MUMBAI, India — As India’s middle class grows, more families are using modern technology to ensure they have a boy, according to gender and population experts. Confronted with a decrease in the number of girls born, the state of Maharashtra, of which Mumbai is the capital, has decided to crack down on the illegal practice of so-called female feticide.

India outlawed the practice of doctors using technologies like ultrasounds to tell patients the sex of their unborn child in 1994. Abortion based on certain grounds is legal, but having one based on sex is not.

Despite the law as well as gains in girls’ education and employment opportunities across India, the practice has continued and even grown as more people have access to ultrasounds. The child sex ratio, the number of girls to every 1,000 boys in the 0 to 6 years age group, dropped from 945 girls in 1991 to 927 girls in 2001, according to data from the United Nations Population Fund based on the census. When just looking at the sex ratio at birth, for the period 2006-08, the ratio drops to 904 girls per 1,000 boys.

Sex determination leads to a missing 500,000 to 700,000 girls across India each year, according to the United Nations Population Fund.

The home minister of Maharashtra, R.R. Patil, warned that female feticide and the resulting skewed sex ratio could turn into a “social disaster” and called combating this crime a top priority. In Maharashtra, the sex ratio drops to 884 girls per 1,000 boys, according to the 2006-2008 data.

‘The doctors who are a part of this shameful act should be punished and the medical council should cancel their license to practice medicine for the rest of their life,” he wrote on his blog.

The state government has since announced a proposal to encourage families to have girls by providing cash incentives. On the birth of a girl child, 5,000 rupees ($114) will be deposited into a bank account under her name, according to local media reports. Once the family ensures the girl completes her schooling and does not marry before the age of 18, she will have access to the money. The finance department has not yet approved the program, which would initially be for families living below the poverty line, according to the Times of India.

Cash incentives have similarly been used in India to encourage women to give birth in hospitals or other medical institutions and have been credited with an increase in institutional deliveries.

However, social activists in Mumbai question the effectiveness of providing cash incentives to encourage women to have a girl child when the families that need to be targeted are not the poor but rather the middle class and affluent.

Poor families ensure they have a boy by having large families, whereas the middle and upper classes now want fewer children and therefore resort to sex determination, according to Sayeed Unisa, a professor with the International Institute for Population Sciences, a Mumbai-based training and research center in the area of population studies.

“Maybe policy makers think this will work in all places, but this is something cultural, social,” Unisa said. “It’s not just you give money, people will have babies.”

There is a long-held belief in many Indian communities that at least one boy is needed to support the parents when they can no longer work and to light their funeral pyre. Girls, on the other hand, can be viewed as a burden given the rising costs of dowries and weddings.

Social activists say the skewed sex ratio shows how little girls and women are valued in many segments of Indian society. Many families still invest less in girls, affecting everything from their nutrition to their education and employment opportunities.

Discrimination occurs throughout a girl’s life in India, and sex determination represents the worst form of it, said A.L. Sharada, program director of Population First, a Mumbai-based non-governmental organization working on population and health issues.

“At every level there is denial or restrictions of the right of the woman, and that expresses itself in the sex determination,” she said.

Studies have shown that female feticide is not a result of families being against having a girl child, but more that they feel they must have at least one boy. Birth order therefore has a deep impact on female feticide as the sex ratio becomes more skewed when a family already has one or two girls and is trying for a final boy child.

A study by the Christian Medical Association of India found that if a family already had two girls, the chance the third child would be a girl reduced to 219 girls for every 1,000 boys. The study was based on births at a public hospital in Delhi for the year 2000-2001.

The skewed sex ratio has become so bad in certain communities that families have resorted to buying wives from poorer areas. A young bride was bought for less than $25 in Haryana, one of India’s worst affected states, according to a recent report in London’s Daily Telegraph.

Such trafficking for marriage is becoming more common as sex ratios worsen, Sharada said. Some families, she added, can only afford one bride and share her among multiple family members.

To combat female feticide, social activists say there must be more monitoring of clinics and implementing the law against sex determination, the judiciary and medical professionals need to be sensitized to the issue, and an environment must be created where people can come forward to complain about non-compliance with the law. In addition, there must be more spaces and opportunities in communities to question gender stereotypes.

Sharada concluded, “We need more openness to the rights of women.”