Ye Gaoli, a farmer in Cangnan county, Zhejiang Province, was pregnant again. Ye already had an 11-year-old daughter, but she and her husband desperately wanted a boy.

Identifying the gender of a fetus without permission is illegal on the Chinese mainland. However, as with many pregnant women, Ye was willing to take the risk of finding out the baby's gender, and then decide whether she wanted to keep it or not.

Ye contacted a private clinic, took an ultrasound and decided to abort upon finding it was a girl, at a cost of 3,800 yuan ($611). 

Ye is not alone in this. Due to the family planning policy and Chinese traditional preferences for male children, a large number of pregnant women visit private clinics or even individuals, mostly without medical certificates, to discover the sex of their unborn child and have abortions. The fetuses are usually 3 to 4 months old or even months older.

"Many pregnant women would have an abortion if they found out the fetus was a girl, because they think female heirs are at a disadvantage compared with male heirs," Zhang Zhongtang, an expert on family planning from the Chinese Academy of Social Sciences, told the Global Times.

Fertile industry

In early March this year, four people, who carried out 736 illegal ultrasounds and 15 gender-selective abortions in Zhejiang, were jailed for terms ranging from one to three years, reports said.

Headed by Liu Ciwang and his wife Huang Xiaomiao, neither of whom had medical licenses, the gang used portable ultrasound machines to check the gender of fetuses and carried out abortions in vehicles from February 2010 to May 2012.

They purchased two minivans, one to pick up pregnant women and the other to carry out the ultrasounds and abortions. The pregnant women were driven to remote areas in Cangnan and Pingyang counties to receive medical attention. 

The gang was efficiently organized, with each member taking charge of specific duties. Liu shouldered the responsibility of attracting potential customers by handing out business cards, picking up pregnant women and taking the money. Huang operated the ultrasound machine and induced the abortions while Li Bingfeng and Guo Ling were employed as drivers.

"Pregnant women would call them according to the number on the name card. The gang members would tell these women to meet them at a specific time and place. Then, they would dispatch a minivan to pick them up, drive them to remote areas in the countryside, and carry out the ultrasound tests or abortions," Zhang Rongmin, a local judge who took charge of the case, told the Global Times.

The business was lucrative, Zhang said. It cost around 60,000 yuan to buy the vehicles and ultrasound machines, but the gang charged 800 to 1,200 yuan for a gender test and 3,800 yuan for an induced abortion.

He added that most of the perpetrators were unlicensed and that it was difficult to gather evidence against them, given their mobility and the lengths they took to keep their operations a secret.

However, it appeared that in certain cases, some medical institutions including private clinics worked as middlemen to get commissions from the gang by introducing new customers to them. When not working in their vans, they also set up shop in rented hotel rooms with hired lookouts keeping watch for the police. 

According to the testimony provided by the court, in the Cangnan case, the minibus in which the abortions were carried out was not equipped with any disinfection facilities, and the poor medical condition put women's lives at risk.

 "Pregnant women were asked to take an anesthetic. Hours later, when abdominal cramps occurred, they were injected with oxytocin to start the abortion," Zhang told the Global Times.

Ways and means

A massive campaign against illegal gender tests and induced abortions, launched by central and local governments back in August 2011, found 6,700 such cases that had taken place in the past three years and over 2,400 people were punished nationwide, Xinhua reported.

The methods of identifying a fetus' gender have also become increasingly diversified.

In another case, a group of four people in Henan went down for terms ranging from six months to two years late last year. They applied a new method to their patients, extracting the placental villi and analyzing samples under a microscope. This procedure greatly improved the accuracy rate and drew in 50 pregnant women seeking to know the gender of their child, with 25 of them deciding to have abortions in 2010, at a cost of between 3,000 to 5,000 yuan each.

"If the accuracy of the gender test is high, it would attract more and more pregnant women through word of mouth. After the 'good reputation' of the group spread, their business expanded," Zhang said.

However, the high accuracy rate of the tests also resulted in severe consequences, Zhang said.

"Before this, many pregnant women wouldn't choose to have abortions because they had doubts about the accuracy of the test. However, after the new methods were applied, they felt relieved and confident in proceeding with the abortions," Zhang said.

Some other new methods, including sending blood samples to Hong Kong for gender tests, have also been used.

One Shandong company charges 5,000 yuan to send the blood sample of a pregnant woman to be tested by contacts in Hong Kong where gender tests are not banned. A salesman who gave his surname as Zhang promised that, if the gender testing proved inaccurate, they would reimburse their customers. Of course, given the likelihood of abortions in case of a female fetus, this inaccuracy may be difficult to correct. 

A lack of supervision on ultrasound machines and other medical equipment has also resulted in a rampant market for gender identification. It is easy for any individual to buy ultrasound machines in China, despite the law requiring hospitals, medical institutions and individual buyers to show certain certificates before they buy an ultrasound machine. However, in reality, buyers don't need to show any certificate before making a purchase.

"The portable ultrasound machine is the best-seller for our company. Its price is comparatively cheaper than the competition and you needn't show any certificate before buying it," said Li, a salesman from Guangzhou-based Kaide Technology Company. The average price of the portable machines is around 10,000 yuan while private clinics and individuals are the main buyers of portable ultrasound scanners, mostly hailing from Beijing and Guangzhou, Li added.

Tilting gender ratio back

"Illegal ultrasounds are running wild across China, in both economically developed areas and rural areas. Rich people want to have a male heir to inherit the family fortune while people in rural areas want strong manpower and farmers think boys can do more to help the family," Zhang told the Global Times.

Influenced by traditional Chinese culture, male children are believed to be vital to a prosperous family as they can carry on with the family bloodline and revive the economic situation.

The problem of imbalanced male and female infants ratio can be traced back to the late 1980s when B-ultrasound technologies became available and was used to identify the genders of babies. The family planning policy was instigated in large part due to a growing gender imbalance that has continued to this day.

Illegal gender identification and abortions are the direct causes behind the increase in the male section of the population. China's gender ratio at birth has remained high since the late 1980s, and reached 117 men to 100 women in 2011, much higher than the global average of between 103:100 and 107:100.

This gender ration has also become imbalanced in larger cities in recent years, given the influx of migrant workers seeking work there. This has distorted the country's gender map to such an extent that where rural areas were once the most affected, cities in the provinces of Guangzhou, Zhejiang and Fujian are now facing some of the largest imbalances in the country.

"The severely imbalanced male and female ratio may cause severe social problems. A large number of men of marriageable age will not be able to find wives, which might cause social instability and threaten public order," Zhai Zhenwu, a sociologist at Renmin University of China, told the Global Times.

According to a 2010 Social Development Blue Paper from the Chinese Academy of Social Sciences, the gender ratio of Chinese aged below 19 is the worst hit among different age groups. By 2020, the number of Chinese men of marriageable age will outnumber their female peers by 24 million.