The trend in male-to-female ratio at birth from 2005 to 2022 in Georgia.

This study examines the impact of family planning and abortion policy changes (2006, 2010, 2014) on Georgia's male-to-female birth ratio. Using data from 920,803 live births (2005-2022), we calculated annual male-to-female ratios per 100 females by region and birth order, assessing trends with linear regression. In 2005, the overall male-to-female ratio was 113.0, declining to 107.2 by 2022. The imbalance was most pronounced in third or higher-order births (from 145.7 in 2005 to 114.3 in 2022), and lowest among first births (109.1 to 107.3). Regionally, Kakheti had the highest ratio (123.1). Notably, after 2014, the ratio declined significantly across all regions and birth orders. These findings suggest that policy interventions were associated with a reduction in sex-selective practices and a gradual move toward a more natural sex ratio at birth in Georgia.