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India’s 2011 census revealed a growing imbalance between the numbers of girls and boys aged 0–6 years, which we postulate is due to increased prenatal sex determination with subsequent selective abortion of female fetuses. We aimed to establish the trends in sex ratio by birth order from 1990 to 2005 with three nationally representative surveys and to quantify the totals of selective abortions of girls with census cohort data.

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This report of the global meeting on Skewed Sex Ratios at Birth: Addressing the Issue and the Way Forward, held in October in Viet Nam, provides an overview of the meeting and delves into some key trends, determinants, consequences and responses on the issue. Challenges and recommendations are also included.