CHINA – Abortion still a tool of state policy, this time to encourage more births

Having for many years imposed abortions on women after one child, China now aims to force them to have more children by restricting abortions for “non-medical purposes”, due to concern over a continuing decline in birth rates – which of course indicate a desire not to have more children. National Health Commission data show that between 2014 and 2018, there were an average of 9.7 million abortions per year, despite a relaxation of one-child policies in 2015. But according to data from China’s National Health and Family Planning Commission in 2015, about 13 million abortions were taking place in the country annually; of those, 62% were for women aged 20–29, most of whom were single. And that number did not include abortions at unlicensed clinics.

Since June 2021, all couples are allowed to have three children instead of two. New policies designed to reduce the financial burden of raising children are also being introduced.

The State Council, China’s cabinet, published the new rules on 27 September 2021. Strict measures aimed at preventing sex selective abortions were passed in 2018. In June 2018, it was reported that Jiangxi province’s Health and Family Planning Commission had issued a notice saying that women who were over 14 weeks pregnant who sought an abortion had to have the signed approval of three medical professionals to confirm the abortion was medically necessary, to help to balance the sex ratio.

The new guidelines claim to want to improve women’s overall access to pre-pregnancy healthcare services, and also claim falsely that the use of abortion to end unwanted pregnancies is harmful to women’s bodies and risks causing infertility.

Although China remains the world’s most populous nation, the latest census showed population growth from 2011 to 2020 was the slowest since the 1950s, and was expected to slow even more within a few years. That may reflect the high cost of having a child by 2020 – US $308,030 – four times the 2005 amount. However, by 2050, almost 25% of China’s population will be over 65 years of age, according to the Asian Development Bank, up from 8.2% of the population in 2010.

A small, qualitative study to understand the childbearing decision process in the era of the two-child policy. found that most women approved of the lifting of the one-child policy, but many were hesitant or uncertain about their own decisions whether to have second children. which they perceived as burdensome, and would require a lot of sacrifice in terms of freedom, energy and money. Similarly, a survey of 10,000 respondents from the government-run All-China Women’s Federation, conducted in 10 provinces around China over the last six months of 2016, found that 53.3% of couples with one child did not want another.

Importantly, premarital sexual and reproductive behaviour are seldom understood in China. A 2017 study published in 2020 found that women born in the 1980s and 1990s were more likely than those born in the 1960s and 1970s to experience a pregnancy prior to first marriage, driven by increases in premarital pregnancy among women with a secondary education or less. Another source of data in 2015 said the number of girls under 16 undergoing abortions was growing by 30% per year in one hospital. Most single mothers are meanwhile excluded from medical insurance and social welfare payments, and many also worry giving birth could hurt their careers. This means the new policy may have no appeal.

SOURCES: AlJazeera, 27 September 2021 + PHOTO Shanghai 19 November 19, 2013 Carlos Barria/Reuters ; QZ, by Jane Li, Tripti Lahiri, 27 September 2021 ; The Guardian, 27 September 2021 ; Studies in Family Planning by Yue Qian, Yongai Jin, 18 September 2020;51(3) ;, 25 June 2018 ; China Daily, 27 January 2015