man rights organizations.<sup>16</sup> Their campaigns led to the central government passing the Prenatal Sex Diagnostic Techniques (Regulation and Prevention of Misuse) (PNDT) Act in 1994. This act was effective from January 1, 1996. The PNDT Act made it illegal to use prenatal sex-diagnostic techniques (like ultrasound) to reveal the sex of a fetus. Following the revelation in the 2001 Census of a continuing deterioration in the sex ratio, the PNDT Act was strengthened by a 2002 Amendment (effective 2003) incorporating a ban on advertising prenatal sex determination and increased penalties for violations.<sup>17</sup> It is widely believed that these regulations have made little difference (Visaria (2005)), although Nandi and Deolalikar (2013) find that they did have some impact. These bans are difficult to enforce because ultrasound (or alternatives like amniocentesis) is also used for medical purposes and in routine prenatal care, making it easy to cover up sex determination as a motive.

Before we move on to the empirical strategy, it is useful to also consider whether we expect an _underlying_ trend in the sex ratio at birth, i.e., a trend in the absence of parental interventions, and in what direction. In general, the fetal environment has improved in India. The growth in income and the decline in poverty since the early 1980s has been widely documented; fertility decline set in from 1981 (Bhalotra and van Soest (2008)); and neonatal mortality rates have been decreasing. Maternal mortality is estimated to have declined (Bhat (2002)) and maternal age at birth has risen. These trends will all have led to improvements in fetal health. Indeed, the availability of ultrasound scans that monitor fetal development will also have contributed to better fetal health. Bio-medical studies show that fetal health improvements tend to favor boys (Trivers and Willard (1973), Almond and Edlund (2007)) and thus the underlying tendency, if any, would be for male child survival to increase over time. Our hypothesis, on the other hand, is that the availability of ultrasound scanners has improved female child survival relative to male children.

# **3 Data and Descriptive Statistics**

To examine mortality and fertility, we use three pooled rounds of the National Family Health Survey (NFHS) conducted in 1992-93, 1998-99, and 2005-06. These nationwide, repeated, cross-sectional surveys are representative at the state level and report complete birth histories for all interviewed women, including children’s month, year, and order of birth, mother’s age at birth, and age at death of deceased children.<sup>18</sup> The sample comprises 503,316 births of 232,259 mothers that occurred in 1973-2005.<sup>19</sup>

> 16Feminist and socialist groups in the United States and other richer countries have hotly defended a prochoice stance against a pro-life stance on abortion. The focus of public discussion is on benefits for women rather than on benefits for children. For instance, `http://www.theguardian.com/commentisfree/2014/ oct/14/abortion-right-to-privacy-women-right-to-equality` and `https://socialistworker.org/ 2013/11/01/abortion-every-womans-right` . Indian feminists, on the other hand, have been divided by the seeming contradiction of supporting a woman’s right to abortion while opposing sex-selective abortion (Kumar (1983), Gangoli (1998)).

> 17More details on the PNDT Act are available in Retherford and Roy (2003) and Visaria (2005).

18Since the state of Sikkim changed its border during the period of analysis, we exclude it from our sample.

19Women who do not survive to the date of interview, for whatever reason, are not in the NFHS data, and nor are their children. Sex-selective abortion in the post-ultrasound period may elevate maternal mortality 7