Like much of the rest of South Asia, Pakistan has a highly patriarchal society. Consequently, the desire for
sons is a dominant and widely prevalent cultural value that is reinforced by feudal kinship systems, which
permeate many parts of the country (UNFPA 2012). While the reliance on sons is stronger in rural areas
because of agricultural work and the tying of land ownership with male inheritance, even in other areas,
boys are seen to be important in carrying on the family name and taking care of parents in old age.
On the other hand, daughters are seen as an expense and an economic burden in both rural and urban
areas, especially in view of the increasing price of dowry (Royan and Zaidi 2011; Zubair et al. 2006;
Fikree and Pasha 2004). A mere 22 percent of women participate in the labor force (Pakistan Labour
Force Survey 2012-13), and this role of women as productive and economically empowered agents is
largely confined to urban areas. The majority of women remain economically dependent on male
household members and are unlikely to be contributing to household income.
In an international comparison, Bongaarts (2013) ranked Pakistan as having the second highest Desired
Sex Ratio for Boys out of a total of 61 countries, and this son preference is validated by results of
successive Pakistan Demographic and Health Surveys (PDHSs). Studies have noted the profound
implications of this preference on fertility decisions: Muhammad (2009) finds that the desire for a son
when a couple has only or mostly daughters is stronger than the desire to have a daughter when a couple
has only or mostly sons. More insidiously, son preference has a proven impact on child care and on the
child sex ratio in Pakistan (Guilmoto 2009), with boys receiving a disproportionate share of their parents’
resources, and the nutritional, health, educational and psychological needs of girls commonly being
neglected. For this reason, in 2000-05, Pakistan was one of the few countries in the world to have higher
female than male mortality below the age of five (Guilmoto 2009).
Such marked preference for sons can translate into sex-selective abortions and uneven sex ratios at birth
(SRBs) when fetal sex determination technology is available and permitted. This is especially true where
fertility rates are declining: as families begin to have fewer children, their desire to determine the gender
of the child increases (Guilmoto 2009). Indeed, the discriminatory practice of prenatal sex selection has
already taken root elsewhere in the region, leading to unequal SRBs and child sex ratios (CSRs) in several
South Asian societies.