In a tight alleyway in East Delhi, Radhika Devi, a bashful mother of two girls, and Manjula Thomas, a health worker who cares for pregnant women, rush to an ultrasound clinic. Devi is five months pregnant and desperately wants to know the sex of her unborn child.

"It's better if it's a boy," she says, her hands shaking nervously. "If it's a girl, we will get it aborted."

Radhika, her husband, Radheshyam, and their two daughters share a single room in the congested, mostly lower-class neighborhood of Khichripur. Radheshyam brings home less than $2 a day as a bus driver--barely enough to put food on their table--and they worry about marrying off their two young daughters.

"All girls' parents must pay dowries," Radhika says. "We will take loans and pay it back bit by bit. It might take up to a year's time."

Though dowries are illegal in India, the law is widely ignored and the Devis fear a third daughter will send them over the edge financially. Instead, they hope for a son to one day provide for the family. He would fetch his own dowry upon marriage, take care of his parents as they grow old (India has no social security program) and carry on the family name.

In India's male-dominated society, especially the northwest, this logic is one reason parents abort an estimated half-million female fetuses each year. The practice, called female feticide, has been responsible for at least 10 million female abortions since 1985, according to a controversial study published in January in the Lancet, the British medical journal.

"All kinds of famines, epidemics and wars are nothing compared to this,"
said Punit Bedi, a New Delhi gynecologist. "In some parts of India, one in every five girls is being eliminated at the fetal stage.

"It is a genocidal situation."

Abortion--legal in India since 1971--originally was trumpeted as a way to control the country's rapidly expanding population, now 1.1 billion people, making it the second most populous country in the world, behind China.

"It was understood that all programs (to control the population) were failing because people would not stop having children until they had at least two boys," Bedi said. "Even one was not considered enough in a country where you cannot ensure childhood survival beyond 60 percent."

In 1994, under pressure from a coalition of activists, the Indian government changed course, outlawing the use of ultrasound machines to reveal fetus gender. In 2002, the penalties were stiffened: up to three years in jail and a $230 fine for the first offense and five years imprisonment and $1,160 for the second.

Aborting a child because of its gender has never been legal, but experts said doctors still act with impunity.

"It's a very low-risk, high-profile business," Bedi said. "Not only do the doctors make a lot of money, they are absolutely sure they will not be caught."

In Punjab, a male-dominated state with the most disparate gap between boys and girls in India, only one doctor has been convicted in the past four years of performing a sex-selective abortion, according to V.K. Goyal, a senior Punjabi health official. The convicted doctor's medical license was suspended for five years and he was fined 400 rupees, around $10.

The Lancet study seemed to confirm that laws were not deterring families from sex selection. By analyzing national birth records and fertility histories from a 1998 Indian government survey of 1 million households, the study estimated at least 500,000 female fetuses in 1997 were aborted. Based on that one year, they came to the 10 million figure.

The study also found that families whose first child was a girl were 30 percent less likely overall to produce another girl. And if the mothers had at least a 10th-grade education the gap was twice as large as that for illiterate mothers.

"Normally in public health the poor are worse off," said Prabhat Jha, an epidemiology professor at the University of Toronto and lead author of the Lancet study. "But here we have the rich and educated that are more often performing sex selections. And that is entirely consistent with being able to afford and have access to ultrasound technology."

Indeed, the drive for male heirs has created an explosion in ultrasound clinics that can determine the sex of a fetus and medical practices that profit mostly from doing sex-selective abortions, activists said. A new ultrasound machine costs $5,000, a used one as little as $2,000 and banks eagerly provide loans, according to Bedi.

"Everybody bought an ultrasound machine. Just about anybody that could make out a girl or a boy bought a machine," Bedi said. "The machine pays for itself within three to six months. The amount of money to be made was so much."

Doctors collect anywhere from $80 to $230 for an ultrasound-plus-abortion package, health officials said. Though precise numbers are hard to come by, experts estimate the business to be worth $100 million to $200 million each year in India.

"I have never seen a qualified doctor starving," Bedi said.

The big business of feticide has moved well beyond India's major cities, according to health officials. Take the rich, agricultural state of Punjab as an example. When the state's first ultrasound clinic opened in 1979 there were 925 girls for every 1,000 boys below the age 7, according to Sabu George, a public health activist who has criticized feticide for more than 20 years. By 1991 it was 875, and by 2001 it had plummeted again, to 793, according to national census figures.

In Nawanshahr, a small farming district in central Punjab, a recent government survey revealed village after village had fewer than six girls for every 10 boys. In the tiny village of Nai Majara, a second-grade class has 14 boys and only three girls. Last year the town produced less than five girls for every 10 boys, according to the survey.

In the quiet village of Chakli Sujait, the town's midwife, Manjit Kaur, said, "I know about every pregnant lady and no abortions are performed here." Earlier, however, the town's health worker had quietly revealed the birth records for the past six years: 34 boys and 19 girls.

Experts warn not to draw conclusions from the small number of births found in Nawanshahr's tiny hamlets. But the district's own survey revealed parents across Nawanshahr managed to produce only 775 girls for every 1,000 boys over the past six years.

As feticide spreads to rural areas like Nawanshahr it is becoming increasingly dangerous for pregnant women, according to Bedi. Ultrasound tests, which bounce sound waves off a fetus, cannot accurately determine its gender until at least the 16th week of pregnancy and sometimes not until the 18th week. Often mothers go for two or three ultrasounds to be sure. That means most sex-selective abortions are done near the end of the second term and some later than that, according to doctors. By then many women "exhaust their money by getting scans done," Bedi said. "Then they go to the cheapest, least qualified and shadiest clinics in town."

Unsafe abortions account for one in five maternal deaths in India, according to a 2005 World Health Organization report.

But attitudes are changing in some communities in India.

In Kajampur, a small village in Nawanshahr, girls and boys have been born in equal number for several years now.

"People here aren't worried about carrying on the family name or paying dowries for daughters," said Mohinder Singh, the proud uncle of a new baby girl. "Due to education in the schools our thinking has changed."

Students at the College for Girls in Chandigarh, the capital of Punjab, also are rejecting old ideas.

"In my personal view a female is as capable as a male. I would not make a distinction whether I had a son or a daughter," said Georgia Georg, a 19-year-old psychology major from the southern state of Kerala. "Kids are in the hands of God."
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