When unusual sex ratios at birth (or any other age) are observed, it is important to consider misreporting, misrecording, or under-registration of births or deaths as possible reasons. Some researchers have in part attributed the high male to female sex ratios reported in mainland China in the last 25 years to the underreporting of the births of female children after the implementation of the one-child policy, though alternative explanations are now generally more widely accepted, including above all the use of ultrasound technology and sex-selective abortion of female fetuses and, probably to a more limited degree, neglect or in some cases infanticide of females. In the case of China, because of deficiencies in the vital statistics registration system, studies of sex ratios at birth have relied either on special fertility surveys, whose accuracy depends on full reporting of births and survival of both male and female infants, or on the national population census from which both birth rates and death rates are calculated from the household's reporting of births and deaths in the 18 months preceding the census.[52] To the extent that this underreporting of births or deaths is sex-selective, both fertility surveys and censuses may inaccurately reflect the actual sex ratios at birth.[53]