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Recent sex ratio at birth in China
  1. Quanbao Jiang1,
  2. Cuiling Zhang2
  1. 1 Institute for Population and Development Studies, Xi’an Jiaotong University, Xi'an, China
  2. 2 China Population and Development Research Centre, Beijing, China
  1. Correspondence to Professor Quanbao Jiang; recluse_jqb{at}


Background China’s sex ratio at birth (SRB) has declined in the past decade but still exceeds the normal level. This study seeks to depict the SRB trend in the past two decades.

Methods We depicted the SRB trend, including SRB by birth order, children composition, residence and hukou type, education, race and province using latest data available from multiple data sources and standardisation and decomposition methods.

Results The SRB remained around 120 in the first decade from 2000 to 2010, and recently declined and approached the normal level during 2010–2020. The SRB for second births and first births converged to the normal level, whereas the SRB for third and above births exceeded the normal level. The rising proportion of second births increased, whereas the decreasing proportion of first births reduced the overall SRB. Parents with only daughters are more likely to abort a female fetus in pursuit of a son, while parents with only sons are more likely to abort a male fetus in pursuit of a daughter. It also shows difference in SRB by residence, hukou type, educational attainment and race. Urban SRB was lower than rural SRB, by the residence and hukou type, but higher than rural SRB after being standardised. Provinces still exhibit differences by original categorised policy even after the implementation of the universal two-child policy.

Conclusions China’s SRB has declined substantially during the past two decades, but the negative effects need to be tackled.

  • health policy
  • public Health
  • other study design

Data availability statement

Data are available upon request.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

Data are available upon request.

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  • Handling editor Sanni Yaya

  • Contributors Both authors contribute equally to this paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Map disclaimer The depiction of boundaries on the map(s) in this article does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.