International Journal of Scientific Reports | August 2020 | Vol 6 | Issue 8 Page 316 International Journal of Scientific Reports Magar AA et al. Int J Sci Rep. 2020 Aug;6(8):316-321 http://www.sci-rep.com pISSN 2454-2156 | eISSN 2454-2164 Original Research Article Gender preference among pregnant women in Nepal Anupama Ale Magar, Rajendra Karkee*, Samyog Upreti, Laxmi Subedi, Anup Ghimire INTRODUCTION There has been decline in fertility and explicit preference for smaller families in most parts of East and South Asia. 1 Aborting a fetus of the undesired sex or halting childbearing only after achieving the desired sex composition of children is common practice in this region. 2 The sex selective abortion inflates the sex ratio at birth and lowers fertility. 3 Sex ratio is a significant social indicator measuring status and equity between male and female in the society indicating gender preference. Nepalese society is patriarchal and son-preferred. Sex- selective abortion is rising and is one of the major causes of imbalances in the sex ratio in Nepal. 4,5 Legalization of abortion in 2002 in Nepal has further led to the sex selective abortion and activists estimate that around 50,000 unborn babies are aborted in Nepal every year after parents find out through ultrasound scans that they are girls. 6 Gender preference affects contraceptive use, pregnancy rates, average number of siblings, sex distribution of children, birth intervals, and duration of postpartum abstinence. 7-10 Further, the risk of postnatal depression in the mothers having baby girls is higher because such mothers often experience domestic violence. 11 There is limited research about women’s preferences for sex of the child across castes, ethnicities, and ecological areas of Nepal, even though this is an important issue in addressing the unbalanced sex ratio and managing the overall demographic transition in the country. 12 Hence, the study was carried out to estimate the gender preference and identify associated factors among the pregnant women in Kathmandu, Nepal. ABSTRACT Background: Nepalese society is traditionally patriarchal and son-preferred with increasing numbers of sex-selective abortions. In this context, this study aims to assess the gender preference and associated factors among pregnant women visiting the antenatal care ward of a large public maternity hospital in Kathmandu, Nepal. Methods: A hospital-based cross-sectional study was carried out among 821 antenatal women. Data was collected via face to face interview with structured questionnaire, and gender preference was assessed using Coombs’ scale. Results: At the first instance, more than half 56.2% respondents wished to have two sons and one daughter if they were to have only three children. On asking further questions as per the Coombs’ scale, about 40% of the respondents had son preference falling in IS scale 7-5, 33% had balanced IS-4, and 27% had daughter preference (IS 3-1). The respondent characteristics significantly associated with gender preference were ecological region (p=0.007), education (p=0.009), marital duration (p=0.044) and parity 0.32. Conclusions: The wish to have son is prevalent among the respondents followed by a mixed gender of children. Educational status, ecological region, and parity explain this differential wish. Women’s education and autonomy are the areas to tackle with sex bias of offspring. Keywords: Gender, Preference, Coombs’ scale, Nepal School of Public Health and Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal Received: 29 March 2020 Accepted: 27 April 2020 *Correspondence: Dr. Rajendra Karkee, E-mail: rkarkee@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20203115