In Armenia, a high value is placed on having sons. Susanna Mkrtchyan, a training and development officer for Save the Children, says she often hears people tell parents of girls things like: “‘You don’t have a son? Poor you. Keep going; you will have a son next time.’”

This preference for a boy, together with advances in ultrasound technology, has created a high demand for sex-selective abortions, and Armenia now has the third highest rate of female fetus abortions in the world, behind China and Azerbaijan. In recent years, this has translated to far more boys being born than girls.

In 2013, the United Nations Population Fund (UNFPA) sounded the alarm, reporting that 114 boys were being born for every 100 girls, compared to the natural ratio of 104-106 boys for every 100 girls. “Our estimates showed that, if nothing changed, we would have 93,000 missing women by 2060,” says Garik Hayrapetyan, head of UNFPA’s Armenia branch.

Although work was already going on in Armenia to combat sex selection, the UNFPA report galvanized government and civil society. In 2016, new legislation made sex-selective abortions illegal. Under this new law, women seeking abortions must attend a counseling session with their doctor and then wait for a three-day “period of reflection” before having the procedure, regardless of the sex of the fetus.

This attempt to address the boy-girl gap has been controversial. While abortion is still legal up to 12 weeks in Armenia, women’s rights organizations have warned that any restrictions on access to abortion could lead to women dying from “backstreet” terminations. Ani Jilozian from the Women’s Support Center believes that poor, marginalized women are most at risk, since they might not be able to wait three days or make multiple visits to the clinic. “Rural women, single mothers – they are the ones who may not be able to make the second trip,” Jilozian says.

She also worries that these rules won’t reduce the number of female fetuses being aborted because, in Armenia, boys are expected to pass down the family name and provide for elderly parents. “If you aren’t changing these harmful gender stereotypes that are the root of the problem, nothing you do in terms of legal change is going to impact the situation,” says Jilozian.

For the past two years, an E.U.-funded project called Combating Gender-Based Sex Selection in Armenia has been tackling these very stereotypes through multiple avenues, including town hall meetings, public awareness campaigns and T.V. discussions across Armenia. The project is being implemented by an independent think-tank and various NGOs, including Save the Children, which brought about 300 medical professionals on board. The organization says that gynecologists, in particular, have played a vital role in stopping sex-selective abortions.

Save the Children’s approach is to ask families to focus on the similarities between girls and boys. Usually, says Mkrtchyan, parents come to the conclusion that they aren’t all that different. “They are really surprised – they see that women are very engaged in all aspects of life, and can support their parents as well as their sons,” she says.

The project is scheduled to end in late April, and according to the International Center for Human Development (ICHD), which oversees the program, it has been an unequivocal success. “We decided that in two years, we would reduce sex-selective abortions by 10 percent,” says Vahan Asatryan, a gender specialist with ICHD. “We already have three times better results than we intended.” The latest statistics bear this out: In 2016, the birth ratio of boys to girls dropped to 112 boys per 100 girls.

But advocates say much is left to be done before sex-selective abortions are eradicated.

“We need more work in overcoming the inequality between the values [placed on] girl and boy children. This would be key to defeating this bitter practice,” says Hayrapetyan of UNFPA. “We still have a long way to go, but we are definitely on the right track”.