Boys outnumber girls at a kindergarten in Ho Chi Minh City. A new Vietnamese study confirms that sex-selection abortion has been a dominant factor behind Vietnam's skewed sex ratio at birth.
The would-be mother started to cry.
"Forgive me," she told her 12 week-plus fetus, which she was aborting.
"Mommy doesn't want to do this, but I have no choice," she said.
Arguably, "mommy" was making a choice. She was having her "daughter" pay the price for being a girl.
The unnamed mother-to-be is one of 35 women cited in a study on sex-selective abortions that confirm a gender bias in Vietnam with far reaching future implications for the nation.
The study was done by Tran Minh Hang of the Vietnam Academy of Social Sciences, who wrote in a report released recently: "The number and gender of"¦ children is highly relevant to the phenomenon of sex selection, because the majority who decided to have sex-selective abortion did so after having had daughters."
She said the study confirms the preference for a son in the context of low fertility in contemporary Vietnam, with women wanting to have a small family and avoid giving birth to female children.
The study, which conducted in-depth interviews with the 35 women who identified themselves as having had sex-selective abortions between January and December 2009, confirms that the practice has been a dominant factor behind Vietnam's skewed sex ratio at birth (SRB).
The country's SRB has been rising steadily over the past few years, from the average 106 males per 100 females compared with a biologically standard figure of 105 in 2006, to 112.3 at present, the General Office for Population Family Planning said at an international workshop last week.
The study, which also interviewed health staff, doctors, and policymakers, indicates that most women who had sex-selective abortions were 12-16 weeks pregnant.
It says the sex-selective abortion trend will weaken government's efforts to reduce the high rate of abortions in the country.
Experts in the field have endorsed the study's findings, saying that, for now, the trend looks set to continue nationwide.
"Whatever efforts are made by people to ensure male births by other means, there is no doubt that selective abortion remains the most effective," said Chirstophe Guilmoto, a French expert with the United Nations Population Fund (UNFPA).
Vietnamese online forums have offered advice on how to have a baby boy everything from special diet, to rigorous sex, to pre-intercourse douching with an alkaline solution.
Meanwhile, experts blame the practice of sex-selective abortions on toothless laws that have failed to thwart it.
While Vietnam does not have any definitive statistics on sex-selective abortions, the General Office for Population Family Planning estimates that around one million abortions are done per year in Vietnam. The World Health Organization has said the country's abortion rate is among the highest in the world.
Abortion has been legal in the country since 1954, and it was only in 2003 that Vietnam banned fetal sex selection.
It has since barred doctors from performing ultrasound checks to reveal the sex of the fetus to the parents, but the regulations are all but impossible to enforce.
Many people, including the doctors themselves, say it is easy for them to inform the patients directly or indirectly about the sex of the fetus, as it is difficult for the authorities to monitor it.
In fact, the doctors stand to lose their clients if they abide by this law.
Furthermore, the doctors quoted in the study and those who spoke to Vietweek said preventing sex selection was very difficult when abortion remains legal.
"Almost all, if not all women who seek abortion never admit that they want to do so because the fetus is female," a doctor at a leading Ho Chi Minh City public hospital told Vietweek on condition of anonymity.
"And if we refuse to perform the abortion for them, they will just simply end up finding a private clinic who will service them, even though this can put the safety of the women at risk," he said.
The study says that a bunch of private clinics providing abortion services have sprouted up around public hospitals in Hanoi.
It quotes a woman who was 14-week pregnant as saying: "When I went there [a private clinic], I was frightened by [its] facilities. The clinic was [bare] and untidy.
"I didn't see any equipment or professional tools. If I [were to] get excessive bleeding, I [would] die before having emergency aid."
The preference for baby boys in Vietnam has its roots in a patriarchal tradition reinforced manifold by Confucianism. A Confucian saying actually goes: "With one son you have a descendant; with 10 daughters you have nothing."
Under the nation's patriarchal system, male descendants carry the family lineage and support their parents when they are old. Women, on the other hand, are considered outsiders who will leave the family after marriage.
Given these deep-rooted beliefs, unless drastic measures are taken, the rising gender imbalance would leave about up to 4.3 million Vietnamese men struggling to find wives by 2030, government forecasts have shown.
Worse still, the situation could lead to increased human trafficking and sex crimes over the next few decades, experts say.
Vietnam is not alone. China, South Korea and India are other countries in the region with skewed SRB.
"Today, 117 million women across Asia are "˜missing' largely due to the current SRB imbalance, which is a direct manifestation of extensive gender discrimination," said Mandeep O'Brien, the UNFPA representative in Vietnam.
Senior Vietnamese officials including Deputy Prime Minister Nguyen Thien Nhan have expressed serious concern about the skewed SRB in the country.
But Vietnam is yet to take serious action to tackle the problem as other countries have done. South Korea has beefed up scrutiny of doctors performing sex diagnosis. India is trying to strictly enforce the ban on prenatal sex disclosure. China has launched a strong policy to support parents of girls.
In Vietnam, policymakers are caught in a dilemma.
Hang, the Vietnamese expert, said: "Prohibiting sex-selective abortion becomes difficult in the context of implementing abortion rights and reducing fertility rates.
"Rather than focusing on abortion itself, public policies should target equity, equality, and social security that are the root causes of the preference for sons, which in turn leads to sex-selective abortion."
A UNFPA study last year offered some hope with the finding that daughters were more valued than previously thought, with many families finding they take better care of parents than sons.
But the new study indicates that the odds continue to be stacked against women in the struggle for gender equality in Vietnam, and that progress is likely to be very slow.
It quoted a policymaker as saying: "To supervise and identify a case of sex-selective abortion is like finding a sewing needle in the ocean.
"We cannot do it."