PG6. One Child

Scenes from China’s “One Child” policy. 

Episode 1 – The young girl

Her monthly cycle was a matter of record. Sooner or later she would be discovered and the longer she waited the more difficult it would be. There was no other choice. She entered the medical clinic and submitted to the abortion. They inserted a piece of metal in her uterus to prevent future pregnancies and sent her home. She knew an official entry had been made and that she would be watched carefully.

Episode 2 – The lovers

Episode 3 – The married couple

The Chairperson of the Women’s Federation laboriously made her way up the stairs to the apartment of the married couple on the third floor. Her information was that the woman was already pregnant and was due to give birth in February. The couple had expected to receive a birth permit but other couples, more favored by the Committee, had come before them. She knew what she had to say. 

The proclamation of the Leader was clear. It was in the best interest of the nation that the birth rate be reduced. Citizens were required to do their best to see that the policy was carried out. She herself would be open to criticism if the quota for their neighborhood was exceeded by even one birth. Perhaps the couple would get a permit next year. In the meantime this pregnancy must be aborted. The woman must go to the hospital and after the abortion an intrauterine device would be implanted to prevent accidental pregnancy. The woman would have to go to the medical clinic every six months for an x-ray examination to make sure the IUD was in place. 

The voluntary visit to the clinic must take place within the next week or the couple will face severe penalties. The husband’s work superiors would be notified. Not only would the husband’s work benefits be reduced but those of his superiors would also be cut. The couple might find that their apartment permit would be canceled. She will accompany the woman to the clinic to verify that the “remedial measures” had been carried out. She had made this speech a hundred times before and knew what the result would be. With a sigh she knocked on the door.

Episode 4 – The family

In neighborhood group meetings those who signed the agreement received praise from the population control officials. Many of the women went further and agreed to undergo the recommended sterilization procedure that would prevent them from reneging on their signed agreement. After the Fallopian tubes that carry eggs from the ovary to the uterus were cut, the women were hailed as leaders in the population control program and got cash bonuses at a public ceremony. 

The Women’s Federation officials were eager to maintain a 100 percent compliance with the Directive in their area. They were quick to let the man and woman know what would happen if they went ahead with their plan to have a second child. The woman would be violating her signed agreement. There would be a heavy fine, equal to about five years of average yearly income. They might have to sell their furniture or home to pay the fine. At their workplaces they would not be eligible for bonuses or overtime work. After the delivery of the second child the woman would be automatically sterilized. The couple would be required to pay back to the government the cost of the free medical and day-care received by their first child. The second would not be eligible for any free care. The birth permits in the community in which they lived would be reduced by one. Some other couple would go without the one child that they were permitted to have. The pressure to adhere to the government policy of One Couple, One Child was overwhelming. 

The practice of one couple, one child and promoting birth spacing between children among rural couples who want another child discouraged population growth. In 1984 the government somewhat relaxed its regulations, but for 5 years the episodes described at the beginning of this chapter were very real for the millions of young people involved

These episodes are not fictitious stories of some imagined dictatorship. They describe the real circumstances that were part of life in China from 1979 to 1984 and, to some extent, continue today.

I. Why Have Such Policies Been Used in China?

The People’s Republic of China experienced a population explosion after World War II that sent its population doubling to 550 million in 1950. The country’s growth of 14 million per year has been equal to a new Australia every year.

China has more people than any other country. By the end of 1995, one out of every five people in the world lived in China. By contrast, the United States, with the third largest population, accounted for only one of every twenty people. China’s population at that time was 126 people per square kilometer (317 persons per square mile), which although relatively high, is not the highest population density in the world because of the country’s vast land resources. China is the world’s third largest country in land area (9.3 million square kilometers, or 3.6 million square miles) but the country’s mountainous and desert regions do not support many inhabitants. 

Much of the population is clustered along the Pacific coast and in several fertile river valleys that extend inland, such as the Huang and the Yangtze. The most populous regions are in the rural areas where farming and other primary industries make for a source of livelihood.

Facing serious problems of overpopulation, the Chinese government acted forcefully to reduce the number of children in China. These policies raised controversies surrounding freedom and human rights. Government policies included legislating family planning to control population growth. The policy demanded that couples marry later in life, therefore having children later in life. The government also initiated the one-child policy. Couples received financial subsidies, longer maternity leave, better housing and even more land if they signed one-child agreement contracts. Families with more than one child without government approval had to pay hefty fines, to 5-10 percent of income for up to 10 years, or be denied job promotions and other incentives. In some cases newly affluent families were willing to pay the fine to have a second child.

The desire to have sons is very strong in Chinese culture. An unfortunate result of the One Couple, One Child policy was a surge in female infanticide. This ancient Chinese custom, which had all but been abandoned, returned. Although the government strongly disapproved of the killing of baby girls, its policy seemed to result in this desperate action.

Also, the government enforced mandatory terminations of unauthorized pregnancies when detected, regardless of stage of pregnancy. Reports of various pregnancy termination procedures such as using forceps to crush the baby’s skull and injecting pure formaldehyde into the soft cap of a newborn baby’s head have sparked an outcry regarding human rights over the years. Other controversial governmental policies included mandatory insertion of an IUD or sterilization of women with one child. Women who resisted deliberate pregnancy terminations were harassed, visited repeatedly and sometimes arrested until they complied. The government also carried out night raids to capture women hiding or trying to flee from birth planning workers. 

Illegal children received no medical or education benefits because they were not entered on the population register. Some officials in rural villages went so far as to maintain records of women’s menstrual cycles to assure that no unplanned babies were born. The government also prohibited marriage for men under the age of 22 and women under the age of 20. To further discourage births, the government gave free contraceptives, abortions and sterilization. 

Although the Chinese government policies for population control resulted in curbing the population growth relatively well, they remain morally questionable to many. 

As a result, the inflexible single-child rule presently has many exceptions. If the first child is a girl, rural families can have a second child in the hope that it will be a boy to help in the fields. In other families a second birth is allowed if the first child is a girl so that the family line may be preserved through a male heir. If the first child has a non-hereditary disease and may not live to adulthood, a second birth is permitted.

In addition to the population policy, the Government now places great emphasis on maternal and child health (MCH). Several laws include special provisions to protect MCH. A three-tier Maternal Care and Health network has been created for the provision of prenatal, perinatal and postnatal care.

Due to allegations by the United States government that China uses coercive methods to pursue population targets, services provided by the United Nation Population Fund (UNFPA, http://www.unfpa.org/) were suspended for a period of time, but have recently been restarted. The Fund’s three-year, 14 million dollar program will cover 32 counties in 22 provinces, many located in populous areas in central and western China. This support has been highly controversial in the United States, and has been a hot political issue in Congress. 

• The U.S. contributed between 30-50 percent of UNFPA’s budget until 1985, when, under the Reagan and Bush administrations, U.S. funding was suspended on the grounds of anti-choice allegations that UNFPA directly or indirectly supported coercive family planning practices (Cohen, 1999).
• President Clinton restored U.S. funding for UNFPA upon entering office in 1993 (Cohen, 1999).
• Following the resumption of UNFPA activities in China in 1998, family planning opponents in Congress succeeded again in canceling funding for UNFPA, citing concerns about China’s “one-child” policy (Cohen, 1999).
• For Fiscal Year 2000, an appropriation of $25 million of U.S. funding for UNFPA was approved without the potentially crippling amendment proposed by Representative Chris Smith (R-NJ) to cut off all U.S. funding for UNFPA if the program engages in any activities in China. [See statement of Congressman Smith below.] Instead, the appropriations act was passed with an amendment that would reduce — but not eliminate — U.S. support for UNFPA if the Population Fund supports a program in China (Congressional Record, 1999; PL 106-113, 1999).
• In the face of a recent increase in birth rate in China the authorities have recently begun to again tighten the regulations. There are calls for “the vigorous implementation of birth control and remedial measures,” meaning abortion. UNFPA has provided assistance to China since 1979.

Here are Congressman Smith’s objections:

Statement of Congressman Christopher H. Smith Vice-Chairman, House International Relations Committee (October 18, 2001)

“In January 1998, the UNFPA signed a new 4-year, $20 million agreement with the PRC. In announcing this program, the UNFPA emphasized that it would work in only 32 counties throughout China, and that the PRC government had agreed that in these 32 counties there would be no coercion and no birth quotas, and that, in keeping with the principles of the Program of Action adopted at the United Nations Conference on Population in Cairo in 1994, abortion is not promoted as a method of family planning. 

UNFPA Praises China’s Family Planning Policy

In March of this year the People’s Daily reported that Thoraya Ahmed Obaid, newly appointed executive director of the United Nations Population Fund, “praised that over the past 20 years, China has seen notable achievements made in population control by implementing the family planning policy. It has thereupon played an active role in curbing the population growth across the world.

Imagine, the wholesale killing of millions of babies and the massive victimization of millions of women is deemed a “notable achievement” by the top UN population control bureaucrats. That seems to me to be breathtakingly cruel. Anyone who cares about human rights should be shocked.”

By the end of 1997, China had 1.243 billion people. Policy makers have vowed to keep the population at 1.3 billion by the turn of the century.

The population policy aims at keeping the annual population growth rate below 1.25 per cent in the 1990-2000 period, maintaining fertility rates at replacement level (total fertility rate around 2) and limiting the total population to below 1.3 billion in the year 2000.

II. Results of China’s Population Control Policy

After a sharp decline in the birth rate brought on by the drastic regulations, China’s birth rate began to rise again. In 1984 there were 4.55 million second births. In 1986 births of a second child amounted to 6.88 million; an increase of 50%. 

The policies of the Chinese government have made substantial progress in reducing the rate of population increase in China at the cost of a loss of personal freedom to its population. At present, China has lower birth rates, death rates and lower overall lower population growth rates. Growth declined from approximately 2.0 percent per year in the 1950s to 1.2 percent during the mid-1980s. By the end of 1995, the birth rate dropped to 17 per thousand from 34 per thousand in 1969. 

The Peoples Republic of China had a target of a population of no more than 1.3 billion by 2000. In recent years, the government of China appears to have again moved toward stricter adherence to the one-child policy, demanding the use of Intra-Uterine Devices, sterilization, and pregnancy termination in specified circumstances. 

However, China is a party to the Plan of Action adopted at the 1990 World Summit for Children and has developed a national action plan. 

An article from the International Press Service provides us with the following perspective.

POPULATION-CHINA: Changes in One-Child Policy Emerging
By Antoaneta Bezlova

BEIJING, Apr 9, 2002 (IPS) – As the United Nations Population Fund (UNFPA) restarts its programs in China, signs are emerging that Beijing might ease its strict, one-child policy that has been in place since the early eighties. 

Suspended more than three years ago due to U.S. allegations that China uses coercive methods to pursue population targets, the UNFPA’s activities will restart this month, the official China Daily reported.

The Fund’s three-year, 14 million U.S. dollar program will cover 32 counties in 22 provinces, many located in populous areas in central and western China.

The program, approved by the UNFPA executive board in January, will focus on promoting reproductive health and family planning in rural China, China Daily said.

Sought for comment, the UNFPA office here issued a statement saying “voluntaryism and the need to remove targets and quotas from family planning providers” would be the underlying principle of the new project.

“It is intended that the successful experiences from the 32 UNFPA-supported counties will contribute to the formulation of the government’s reproductive health and family planning strategies for the future,” UNFPA said.

UNFPA suspended its operations following a 1995 report in the ‘New York Times’ on forced termination of pregnancies in southern China, which prompted Washington to withhold contributions to the UN body.

For every dollar UNFPA spent in China, Washington cut a corresponding amount from its contribution, forcing the Fund to suspend its China operations. A U.S. embassy spokesman said Thursday that Washington still opposes UNFPA’s activities in China and would continue withholding funding.

The restarting of the UNFPA’s work comes at a time when China’s reputation has been enjoying a boost, not least from the European Union’s decision to stop putting forward resolutions critical of Beijing’s human rights record at the United Nations Human Rights Commission in Geneva last month.

Yet the resumption of UNFPA’s activities here is more a sign of a modification of China’s one-child policy and a reflection of social change — than a move aimed at scoring political points.

China began implementing its harsh one-child policy in the early 80s. Couples in urban areas were allowed only one child, and only in a few rural areas could families have a second child after a gap of around four years.

By end-1997, China had 1.243 billion people. Policy makers have vowed to keep the population at 1.3 billion by the turn of the century.

But plans to implement the new UNFPA project, because it is based on eliminating quotas and pushing voluntaryism instead, shows that Chinese family planners might be easing the strict enforcement of the policy in favour of persuasion and education.

A spokesman for the Family Planning Commission denied that the UN program represents a fundamental change of policy, but also says China aims to shift tactics somewhat.

‘’We may adjust our policy to some extent,” the spokesman said. ‘’We are trying to change the working approach from the administrative kind to the service kind. Instead of telling people when they can give birth, China will now try providing education, training, clinics and counseling.”

Experts suggest this adjustment can be traced to a string of radical changes taking place in Chinese society, as its old socialist welfare system is replaced by a capitalist-style one.

‘’Before was easy,” said one western observer in Beijing. ‘’The work unit was deciding when the family can have a child, according to an annual quota assigned for each unit. But now when the link between the work units and people is disappearing, they can’t play their previous role.’’

Indeed, the state is relinquishing its cradle-to-grave care for the population, weaning it away from a system were everything from housing to medical assistance was provided at no cost. These days, China’s state workers are told they are on their own. Work units are no longer responsible for them in the old way.

But easing the old welfare policy comes with a cost: the state loses its previous leverage over the population. Hence, more than at any other time in the past, there is a need for education, counseling and persuasion of people in China.

Still, dropping its coercive quota system in favor of persuasion would not mean Beijing will officially tolerate couples having more than one child. In fact, China is trying to emphasize even more vigorously that the one-child policy has not changed and that its goals remain in place.

Indeed, a recent national meeting on family planning here stressed that ‘family planning is China’s most fundamental policy’ and warned that ‘family planning work shouldn’t be slackened’.

Still, other adjustments in this policy have already emerged. Late last year, demographers at a population conference came up with alarming findings that China would have some 136 million elderly people in the beginning of next century.

Scientists warned that the shrinking workforce produced by the ‘one-child’ family policy of the 80s, would soon have to struggle to support an increasing number of retirees born under the ‘baby- boom’ policy of Mao’s period.

Officials from the State Family Planning Commission revealed then that a relaxed one-child policy was among the remedies China hopes can help correct the imbalance between old and young. In the future, they said, when single children marry they will be allowed to have a second child.

Such ‘double only-child’ families were rare in China before the 1990s, they pointed out. But today, more and more single children born in the late 70s and early 80s are reaching marrying and child-bearing age, and the trend is expected to continue in the future.

Question 6.1. 
What do you think of the role of the Chinese government in controlling its population? Do you feel it was justified?

Question 6.2. 
UNFPA cut funding to China due to pressure from other nations. How do you feel about that action?

Question 6.3. 
Do you think the United States was justified when it cut funding to UNFPA for helping China?

Question 6.4
After checking the Population Clock https://www.census.gov/popclock/ and articles in the GSS Stay Current page for this chapter, do you think China has realized its goals?

III. The Case of India

In New Delhi there is a population clock at a busy intersection near the All India Institute of Medical Sciences. It adds 1,940 individuals to the population each hour, 24 hours a day. That amounts to an additional 16.9 million people a year to a country already holding 931 million. India is home to 16% of the world’s population with just 2.3% of the world’s land resources. This rapid growth creates many problems. More intensive farming leads to degradation of the land. In many areas increasing reliance on irrigation has put the water supply for drinking and sanitation in jeopardy. Although most of India suffers from a water shortage, one fourth of the cropland is subject to flooding from the seasonal monsoons. The impacts of flooding and food shortages forces millions of farmers to leave their lands and move to the urban centers where the misery of homelessness and starvation grows with the increase. A family sleeping in the streets and alleyways is common in India’s major cities. 

In some Indian states, notably the state of Kerala in the southwest part of the country, impressive advances have been made in medical care and education. Infant mortality and life expectancy are close to that of industrialized countries and children must stay in school through the tenth grade. The children of the poor in Bombay, Calcutta and Delhi are not so lucky. For them there is no school. Their time is spent helping their parents scavenge for food. 

Some cities like Madras, on the Southeastern coast, must shut down the water supply for many hours during the day to extend supplies. Children of the poor, both in the cities and in the countryside, suffer from illness of the digestive system because of the lack of clean drinking water and persistent malnutrition. Approximately 40% of India’s total population suffers from malnutrition.

It didn’t take long for Indian leaders to recognize the importance of limiting population growth. In 1951 the government announced a policy to lower the birthrate. A network of clinics was established throughout the country. Contraceptives and birth control information were made available. The program has had some success and birth control has become more socially acceptable. It is estimated that in excess of 90 million unintended births have been prevented by the program. 

In the mid-1970s a government emphasis on sterilization procedures and a strongly negative public reaction made the population control program falter. Experts agree that India needs a large-scale training effort to provide the technical personnel for effective outreach programs. They also call for an extensive program of public education. Recently the government has issued an action plan that promises to improve the quality of services, reduce the emphasis on sterilization, and expand availability of contraceptive methods.

National Public Radio’s Michael Sullivan reports from New Delhi that India officially announced its population has reached 1 billion people. India, one of the first countries to establish a population policy in the 1950’s, has had little success in holding down population growth. Observers say this is partly because of an ill-advised forced sterilization program in the 1970’s that turned the Indian public against contraception efforts. Although India’s population growth rate is not as high today as it was in the 1970s, it is still twice that of China. If India’s population continues to grow at the current rate, it will exceed that of China by mid-century. 

What is India Doing to Solve Its Problems?

“Major Drive to Popularize the Pill”
(Compiled from articles in Hindustan Times and The Pioneer)

NEW DELHI, November 18, 1998. ICICI Ltd. launched its two-year “Goli ke Humjoli” (Friends of the Pill) program, one of the largest private sector initiatives to promote low-dose oral contraceptive pills in India.

Though oral contraceptives are available over-the-counter without prescription, only 1.2 percent of Indian women use them as compared to 15-25 percent in other industrialized and developing countries.

The Rs. 6.8 crore communications campaign, funded by the United States Agency for International Development (USAID), will be administered by PACT-CRH (Program for the Advancement of Commercial Technology-Child and Reproductive Health) and managed by ICICI.

While the government has poured crores into family planning communication over the last 50 years, this is a unique private effort involving doctors, chemists, opinion leaders, civic groups and health organizations.

“We will not be projecting any particular brand. Nor will we be giving a single free pill. We are promoting a concept, not a brand,” says Ajit Ramaswamy of the major public relations firm that is looking after the communications for the campaign. A television spot has been created that will begin showing on Doordarshan and other channels in each state.

The target audience is moderate-income young couples living in major urban cities that already have one child and are looking for an effective contraceptive method for child spacing. The program will cover Delhi, and the four states that account for 89 percent of the total population of—Uttar Pradesh, Madhya Pradesh, Rajasthan, and Bihar. Before launching the campaign, an independent survey in these states indicated a high awareness of available contraceptive methods, but a lack of knowledge about how and when to use various methods. Many myths also were associated with the pill, including bloating, cancer causing, and pills being stored in the stomach.

These myths are being dispelled, while the main benefits of the pill are being promoted through the campaign. One of the main benefits of this painless, reversible contraceptive is that once a woman discontinues the pill, she can get pregnant immediately. Secondly, its efficacy is as high as 98.4 percent. Also, husbands seem to prefer this method, because “it doesn’t reduce sexual pleasure.”

See Staying up to date for this chapter.