monitoring and evaluation program, particularly given the lack of coordination between different departments in specific geographic areas, and difficulties tracking the country’s floating population. These efforts also raise ethical dilemmas about excessive intrusion required into women’s lives for such monitoring exercises to work. Even simple monitoring efforts to calculate the SRB at the regional level and estimate the severity of the practice are challenging due to poor vital registration systems, particularly in economically disadvantaged areas (Guilmoto 2012a; WHO 2011).

Unnecessarily harsh measures can also alienate some of the key stakeholders in countering sex imbalances. For example, the Indian Radiological and Imaging Association has repeatedly complained against the enforcement of the PC PNDT Act. Doctors and medical practitioners argue that they are being harassed by local authorities for minor clerical errors, their equipment has been unfairly seized, and in some extreme cases, their licenses revoked for paper-work discrepancies. In 2016, members of the association even held a nation-wide strike to protest the implementation of the PC PNDT Act (The Indian Express 2016).

The ability of keep up with the pace of development in sex determination technology is another concern. For example, in 2015, the Chinese government had to enforce a new ban preventing the smuggling of mothers’ blood samples to Hong Kong SAR, China, for fetal DNA tests (Global Times 2012; MarketWatch 2015). Moreover, even if countries manage to ban the specific technologies, affluent individuals who actively want sons can travel to regions that have legal access to these methods. This is evidenced in the case of affluent Asians who travel to Europe or Thailand for prenatal sex selection (Guilmoto 2012a).

# _3.1.2 Unintended Consequences of the Ban_

Bans are a common legal tool used by societies to restrict social “wrongs”. But if underlying preferences do not change, bans are particularly likely to be self-defeating. Bans push individuals to circumvent the law and seek alternatives that can pose greater risks for the very individuals bans seek to protect (Sunstein 1994). Bans against child labor exemplify this. In a perfect world, such bans can force employers to stop using child labor. But in reality, they simply lower the wages children are paid, and consequently, compel poorer families to supply more child labor at the cost of the child’s education (Bharadwaj et al. 2013; Edmonds & Shrestha 2012). Similarly, policies that prohibit employers from asking about job applicants’ criminal histories as a way of reducing racial disparities in employment are found to be counterproductive. Agan and Starr (2018) examine the effectiveness of “Ban the Box” policies in the U.S., and their results suggest that these policies actually encourage racial discrimination as applicants with distinctly black names received fewer call-backs than applicants with distinctly white names.

Bans against the use of prenatal sex selection technology are no different. They can result in unintended consequences for the women and girls they intend to protect. First, strict enforcement of bans could mean that women who want to abort unwanted female fetuses would seek clandestine services, and risk unsafe abortion procedures (Nie 2010). In-depth interviews with health care providers in Nepal suggest that medical personnel are aware that their patients may seek illegal 13