese Children's Center in Beijing, stated "it is undeniable that single children will create a different society, we must first enhance single children's opportunities and abilities at social communication, interaction and development." Single children in China are deprived of the experiences undergone by their mothers and fathers. The well-being of children who are in only-child households are considered to be at risk and participate in typical stereotypes of single-children, such as being spoiled, selfish and unsociable. ^[7] The one child-policy has been called the "most momentous and far reaching in its implication for China's population and economic development." Chinese women's reproduction is viewed as a feature of social modernization and sacrifice for political implications. Reproductive rights have been co-opted by the government as a guide towards social modernization. ^[8]

At the beginning of 2017, the Chinese government modified its family planning laws to finally allow married couples to have a second child. In 2016 the National Health and Family Planning Commission of China reported that live births in national hospitals numbered 18.46 million and that the fertility rate reached 1.7 percent, the highest rate since 2000. The effect of the new policy to relax birth-planning regulations has debunked 400 million averted births. Since the policy has been enacted, 261.4 million unregistered people who have lived at their residence for at least 6 months were found. ^[9] The policy change has taken pressure off parents to participate in sex-selective abortion or even avoiding registering female babies at birth, as they now have room for two children. The implementation of the two-child policy has given families room to grow but also control population in the country, in a managed and more humane way. ^[10] Although the two-child policy was implemented, the 35-year old social policy is unlikely to take part in a baby boom, in attempt to spark economic growth. The country is believed to be a true single-society even when given the option to take part in extending their family count. ^[11] The two-child policy is not expected to serve as a baby boom, rather a moderate increase in fertility among Chinese women. There are still effects resulting from the one-child policy which the two-child policy is intended to attempt to reverse including, population aging, reduction in sex ratio birth, more oppressive elements of child policy, contributions to economic growth and allow freedom to couples to have their desired amount of children. ^[12]

In an attempt to call for birth control to control the countries population in 2015, the Chinese government expanded to the use of contraceptive use. “20 years ago if you went to the rural villages, you could see the slogans on the wall that read, ‘if you have one child, IUD please, if you have two children, sterilization please,’” describes Kaining Zhang, a research physician at the Yunnan Health and Development Research Association. “There is still a very strong influence [from that] policy.” ^[13] The attitudes towards reproductive heath have dramatically changed throughout the country. Sexual health was often times something kept private and not openly discussed. A survey conducted by Renmin University in 2015 states that more than half of the respondents think premarital sex is acceptable. The traditional views on sexual health, contraception are rapidly changing affecting primarily the young an unmarried generation. ^[14]

China has one of the highest rates of contraceptive use in the world, even in comparison to other Asian countries. Among 84.6% women who are currently married or in union are using a form of contraception. The United States has a lower rate of 78.6%. Japan, a neighboring country has reports as low as 54.3% prevalence. The one-child policy enacted in 1979 is the primary contributor of increased contraceptive use. ^[15] In attempt to really decrease the population, China's family planning policies actually emphasize birth control and many forms are available both in urban and rural areas for free. ^[16] The strict implications of the one-child policy did allow for many women to receive birth control methods however it typically only benefits those who are married. The young population who is not covered are not married and therefore fall into the gap of unintended pregnancy. ^[17] The National Population and Family Planning Commission did however over see China's views by making improvements with the increased access to birth control, and also sex education. Providing women with the access and social support of contraceptive use not only allows for population control, but allows families to analyze their option before considering abortion options. The International Family Planning Perspectives states, "the effect of sex preference on childbearing is becoming stronger as fertility declines, because couples must achieve their desired number of sons within a smaller overall number of children." Although contraceptives aren't always related to sex preference, "an improvement in the status of women and female children should be helpful in reducing son preference and improvement in maternal and child health and family planning services should be helpful in reducing the number of abortions in the country." ^[18] Access to prenatal sex determination will lead to an increase number of wanted births, leading to less discrimination against girls and a lower overall female mortality rate. Fewer sex selective abortions and reduced son will reduce son preference and create less participation in sex selective abortions which would ultimately level the imbalanced sex ratio.

The continued discrimination against girls and preference of sons has lead to a highly imbalanced sex ration at birth. The sex ratio is defined as the number of boys born to every 100 girls. China is a country with known son preference which is emerging to affect reproductive ages both now and in future generations to come. Due to these sex-selective abortions, there is now clear evidence that suggests an overwhelming number of "missing women" throughout the country. Many countries take part in the selective abortion to ensure a different sex in the second pregnancy. If the first child is a girl, couples then use the selective abortion to ensure a boy in the second pregnancy, especially in more rural and uneducated areas. The consequences of this male surplus are inevitable upcoming. ^[19] Men will be left wifeless as there will be no women for the men to marry. The social status of many Chinese countries is dependent on marriages, especially women who are handed off. The consequences of these sex-seletive abortions go beyond societal issues, but even psychological amongst young, unmarried men. "Men who have low self esteem are inclined to depression and tend to be withdrawn" according to the Canadian Medical Association Journal. ^[20] It is likely for their self-esteem to drop due to the unavailability of women. It is feared through the country that men will become outcasted and develop antisocial behavior due to the lack of social order as a consequence of the events. The primary cause of prenatal sex selection comes from one root cause; son preference.

In attempt to keep its population under 1.2 billion, China has carried out a female infanticide program by limiting couples to one child. Female infanticide was common in traditional China as families favored sons to care for them the rest of their lives. The government has implemented policies in attempt to help with the situation such as creating a single-child policy but has had almost reverse affects. Daughters are viewed as "marrying out" and leaving their families, whereas men are financially loyal to their families. Girls are in return viewed as a burden to raise, among many neighboring countries to China. The Quan Han Shu mentions that no festivities were held when a daughter was born into a prosperous family, and the poor people did not even rear their children. ^[21] In a recent Chinese natural survey in 2003, thirty-seven percent of young women, predominately urban, said they had no gender preference and forty-five precent reported their ideal family would consist of one boy and one girl. ^[22] The elimination of female infants has contributed to the phenomenon known as, "missing women." The social, economic and physical repercussions are still nor relied. Female infanticide, sex abortions, drowning, and withholding of health care and nutrition are only a few consequences of the restrictive one-child policy. ^[23]

Although there is extensive damage to the gender ratio throughout the country, it is still possible to implement change to benefit future generations of the country. ^[24] According to the Canadian Medical Association, it is crucial to both outlaw sex selection and fix the primary issue of son preference. Many laws already forbid fetal sex determination throughout countries in Asia, including China, but still continues to be a problem. Establishing responsibility to those performing illegal acts such as abortion is one step closer to ensuring a healthy, family oriented society. Holding doctors, clinics and establishments accountable by law is believed to make astounding differences in the sex preference. ^[25]

Son preference as a whole, is largely challenging in the country. It is primarily important to spread public awareness though campaigns, media, and posters including advantages of females. The results of many campaigns such as the "Care for Girls" campaign on China, by the National Population and Family Planning Commission, encourages female births and requests participation from many neighboring countries. In one of the participating counties in Shanxi providence, the sex ratio birth was reduced from 135 in the year 2003 to 117 just three years later. ^[26] The country must implement a less traditional form of gender approach and encourage women for higher status positions in society. The Chinese government is essential in improving their gender and social rights. In 1992, the Law on the Protection of Rights and Interests of Women ensured women equal rights among politics, culture, education, work property rights and even marriage. Evidence shows that a country who supports higher status of women leads to a less traditional view of gender and lowers the level of son preference. All these socioeconomic improvements have lead to a steer away from traditional views of women to a more modern approach, working to end the gender gap in entirety.