“How many babies have you killed, roughly?” This is a question that tolls through the 2024 BBC documentary, The Midwife’s Confession. Available for free streaming on YouTube, the documentary centers around Katihar in the Kosi region of Bihar, India. The documentary deals with the outlawed yet prevalent practice of female infanticide. A result of the National-award winning journalist and filmmaker Amitabh Parashar’s twenty-eight-year-long journalistic engagement with the topic in Bihar, the documentary investigates the fraught socio-political terrain informed by gender biases and caste realities that forces the midwives to kill the girl children they help bring to life.
January 24 is celebrated as National Girl Child Day in India. However, the national celebration obscures some brutal statistics, inviting reflection on how easily the language of rights collapses in the face of entrenched social practices. With a sex ration of 1.11 (111 males per 100 females), India ranks a disappointing fourth in terms of sex ration imbalance, behind only Lichtenstein (12.6), China (11.5), and Armenia (11.3).The CIA Factbook 2020 reports that in South and South East Asia, India and China share the sex ratio at birth (1.11), performing worse than Myanmar (1.06), Pakistan, Afghanistan, and Bhutan (1.05), and Sri Lanka and Bangladesh (1.04). According to the 2025 World Economic Forum’s Global Gender Gap Report, India is among the lowest-ranked countries in South Asia, slipping to 131 (it ranked 129 in the year 2024) out of 148 countries. While this metric is not surprising—South Asia remains abysmally behind the other major regions of the world, scoring 64.1% in the gender parity index— India, within the region, fared worse than Bangladesh (24), Bhutan (119), Nepal (125), Sri Lanka (130), outperforming only Maldives (138) and Pakistan (148).
Within India, Bihar remains a significant outlier regarding sex preference, registering the lowest sex-ratio at birth (SRB) among all the other states of India. According to the 2023 Civil Registration System Report of the Government of India, Bihar recorded only 882 females per 1000 males, demonstrating a disturbing decline from 964 females per 1000 males in 2020. Bihar is the only state to record a falling SRB since 2020 and has the lowest SRB among all the states in India. In an equally disturbing pattern, a Government of India survey of 2021 revealed the literacy rate in the state at 55 percent for females compared to 76.4 percent males aged between 15-49 years.
In face of these skewed statistics, the question the documentary poses transcends the locales of backward Bihar to mirror the ongoing global crisis of femicide. According to the United Nations Office on Drugs and Crime, an estimated 47,000 women and girls were killed by intimate partners or other family members in 2020, a figure that translates to one woman or girl being killed by someone within her own family every eleven minutes. Although this form of gender-based violence cuts across regions, Asia accounts for the highest number of victims in absolute terms, revealing how the home itself continues to function as a site of danger for women. The Pew Research Report, derived from the last three rounds of the National Family Health Survey conducted by the Government of India, revealed that at least 9 million girls are ‘missing’ in India as a result of female infanticide from 2000 to 2019. This despite the fact that India, like China (1986), has banned sex-determination testing through the Pre-Conception and Pre-Natal Diagnostic Techniques Act 1994.
The documentary confronts the continued reality of sex-based discrimination at birth in India. As if in keeping with the sanitized statistics, the documentary engages in almost a clinical assessment of the different ways the midwives employed to kill the girls—strangling, feeding urea fertilizers, stuffing their mouths with salt. However, Parashar’s empathetic gaze uses these chilling instances to expose an overlapping system of coercion where the midwives’ cruelty is a further testament to their disempowerment and dehumanization. It highlights that the continuance of this outlawed practice across several districts in Bihar points to the chasm between constitutional guarantees of human rights and gender equality and the lived realities of vulnerable communities. As Parashar says, “I am pointing a finger at society’s mindset. I am questioning history.”
However, what anchors the documentary is its ability to centre social change, painstakingly achieved through efforts of different non-governmental agencies and passionate individuals. It documents the power of a community of midwives educated into empowerment, who in time become saviors of the girls they were hitherto coerced into killing. While an exhaustive and meaningful democratization of the home and society is hindered by dowry, caste obligations and economic precarity, the hope to transcend these constraints is palpable. The question transforms from ‘how many babies have you killed’ to ‘how many babies have you saved.’
This interview with Parashar is an attempt to reflect on the failures of democratic institutions, on the persistence of gender hierarchies, but most of all on how an unchanging social imagination continues to claim lives of girls despite the presence of laws.
Amitabh Parashar is an Indian journalist and filmmaker who has won the National Award for his documentary, The Eye of Darkness (2017). Produced in 2024 by BBC Global Eye, The Midwife’s Confession has won the 2025 Gracie Award for the Best Historical Documentary, Health and Social Video Award by the Association of International Broadcasting (AIB), UK, and has been nominated for the Critics’ Choice Awards 2025 (India) in the Best Documentary category.
“It was hard to explain to those young men why I was so moved. Was it because they had saved a life? Was it because this child had come so close to dying? Or was I weeping for those other babies, girls, all of them, who had been thrown away or murdered in the thirty years I’ve been following this story?”
IP: A very striking aspect of the documentary for me is the complex space the midwives occupy as perpetrators and saviours. How did you approach portraying them simultaneously as victims of systemic oppression and as agents perpetuating its societal practices?
AP: The midwives I spoke to belonged to the lowest rungs of the society, both in terms of caste and socio-economic, and their job was to assist with the birth of children. The fact that they were being ordered to take the very lives that they helped bring into this world was absolutely stupefying and horrid to me.
The midwives were warm-hearted and passionate about their own children. I’d wonder how these mothers could kill babies for a few rupees. I’d look at their hands and think to myself, how could they strangle with those hands? Some midwives cried while narrating how they’d managed to stop other midwives. When I was interviewing them initially, it became increasingly clear that they were threatened with grave consequences if they didn’t do as asked.
None of the midwives were doing it out of greed. They feared for their lives and felt remorse after every killing. Their irony touched me greatly.
Another irony that gives me goosebumps till today when I think about it; on one side there were families which got them to commit murders due to fear of dowry, on the other side there were these midwives who were committing murders in exchange for some extra money to arrange dowry for their daughters!! In the film, Siro admits she was haunted by nightmares.
My attempt was to tell the stories of midwives who were forced into this vile act but turned the tide against it as agents of change in society.
IP: The documentary highlights key socio-political factors such as dowry, caste and the economic precarity of the midwives that shape the social milieu of Katihar. How do you think these intersecting structures have facilitated the persistence of female infanticide in the regions around Kosi?
AP: The midwives in the film were poor and assisted families for generations. Midwifery was their traditional work and in 1990s Bihar or earlier, most births were home deliveries due to the absence of hospitals and medical centers, which is true even today in many remote districts and villages, though numbers have decreased considerably. But infanticide is not just limited to Kosi or Bihar. Even today, numerous regions in India have such cases, for essentially the same reasons.
On the one hand, we are a society where girls are not only equaling boys in many areas, but also advancing. They have no shortage of options and opportunities. They have developed tremendous self-confidence, which is heartening. But on the other hand, even the father of an educated girl has to struggle to raise dowry. Even today, archaic thinking about girls prevails in many homes.
What is a matter of great concern is that the same social evils that previously existed among upper castes and affluent families have become ingrained in the so-called lower castes and economically weaker sections of society.
Dowry is the biggest among these. The dowry system renders daughters an unbearable economic burden in poor households, where marriage can plunge a family into lifelong debt. Families keep having children until a boy is born. In many of these families, the pressure to produce a son overrides any concern for the woman’s health or the household’s survival. More births mean more mouths to feed, less stability, and more desperation, which in turn sustains infanticide.
It’s a brutal arithmetic of survival inside a society that still assigns worth by gender.
During my research, I found many such examples. Many such tragic stories.
IP: The film also documents the return of the sequestered, if not missing, daughters. Monica’s return to Bihar to meet Siro ji and Anila ji, two of the midwives responsible for Monica’s survival, was one of the most evocative and pivotal moments of the documentary. Why was this reunion important to you as a journalist and filmmaker?
AP: One of the biggest and most challenging quests during the making of this film was to find someone who was rescued by the midwives as a baby. It was very important to document the midwives’ incredibly transformative journeys of redemption and the change they’ve helped bring into the society that has wronged them. Adoption centers remained tight lipped for privacy reasons and rightly so, about the children that are brought to them, so they sadly couldn’t help. My pursuit with them had to end there.
I’d like to tell you that before Monica, I learned about a girl who was saved from death by a midwife, Bhago Devi. Bhago Devi was one who killed maximum girls, and when she began saving girls instead of killing them, she became a master at saving them as well. She saved many.
One of the girls Bhago Devi brought to Anila Jee was adopted by a family in Patna, the capital of Bihar. Anila was in touch with the girl’s parents for the first few years, but then realized they didn’t want her to see them regularly. They feared the community around them would find out that the baby was adopted. Anila had no contact with the girl after that. I managed to reach the girl’s family through my connections in Patna. But when I learned that the family hadn’t told her she was adopted, I backed off. She was about to get married then.
After some effort, I was able to get in touch Ms. Medha Shekhar, an activist who authored an eye opening report about infanticide in Bihar, whose only copy I kept safe for all these years. She was in touch with Monica, who was likely saved by Siro and then Ms. Shekhar helped send the baby over to an adoption agency in Pune. The best thing about Monica and her family was that the adoption wasn’t a secret.
More as a filmmaker than a journalist, I wondered what would happen if Siro met the girl she had not only saved but also brought from Katihar to Patna to be sent from Patna to Pune for adoption. I imagined this scene which looked impossible to me. When it finally happened, we all saw the impact of their meeting. I had never seen Siro cry before. Anila too had never seen her cry. But that day, she cried profusely. Anila later told me that her tears brought out the guilt inside her after so many years. I felt the same way.
So, bringing Monica to Bihar, her birthplace and face to face with her savior was one of the most poignant moments in my career. It was surreal and soul stirring to me as a filmmaker and journalist.
IP: How does female infanticide reflect on the state of Indian politics todays? What does the continuance of this heinous outlawed practice tell us about the gaps in Indian democracy?
AP: Democracy hasn’t yet democratized the home. Political participation has grown, but not enough to shift centuries old mindsets about lineage, inheritance, and masculinity. On paper, we have the promises of equality, dignity, and justice for all.
In practice, the survival of this heinous crime shows how deeply social hierarchies and gender prejudice still shape power at the most intimate level, the family.
IP: The Midwife’s Confession, in its honest documentation of the reality of female infanticide can also be seen as an intervention in a broader struggle for social change. In your view, what social, political and artistic steps are needed to take this conversation forward and enable pragmatic transformation?
I believe that first, a large and influential segment of society must acknowledge the existence of the problem. Politics aside, we as a society live in denial mode. I remember when I met some experienced and intelligent women journalists at the very beginning of this project, they questioned my research, claiming that even today, girls are being thrown away to die after birth, and that this is happening everywhere. They told me, “This used to happen, but not anymore.” When I provided examples with proof, they were astonished. After watching the film, many people expressed surprise about the continuation of such practices.
For me, throwing away a girl child in the hope that she will die is also female infanticide. If she’s lucky, someone will save her. If not, she dies. You might be surprised to know that in a major city like Delhi, incidents of post-birth killing have been reported this year and last, and English newspapers have even reported on them. The problem is that those who don’t want to take it seriously won’t, no matter how much effort you put in.
Now, let me get to your question.
The work starts with restoring dignity and agency to the same women who were once blamed. Midwives, mothers, daughters.
Empowering women within their communities rather than pathologizing them is one of the most essential steps. Enforcing laws with local accountability instead of token schemes and artistically, moving from spectacle to solidarity, stories told with the people most affected, and creating safe and inclusive spaces.
When my film was first screened for BBC staff in India, several women journalists came to me with their deeply personal experiences. Many of them started crying. For many, it was their own story that they didn’t have the courage to share with the world. My film gave them a voice. Just imagine, these are all enlightened and accomplished women. It’s been more than a year since the film was released, but to this day, people from all over the world, especially women, are still emotional after watching my film on YouTube (where the film is available in English, Hindi, and other languages), sharing their experiences publicly. Many of them were adopted from Bihar or India years ago and now live outside India. Like Monica, they all want to understand their roots.
Apart from these women, there were some men who said, “We will never think of demanding dowry in our lives.”
Only when empathy, policy, and art align can the cycle that once made killing a girl seem inevitable begin to break.
We need to have more conversations around gender sensitivity in academic, cultural, political and artistic spaces. We need more women in all walks of life, whether it’s cinema or politics.
The interview was conducted by Ishita Prasher, Assistant Editor (Cross-Regional Hub). Anubha Anushree and Utkrisht Upadhyay provided additional inputs.
