Published: 2020-07-21

Gender preference among pregnant women in Nepal

Anupama Ale Magar, Rajendra Karkee, Samyog Upreti, Laxmi Subedi, Anup Ghimire


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.


Gender, Preference, Coombs’ scale, Nepal

Full Text:



Dey I, Chaudhuri RN. Gender preference and its implications on reproductive behaviour of mothers in a rural area of West Bengal. Indian J Community Med. 2009;34(1):65-7.

Paul A, Dasgupta S, Bhattacharya S. Gender Preference among the Mothers attending Antenatal Clinic of Burdwan Medical College, West Bengal. Indian J Matern Child Heal. 2014;16(1).

Bongaarts J. Fertility and reproductive preferences in post-transitional societies. Popul Dev Rev. 2001;27:260-81.

Frost MD, Puri M, Hinde PRA. Falling sex ratios and emerging evidence of sex-selective abortion in Nepal: Evidence from nationally representative survey data. BMJ Open. 2015;3(5):1-8.

Lamichhane P, Harken T, Puri M, Darney PD, Blum M, Harper CC, et al. Sex-selective abortion in Nepal: a qualitative study of health workers’ perspectives. Womens Health Issues. 2011;21(3):37-41.

Slaughter of our unborn daughter. Nepali times. Available at php?id=19627#.XmnW_KgzaM9. Accessed on 14 September 2012.

Khan MA, Khanum PA. Influence of son preference on contraceptive use in Bangladesh. Asia-Pacific Popul J. 2000;15(3):43-56.

Rai P, Paudel IS, Ghimire A, Pokharel PK, Rijal R, Niraula SR. Effect of gender preference on fertility: cross-sectional study among women of Tharu community from rural area of eastern region of Nepal. Reprod Health. 2014;11(1):15.

Rahman M, Vanzo DJ. Gender Preference and Birth Spacing in Matlab, Bangladesh. Demography. 1993;30(3):315-32.

Calhoun LM, Nanda P, Speizer IS, Jain M. The effect of family sex composition on fertility desires and family planning behaviours in urban Uttar Pradesh, India. Reprod Health. 2013;10(1):48.

Cankorur VS, Duman B, Taylor C, Stewart R. Gender preference and perinatal depression in Turkey: a cohort study. PLoS One. 2017;12(3):1-13.

Sapkota JB, Paudel DB, Neupane P, Thapa RB. Preference for Sex of Children Among Women in Nepal. Glob Soc Welf. 2019;6(2):69-78.

Coombs LC. Preferences for Sex of Children Among U.S. Couples. Fam Plann Perspect. 1977;9(6):259-65.

Coombs CH, Coombs LC, Mcclelland GH, Coombs LC. Preference Scales for Number and Sex of Children. Popul Stud (NY). 1975;29(2):273-98.

Srivastava A, Singh J, Singh O, Singh V, Singh N. Gender Preference, Attitude and Awareness of Young eligible couples towards Prenatal Sex Determination in Lucknow District. Natl J Community Med. 2014;5(1):148-52.

Thapa M, Bajracharya J. Gender Preference in Current Pregnancy among Primigravidae. Nepal J Obstet Gynaecol. 2017;12(1):36-9.

Kanyadi S, Kulkarni R. Determinants of gender preference among women of Belagavi: a cross sectional study. Int J Community Med Public Heal. 2017;4(12):4733.

MB P, Dhanpal S, Lokanath H. A study of gender preference, knowledge and attitude regarding prenatal diagnostic techniques act among pregnant women in an urban slum of Bengaluru. Int J Community Med Public Heal. 2015;2(3):282-7.

Hank K, Kohler HP. Gender Preferences for Children in Europe: Empirical Results from 17 FFS Countries. Demogr Res. 2000;2(1).