India’s 2011 census data show that “wealthier, better-educated families,” who have a first-born daughter “are choosing more and more often to abort [subsequent] pregnancies if the child is female,” despite fetal sex determination and sex-selective abortion being illegal in the country, according to a study published on Tuesday in the Lancet, National Journal reports. The study showed “the country has 7.1 million more boys age 6 and under than girls – a huge jump since 1991, when there were 4.2 million fewer girls than boys,” National Journal writes (Fox, 5/24).

“The increasingly lopsided ratio of girls to boys is larger in wealthy households than poorer ones, the researchers reported. Between 1980 and 2010, they estimate, four to 12 million girls were aborted because of their sex,” according to Agence France-Presse. Few health care providers have been charged or convicted under a 1996 government regulation designed to prevent ultrasound for fetal sex determination, the researchers said, according to the article. S. V. Subramanian of the Harvard School of Public Health wrote in an accompanying Lancet commentary, “The financial incentive for physicians to undertake this illegal activity seems to be far greater than the penalties associated with breaking the law” (5/24).