By / Aug 26

The ratio of baby boys to baby girls born in India now appears to be normalizing, according to a new Pew Research Center analysis of India’s National Family Health Survey. Since the 1970s, the ratio of boys to girls has been artificially skewed, leading to millions of “missing girls”—the estimated number of how many more females there would be if there were no sex-selective abortions and mistreatment or neglect of females.

For most of human history, until the early 1980s, there has been a slight, yet consistent, excess of baby boys over baby girls born in any population. During that period the sex ratio at birth (SRB) tended to fall within a narrow range, usually around 103 to 106 newborn boys for every 100 newborn girls. 

But scholars have observed that the ratios can become heavily skewed when three preconditions are met: a widespread desire for sons and/or aversion to daughters; parents seeking to have smaller families; and the availability of ultrasound technology and abortion services (which became more widespread in the 1970s). 

Since the 1980s, biologically impossible ratios have been found in various countries around the world, including Armenia, Austria, Azerbaijan, Cyprus, El Salvador, Egypt, Georgia, Greece, Hong Kong, India, Italy, Libya, Macedonia, Malaysia, Pakistan, Portugal, Philippines, Republic of Korea, Spain,Taiwan, Tunisia, Yugoslavia, and Venezuela. 

When China implemented a one-child policy in the late 1970s, the SRBs in some regions of the country increased to between 120 and 130. As demographer Nicholas Eberstadt has pointed out, this is “a phenomenon utterly without natural precedent in human history.” Because of China’s one-child policy, there are an estimated 30 million to 60 million “missing girls.”  

China ended its one-child policy in 2016 and adopted a three-child policy in 2021. Today, China is tied with Azerbaijan for the highest SBR in the world, at 115. Two other former Soviet republics—Armenia (114) and Georgia (109)—also top the list of highest SBRs. From 2000 to 2020, Vietnam and Albania had the world’s fourth- and fifth-widest average annual sex ratio at birth (111 each). 

India remains near the top of the global list, with an average sex ratio at birth of around 110. The size of the population means the country has an outsized impact on the overall number of girls killed by sex-selective abortion. China currently has the world’s largest population (1.426 billion), but India (1.417 billion) is expected to claim this title next year. Because of sex-selective abortion or neglect, an estimated 142.6 million females went “missing” between 1970 and 2020, according to a 2020 UN report. Two countries—China (51%) and India (32%)—accounted for more than two-thirds of that total.  

As Pew Research notes, countries where males heavily outnumber females at birth also tend to have a high childhood mortality rate for girls, either because girls are being killed soon after birth, or because they are neglected by their parents during childhood.

Religion in India has historically been a determining influence on the preference for baby boys, and thus on the SRB. In 2001, Sikhs had 130 boys for every 100 girls. The Sikh birth ratio today is around 110—closer to the country’s Hindu majority (109). Muslims in the country also have an artificially high rate at 106. At 103, the Christians in India have an SRB ratio that is closer to the natural balance. 

The one bright spot in the analysis is the influence of Chrisitanity in India, especially in the southern area of the country. As the report says, Christianity has been a boon for women:

Women, in particular, may have benefited from these types of changes. Christian missions in India have emphasized evangelical work among women since the 19th century, operating schools for girls as well as for boys. There were also missionary programs dedicated to educating women and training them for employment, such as the Mukti (Salvation) Mission. In addition, many Christian organizations prioritize maternal and child health by improving women’s access to health care facilities. Some scholars trace Christian missionary work to long-lasting benefits for Christians and cite the Christian emphasis on empowering women as a partial explanation for Christian girls’ better health outcomes.

There remains a significant need for more evangelism within the country. According to the Joshua Project, India has the largest number of unreached people of any nation—1.3 billion people within 2,135 unreached people groups. 

These realities around the world are a call to action. First, we can pray that God will raise up missionaries and that the gospel will spread throughout the land. We can also pray that people will be saved and that Christianity’s influence will bring about an overall cultural change. We must also advocate, in our communities and on an international stage, for the dignity of every person—including the preborn—to be recognized and upheld. And we must be willing to step up and care for children who need a loving home and come alongside parents who need help raising their kids. Finally, let’s pray that God will use all of these efforts to lead to a future where no country will have millions of “missing girls.”  

By / May 12

The following was written by a dear friend who is a medical practitioner living in Delhi, India. 

Unless you have been taking a break from all social media, online news, and television, you probably haven’t missed the devastating headlines from every major news outlet in the world. India, specifically Delhi, has become the latest COVID-19 epicenter. The trouble is, unlike her peers who were the most recent epicenters (U.S., U.K., and Brazil), the urban cities of Northern India are bursting at the seams with people, and now disease. Only a few know the luxury of living in a home big enough to allow social distancing, have access to clean water, soap, and masks, and are able to work from home. Couple that with a national belief that the pandemic was all but over and a medical infrastructure that can only truly flourish in the best of times, and here we are.

Like most Delhiites, for the past three weeks we have nervously checked our phones with each ring or ding, wondering who else has been infected or worse, who else has died. Sometimes the text has been expected — a friend’s uncle or neighbor or grandparent has succumbed, or there is another urgent request for a medical consultation. Sometimes it’s unexpected, and we grieve the loss of a dad in his 30s, a young pregnant woman, or a toddler.

As the numbers began to climb, it was suddenly no longer enough to have money or family members around. In fact, no amount of cash, status, or influence could have gotten you oxygen last week. And for whole families who were infected, the situation quickly became impossible to manage without help. How do you buy groceries or food, stand in line to get an oxygen cylinder filled, or go from hospital to hospital to see who has an open bed when everyone you know has COVID? 

Goodwill groups 

At nearly the same time I noticed the ship beginning to sink, I encountered a wave of creative, motivated strangers who began to show up with solutions. Overnight, it seemed that miniature “goodwill groups” were forming in every corner of the city. 

Three weeks ago, I was asked to join a telemedicine consultation crew that would treat patients over the phone. Thirty of us manned the medical side and over 300 began to organize into a small army that volunteered to do everything from finding medication to babysitting kids whose parents were both extremely ill.

Christians in particular began to organize meal and medication delivery services, buy pulse oximeters and thermometers to hand out to impoverished patients, and acquire e-passes to be able to run errands for those stuck at home. Over and over again, I watched as people offered their cars to be used as ambulances, learned how to don PPE to administer oxygen, and risked their own safety to donate blood (at a less-than-hygienic hospital) to perfect strangers. One brother from my local fellowship stood in line for six hours in 108 degree heat to buy an oxygen concentrator for a patient I was caring for — not because he knew the patient or because he would be rewarded monetarily, but because sitting at home in fear and frustration was not an option for him. And it hasn’t been for literally millions of others.

In the darkest cave, even the fire from a single match can create enough light to show a trapped explorer the way out. And if New Delhi is experiencing soul-crushing darkness right now, she is also ablaze with millions of good deeds.

What can you do? 

Perhaps you have been wondering what you can do for India during this most recent outbreak. Honestly, the options are as endless as your creativity, but here are a few things that will likely make the biggest impact.

1. Check in with your Indian friends. 

Eighteen million Indians live outside of India, so you likely have Indian friends, or at the very least, know where an Indian family lives or works. Your Indian friends very likely know someone who has died in the past month. Call them. Check on them. Grieve with them. Several years ago I was in India when a loved one in the United States was suddenly killed in a horrific car crash. I couldn’t get back to America, and it nearly crushed my soul. Indians can’t get back home right now to check on their family, to care for their aging parents, or to attend last rites after a family member or friend has died. If you don’t have a relationship with any Indians right now, go eat at an Indian restaurant and ask your server how they are doing (I guarantee you that they can use the extra business right now), send your Indian doctor a card or flowers, or ask the Indian grocer if you can pray for him.

2. Be careful how you give. 

Giving right now is fairly tricky. Many NGOs are no longer allowed to receive foreign funds. Though good deeds are found on every corner, so are corrupt practices. It is difficult to know if the money you are sending to an organization will even trickle down to the people who need it most. If you personally know someone living in India, I would start there. If your friends can’t use the money themselves, they certainly know someone who can. As Delhi goes into her fourth week of lockdown, COVID is no longer the scariest threat. Instead, it is not being able to feed children, pay rent, or buy monthly medication. 

3. Pray! 

I’m not offering a bandaid for cancer or simple platitudes when I ask you to pray.  I cannot pretend to know exactly how prayer works, but I have seen the presence of God with my own eyes over these past several weeks. I have watched people turn the corner when they shouldn’t have. I have seen oxygen last for hours longer than could have ever been possible. I’ve seen religious and social differences truly overlooked for the first time in my six years here in India. 

An elderly gentleman that I know spent the night on the steps outside of the hospital because he was “too far gone.” The family begged for prayer, and we prayed — with all of our heart and soul and guts, we cried out to the One who gives life and breath. And from a medical perspective, I cannot know how he survived. I cannot know why he is recovering and will be going home to his family soon. 

And after you are done praying that this country and her people will survive another night, pray that the seeds planted in the burning ground of Delhi this past month will burst into an uncountable gospel harvest in the weeks, months, and years to come.

By / May 7

Mother’s Day can be bittersweet for many. One in 10 couples struggle with infertility, and approximately 10 to 20% of known pregnancies end in miscarriages. For many women who long to have a child, Mother’s Day can serve as a difficult reminder of what they desire, but do not have. The potential pain of Mother’s Day extends further still — for women have chosen an adoption plan for their child, single women who desire to be married and have a family, or women who have had an abortion. And others might be grieving the loss of or navigating a difficult relationship with their mother.


Personally, Mother’s Day can be filled with conflicting emotions. I was born with a somewhat rare medical condition that prevents me from bearing biological children. The loss of that dream feels especially poignant this time of year. But I also have a desire to honor my own mother and mother-in-law and celebrate the women in my life who are mothers. Romans 12:15 is often on my lips as I navigate these tensions and seek to “rejoice with those who rejoice, weep with those who weep.”

My husband and I are in the process of an international adoption from India. This Mother’s Day, I feel the strange tension of pursuing motherhood but not yet stepping into the role of “mother.” I’m waiting for paperwork to be approved, for a social worker to deem us eligible to be parents, and to be matched with a child. But I know that waiting is not in vain. 

As an adoptee myself, I’m aware that my children’s stories will contain trauma. Even if our children are adopted young, there is trauma involved any time there’s a break in the natural family. The issue of adoption and child welfare is deeply important to me. I’ve spent time and energy navigating the complexities of these issues in order to advocate on behalf of vulnerable children. While we wait, we are reading books on trauma-informed parenting, listening to seminars, and gleaning wisdom from other adoptive parents so that we can love our children well. Our waiting is not in vain.


We’re also watching the devastating effects of the COVID-19 pandemic in India with broken hearts. According to the BBC, “India has seen more than 300,000 new cases a day for nearly two weeks straight while deaths stand at 220,000. Experts say total Covid cases and deaths in India are likely to be much higher, citing lack of testing and patients dying at home without being seen by doctors.” The images and stories we’re witnessing have caused global alarm and attention. I can’t help but wonder how many children will be orphaned because of the thousands of COVID-19 deaths. 


As we watch and wait, we do the best thing we know how to do: We pray. We lift up our future children in prayer almost daily. They might not be known to us, but they are known to our Father, and in that, we take great comfort. We pray for their safety and protection. We pray for their biological parents and the challenging circumstances that led them to making an adoption plan for their children. We pray for the leaders in India to make good and wise decisions for their citizens. We pray for the souls of our children, that they might come to know the Lord as their Savior at a young age.

In my waiting, I often echo the words of David, “O my Strength, I will watch for you, for you, O God, are my fortress.” Waiting can often feel helpless, but Psalm 27:14 reminds us to “be strong, and let your heart take courage” as we “wait for the Lord.” I fix my eyes upon the Lord and ask him to fill me with his strength when I feel weak. 

If you find yourself in a season of waiting right now, allow me to remind you that you are never alone in your struggle. Psalm 38:9 reminds us that “all our longing is before God; our sighing is not hidden from Him.” The Lord promises never to leave or forsake his children. He promises to be good and to set his steadfast love upon us. When you feel overwhelmed and discouraged, on Mother’s Day or any time, press into the promises of the Lord. 

By / Apr 30

In this episode, Josh, Lindsay, and Brent discuss Biden’s joint address to congress, India and the coronavirus tsunami, no need for masks outdoors, COVID-19 vaccine is safe for pregnant women, and the 2021 NFL draft. Lindsay gives a rundown of this week’s ERLC content including Seth Woodley with “How literature teaches us about leadership: Cultivating virtue reading,” Josh Wester, Jordan Wootten, and Brent McCracken with “Why we desperately need wisdom in this age of information,” and Ericka Anderson with “Why a second chance for incarcerated men is important.”

ERLC Content


  1. Biden promotes sweeping agenda in speech
  2. FDA moves to ban menthol cigarettes
  3. Fact Sheet: The American Families Plan
  4. India’s COVID-19 death toll tops 200,000
  5. CDC: If You’re Vaccinated, You Don’t Need To Mask Outdoors
  6. Coronavirus cases are finally falling
  7. Preliminary Findings of mRNA COVID-19 Vaccine Safety in Pregnant Women
  8. The NFL draft is this week
  9. Bill Belechick’s WFH draft


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