Boys Preferred : S. Korean Parents Tip Birth Ratio

A few years ago, when some of Seoul’s leading obstetricians noticed that boys significantly outnumbered girls on school playgrounds, they quietly undertook a survey of births at seven of the city’s large hospitals.

They found that for every 100 girls born in 1983, there were 109 boys born. The next year, 110 boys were born for every 100 girls.

Normally, according to the World Health Organization, male births outnumber female births by no more than 106 to 100 in any country. And, as the infants mature, a higher mortality rate among males brings the two sexes roughly into balance.

The Korean doctors kept their findings to themselves for two years, but the 1985 figures forced them to break that silence. In the first 10 months of the year, there were 117 male births for every 100 females.

Females Were Aborted

The doctors’ conclusion: some Korean parents were aborting fetuses once they established, through relatively new medical technology, that the babies would be female.

“It’s a terrible situation,” said Dr. Roh Gyung Byung, superintendent of the Cheil General Hospital and vice president of the Korea Hospital Assn.

Dr. Kim Seung Jo, secretary general of the Korean Assn. of Obstetricians and Gynecologists, said the medical profession “has been less oriented to social problems than most others” but could no longer afford to remain aloof in the face of overwhelming evidence that baby girls are being killed in the womb because of their sex.

Dr. Park Chan Moo, a retired obstetrician who heads the Korea Institute for Population and Health, the agency in charge of the government’s birth control program, called the situation alarming.

Male Preference Blamed

All three doctors see the strong preference of South Koreans for male babies as the root of the problem. The preference stems from a Confucian ethic emphasizing family continuity through the male side. The tradition is reinforced by a “Family Law,” which allows only sons to carry on the family name.

The emphasis on masculinity caused no problems until the advent of widespread birth control and the availability of an ultrasonic test and a surgical procedure called amniocentesis for determining the sex of unborn infants.

The tests, which are simple and painless, are designed to monitor growth and to disclose any genetic problems or congenital deformities.

In South Korea as well as in the United States, the tests are administered mainly to pregnant women above the age of 35, who are far more likely than younger women to have children with Down’s syndrome and other congenital deformities. The ultrasound test provides an outline of the fetus in the uterus; then a doctor inserts a needle through the woman’s abdomen to take a small sample of the amniotic fluid. Tests of this fluid reveal the sex of the fetus as well as evidence of congenital defects and some genetic diseases.

But some obstetricians here have developed a lucrative business by giving the tests for the exclusive purpose of determining the sex of the fetus. And many women, on learning that the fetuses are female, promptly have abortions, the obstetricians and gynecologists association suspects.

Abortion is illegal here except for medical reasons or in the case of rape or incest, but “for the past 20 years abortions have become rather free because the government doesn’t punish anyone,” Park, the birth control official, said. He estimated that more than a million abortions are performed every year.

A government program to reduce the birth rate, begun in 1962, also has led authorities to “look the other way” on abortions, according to Dr. Lee Sung Woo, director of the medical affairs543323506Social Affairs.

But in February, after the obstetricians’ survey was made public, President Chun Doo Hwan ordered the Health Ministry to halt the use of ultrasound and amniocentesis for the purpose of determining the sex of a fetus. The ministry sent a letter to more than 1,000 hospitals and clinics that had been performing the tests, Lee said. Also, the obstetricians and hospital associations sent out a circular ordering their members to stop the tests.

May Prosecute Doctors

The authorities, hoping that persuasion will suffice, are planning no punitive legal action for now, Lee said. “But if this practice continues, we will take drastic measures against doctors, including prosecution and cancellation of their licenses,” he said.

Lee said the ministry had identified a number of doctors who were “collecting customers because they became well known for giving sex-determination tests.” Each performed three or four tests a day, he said.

He refused to disclose how many doctors are involved. He said the number is small, but that, “however small it is, the practice of sex selection is obviously unethical and must be stopped.”

Lee and a number of leading private obstetricians agree that the hospital survey does not reflect any peculiarly Korean phenomenon.

Kim, of the obstetrics and gynecology association, said couples who choose sex selection are “intelligent, well-educated, socially prominent urbanites,” particularly in Seoul.

“Usually,” he said, “these couples have only one or two children and want to make sure that they have a boy. They are overplanned family planners.”

Rare Among Farmers, Poor

Sex selection is believed to be nonexistent among farmers and poorer workers, who have limited access to advanced medical treatment. But South Koreans increasingly are clustering in urban areas. Seoul, for example, has 9.8 million people, or 23.8% of the country’s population.

Until about a decade ago, when the equipment for ultrasonic testing became widely available, South Korea had no particular problem in the sexual balance of its population. Even today, it ranks 41st in the world in male predominance in its population, behind such other Asian societies as Hong Kong, Taiwan, China and Singapore, according to a study by Facts on File.

In the years before gender tests were available, few parents practiced birth control. But, over the past 25 years, the government’s population control program has helped reduce South Korea’s growth rate from 2.84% to 1.25% and to reduce the number of babies born to the average mother from 6 to 2.1.

The campaign started with an appeal to “Have few children and bring them up well.” In 1971, this became “Let’s stop at two,” and, in 1983, “Even two are too many.” The government has backed up the rhetoric with tax incentives and increased access to inexpensive housing for couples with only one or two children.

Birth Control Common

According to a survey by the Korea Institute for Population and Health, birth control is practiced by 60% of the women of child-bearing age with two children, and by 26.4% of those with one child.

But the program’s success has made mothers more conscious of the sex of their children.

“If they have a boy as their first child, some couples don’t want a second child,” Kim said. “If they have had two boys, they stop. But, if the first child or the first two children are girls, they will try again.”

Roh, the hospital association president, said: “Three or four pregnant women come to me every month asking if I can help them determine the sex of their unborn child. Mostly, they are mothers bearing their third child, although sometimes it is a second child. Often they are just curious. But, perhaps half of them would get an abortion if they were sure the fetus was female.”

Roh said he tries to encourage the mothers not to spurn daughters by telling them that, in some ways, girls will have easier lives than boys in South Korea.

Advantages for Women

“They can marry more easily than men,” he said, noting that men now outnumber women in the 20-29 age group by a ratio of 104.5 to 100. “I also try to reassure them by saying that the Family Law will change by the time their daughters grow up.”

In South Korea, the collection of vital statistics is still in a relatively primitive state--no nationwide data has been collected on the ratio of male births to female births--and no one is sure just what is taking place.

But the statistics that have been compiled suggest that male preference is beginning to become a nationwide problem. The 1980 census, the most recent count breaking down the sexes by age, shows that males dominated the age group from birth to 4 years by a ratio of 107.2 to 100, and Kim estimates that that ratio has since risen to 108 to 100.

“That’s an alarming number,” Roh said.

By comparison, in the United States boys in the under-4 group outnumber girls 104.7 to 100. In Japan, culturally and racially similar to Korea, the ratio is only 105.4 to 100. In 1960, before the birth control program was initiated, South Korea had about the same ratio of males to females in this age group (105.3 to 100) that Japan now has.

Government officials and obstetricians agree that South Koreans must eventually give up their preference for boys. And they agree that, as a step in this direction, the Family Law must be amended to allow a daughter to carry on the family name and to assure females of equal rights.

Continuing Family Name

According to Roh, it is not so much the preference for boys as the desire to see the family name continued that has caused the problem.

“Japan is not so strict,” Park said. “When an only daughter gets married there, her husband can assume her family name to carry on the family.”

In Japan, birth control is even more widespread than in South Korea. And Japan has become the only male-dominant society in East Asia in which women outnumber men in the total population--the typical pattern in advanced countries.

In South Korea, a woman retains her family name throughout her life, even after marriage. Her children take the husband’s name. This tradition, reinforced by law, means a great deal in a country where voluminous ancestry records are kept and worship of prominent male ancestors continues for centuries.

Park produced two encyclopedia-size books, part of a 12-volume set, showing his male forebears back through 25 generations and 700 years. The books contain maps pinpointing the location of graves to facilitate veneration.

1,000-Year Family History

Roh said his family can trace its roots back 1,000 years, to a forebear who came from China and had eight sons whose offspring have accounted for 300,000 South Koreans, all of whom can be identified through family records.

Koreans take great pride in their family system and the concept that the family takes precedence over the individual as the basic unit of society. No one advocates abolishing the Family Law. But the advocates of change want to get rid of what they view as irrationalities in it. The Health and Social Affairs Ministry is on record as favoring revision of the Family Law; so, too, are the nation’s obstetricians.

So far, however, scientific evidence and modern argument have proved weak in the face of Confucian belief.

Even today, because of the Family Law, a man and a woman named Kim who trace their common ancestor to the Kimhae region of South Korea through a paternal line 2,000 years old cannot marry, although their blood relationship has been diluted by 74 generations. If they defy the law, they cannot register their marriage. One-sixth of the Korean population is named Kim--and all have a common ancestor.

Nowhere else in the world is there such an eternal ban on marriage within the clan. Even China, which originated the custom, abandoned it at the turn of the century.

Many Have Same Names

More than half of all South Koreans carry one of four names--Kim, Lee, Park or Choi.

There is no organized Confucian movement in South Korea, but, according to Park, “when we try to amend the Family Law, they appear from nowhere to make threats to the Ministry of Health an1679840111assemblymen.”

President Chun and the late President Park Chung Hee, both authoritarian rulers, tried to change the law without success. Members of the National Assembly, Park said, fear that voting for any change in the law will jeopardize their reelection.

Chun’s government, which tried and failed to amend the law two years ago, has pledged to try again this year. But it set 1991 as its target date. That seems safe enough, at least for Chun, who has promised to leave office in 1988.