A complex network of companies, middlemen and clinics in mainland China and Hong Kong is carrying on a roaring trade in on-the-quiet prenatal testing to determine the gender of fetuses for Chinese couples, a practice that is banned on the mainland because of its association with sex-selective abortion, RFA has learned.
According to government figures for last year, China is home to 34 million more men than women, reflecting the longer-term effects of selective abortion, abandoned baby girls, and the country's family planning restrictions.
China's population stood at 1.38 billion at the end of last year, according to official statistics released last month, of whom 708 million are men and 674 million are women.
In 2014, officials described the gender imbalance as the "most serious" problem, outlawing gender testing of unborn babies in a bid to make sex-selective abortions less common.
But an employee surnamed Chan who answered the phone at a medical intermediary company in Hong Kong's Sheung Shui district confirmed that it supplies gender testing kits to mainland China which could enable parents-to-be to determine the sex of their unborn child.
The company also helps mainland testing firms by importing blood samples to Hong Kong for testing, circumventing Chinese regulations that forbid such tests, she said.
"I think it's the mainland Chinese intermediary that takes the money, if [the customer] can't come here [to Hong Kong]," Chan said. "All they have to do is go to the mainland middleman."
"If they want an ultrasound, then they need to find a doctor over in mainland China who will do it for them, then bring it with them [to Hong Kong]," she said.
An employee surnamed Huang, whose contact details were printed on a leaflet advertising the process and obtained by RFA from a Hong Kong-based intermediary company, said parents-to-be wanting gender testing often mail their own blood samples to Hong Kong, as formally importing the samples is also covered by the ban.
"It works like this: you take the blood sample yourself and mail it to me, and then I will help you to get it into Hong Kong," Huang said, adding that many pregnant women don't dare to make the trip to Hong Kong for fear of being caught.
"In the past three months, the border guards have been looking out for pregnant women," he said. "If you're not [obviously] pregnant, they'll let you through, but if you are, they turn you back [at the border]."
'Pretty big risk'
Huang said his company arranges for the blood samples to be taken to the Sheung Shui company for testing, at a cost of 3,000 yuan each, including transportation costs, testing equipment and results.
He said the middlemen run some risks in smuggling the blood samples across the border, however.
"If you take blood across the border, you can wind up with a fine, so there's a pretty big risk attached," Huang said. "But we're used to it; it's not too bad."
There are even more direct methods of getting around regulations banning gender-testing, however.
RFA learned from a fairly large medical clinic in Shenzhen's Baoan district, across the internal immigration border with Hong Kong, that people wanting such tests are charged 100 yuan for the taking of the blood sample in clinical conditions.
"If you want the blood test done over here, then it's 100 yuan per sample," an employee at the clinic said when visited by RFA.
"We have a friend on the Hong Kong side who brings over test tubes for the samples to go in when we take the blood for [the customer]," the employee said. "Then, as soon as the sample is taken, he takes them back to Hong Kong on the subway."
Hong Kong's Mass Transit Railway (MTR) subway system connects with the Shenzhen Metro at the border town of Lo Wu.
The Hong Kong clinic also offers ultrasound scans of babies as early as seven weeks, the employee said, while the Shenzhen clinic can't offer them before four months.
"We can carry out an ultrasound on this side of the border on the quiet at four months," the employee said.
"But that's not as good as doing it at two months, if you then decide to abort, if it isn't developing normally, or if you don't want it, or if it is going to harm your health."
PRC population controls
While the Hong Kong clinic promises an accuracy rate of more than 98 percent, a Hong Kong gynecologist told RFA that there are considerable risks to ultrasound scans as early as seven weeks.
She said first-trimester scans carry a greater risk of a miscarriage soon after the scan, and may result in errors when trying to determine the sex of the fetus.
Hong Kong Democratic Party lawmaker James To, who is also a lawyer, said such practices are the result of long-running population controls in mainland China, alongside traditional preferences for male offspring in China.
"I think that, regardless of the fact that they have relaxed the one-child policy now, there are still some traditional attitudes [in China], and some families might want to make sure they have at least one son," To told RFA. "They want to make sure they don't wind up with two daughters, which they would probably find unacceptable."
"So they get a blood sample and send it to Hong Kong for testing, and if they don't like the result, they'll get an abortion," he said. "Of course, this is very far from ideal."
He said part of the problem is caused by the ruling Chinese Communist Party's insistence on limiting the rights of its citizens to give birth, although the one-child policy has now become a two-child limit.
U.S.-based women’s rights activist Reggie Littlejohn in February called for an end to China’s coercive population control regime, saying it makes sex-selective abortions more, not less, likely.
"The Chinese government has been lauded by many for its supposed ‘loosening’ of its one-child policy, yet the coercive nature of the program remains, and it continues to result in the selective abortion of countless girls," Littlejohn, who heads the Women’s Rights Without Frontiers group, said.
"It is a travesty that most women’s rights organizations remain silent in the face of this attack on women and girls."
Littlejohn was commenting in February on a January article posted on the state-backed ECNS news service titled "In pursuit of boy babies, families send samples to HK for sex tests, abort girls," which had been removed when the link was tested by RFA on Thursday.
"We predicted last year that the increasing availability of non-invasive pregnancy tests and the modified two-child policy would result in an increase, not a decrease, in sex-selective abortion," Littlejohn told the pro-life group National Right to Life.
"In fact, with the two child policy, odds are increased that girls will be selectively aborted. Couples whose first child is a girl will often abort the second child if she is also a girl. Second daughters remain endangered," she said.
Reported by Wo Miu and Wong Lok-to for RFA's Cantonese Service. Translated and edited by Luisetta Mudie.