Abstract
BACKGROUND: China's sex ratio at birth (SRB) has declined in the past decade but still exceeds the normal level. This study seeks to depict the SRB trend in the past two decades. METHODS: We depicted the SRB trend, including SRB by birth order, children composition, residence and hukou type, education, race and province using latest data available from multiple data sources and standardisation and decomposition methods. RESULTS: The SRB remained around 120 in the first decade from 2000 to 2010, and recently declined and approached the normal level during 2010-2020. The SRB for second births and first births converged to the normal level, whereas the SRB for third and above births exceeded the normal level. The rising proportion of second births increased, whereas the decreasing proportion of first births reduced the overall SRB. Parents with only daughters are more likely to abort a female fetus in pursuit of a son, while parents with only sons are more likely to abort a male fetus in pursuit of a daughter. It also shows difference in SRB by residence, hukou type, educational attainment and race. Urban SRB was lower than rural SRB, by the residence and hukou type, but higher than rural SRB after being standardised. Provinces still exhibit differences by original categorised policy even after the implementation of the universal two-child policy. CONCLUSIONS: China's SRB has declined substantially during the past two decades, but the negative effects need to be tackled.