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The
Brownstone Journal >>
Issues >> Vol.
XII Spring 2005
Family Planning in Post-Mao China
Laura Matherne (UNI 05) is completing
an independently-designed degree in Contemporary Chinese Politics.
In any newly forming state, the establishment
of a national identity is of prime importance. Often a country's
sense of itself can be best articulated through literature.
The formation of the Irish Free State, and later the Since Deng
Xiaoping came to power in the Communist party over twenty years
ago—supplanting traditional Maoists like Hua Guofeng—the Chinese
government has made population control an integral part of its
reform system. The policy has shifted over the years, relaxing
due to both the lack of peasant support and international outcries
against human rights violations. The policy, known to outsiders
as the "one-child policy," was officially passed into
law on September 1, 2002. Translated as the "Law on Population
and Family Planning," the legislation was late in coming
(although Deng had promoted the idea of such legislation as
early as 1979; see Hu). According to Zhao Bingli, vice minister
of the State Family Planning Commission, the government was
convinced, for several reasons, that the time was right to introduce
the new law. He based this belief on the premise that "after
years of implementing the basic policy it is now widely supported
by the people, and a set of successive experiences have been
formed which suit the country's current situation and modern
economic and social development" (Hu). This may indeed
be true, but the question remains: will bringing into law a
policy that has been in place for decades substantially change
the practices of local cadres and family planning experts? The
resources needed to perfect a system such as population control
are expensive and will take time to develop. Additionally, the
central government of the People's Republic of China may have
made official a policy that will be seen by the international
community as a continued violation of the rights of its citizens.
More than one-fifth of the world's population
lives in China. The Chinese government has taken extraordinary
lengths to control its growing population. With such a large
number of people, reform and economic improvement are even more
difficult to accomplish. In China, "rapid population growth
strained the agricultural and other parts of the economy, thus
dashing hopes for quick per capita economic gains" (Banister
9). Today, the problem of underemployment due to an excess of
[potential employees] has become an equally difficult problem
to solve. Mass layoffs in failing state-owned enterprises have
become a source of worker unrest. The population has become
so large that as an economically developing country, China does
not have the jobs to accommodate everyone. As this is a common
problem in developing nations, it is important to distinguish
China's success in implementing extremely strict policies of
population control where other countries have failed due to
popular backlash (1).
These policies of population control have come
into being gradually, and as China has changed, so have the
means of implementation. In the 1950s and 1960s, Mao Zedong
encouraged large families, forcing China to find a solution
now to the problem of approximately 13 million women entering
marriage and childbearing years every year since 1980 (Shanor
and Shanor 53). In the 1970s, though there was no set policy,
Chinese families were encouraged to emulate the model of a two-child
family. Though progress was made in reducing birth rates in
this manner, it soon became evident that this was not enough
to solve the population problem. In 1980, the post-Mao leadership
initiated a new policy, in which "even rural couples were
prohibited from having a second child" (White 137, 1994).
As early as 1979, economic penalties were imposed on couples
producing a second or third child.
In order to effectively carry out their new
plan, the post-Mao Communist party adopted the most decidedly
Maoist tool of organization: the mass-mobilization campaign.
Provincial leaders responded to the call of the central government
by "recruiting family planning activists and propagandists
from various units; sending medical and propaganda teams into
the countryside to promote birth control; and publishing articles
glorifying the one-child family" (White 1990). There were
many cases, however, in which mobilization was not enough and
the government found the need to expand the policy. As soon
as 1983, the government dealt with the duotai problem (third
or additional births) by "promoting sterilization for childbearing-age
couples with two or more children" (White 137). As is characteristic
of a society built around mass-mobilization, overzealousness
became a problem. This is evidenced by documented cases of forced
abortion and sterilization. In response to backlash, Central
Document 7 was created, renouncing the excesses of the sterilization
campaign and admitting the problem of coercion. This document
"was simply good politics" (White 145, 1994) in that
nothing actually changed in the implementation of sterilization.
The government in Beijing deferred criticism
to the local officials, whom they said had been given responsibility
for the programs:
It is they, defenders of the current policy
claim, who should be blamed for the cases reported in the
Western press about women forcefully aborted late in their
pregnancies, others unwillingly sterilized, or couples who
had their homes destroyed and heavy fines imposed after the
birth of a second or third child. (Shanor
50)
However, the policy has been modified over
time to be more acceptable to the peasant population. It is
not, in fact, the "one-child" policy as understood
by this title. In response to several problems with male-preference,
the government began allowing rural couples whose first child
was a girl to register to have a second child, a so called "single-daughter
household" policy. Ethnic minorities usually face laxer
rules, and are allowed to have multiple children. The policy
in each province varies slightly according to individual circumstance
(Hu).
The policy, though relaxed, remains a strict
one: women are not allowed to marry until the age of 23 and
couples must wait four years after the birth of the first child
to have a second ("Coercive population control in China"
17). However, approximately twenty percent of the 10 million
marriages that take place every year are illegal, rendering
these couples subject to fines, reeducation and separation (Shanor
56). The plan has, however, been successful to some degree,
and there are many reasons why Chinese citizens now follow the
family planning program voluntarily.
Individual economic situations do inspire compliance
in some cases. Housing in China is in short supply, and what
is available is often inadequate. Indoor water and sanitary
plumbing are signs of affluence in the countryside, and what
money people have now goes toward improving their homes to make
them inhabitable by at least quasi-modern standards. There is
little privacy. Families merit subdivided apartments, but individuals
do not, and young couples find it difficult to live away from
their parents. Eighty million citizens have inadequate diets,
and must reserve money simply for enough food. Shortages of
power and equipment force companies to use the one resource
they have in excess, human beings, for hard labor. "Only
the relatively privileged few in China are not affected in some
way in their daily lives by the distortions and shortages caused
by overpopulation" (Shanor 62).
On the other hand, not all incentives to follow
family planning are dictated by shortages. With China's growing
market economy and the emergence of a "middle class,"
many people dream of becoming wealthy. For them, bearing too
many children becomes an economic burden. It is economically
irrational to limit one's social mobility by adding the cost
of childcare, especially with the steady rise of cost of living
expenses. This has, for the immediate future at least, made
birth control more acceptable (Peng 30).
Family planning took a secondary role to economic
reform in the mid-1980s, as part of the theory that rather than
using population control to aid economic increase, "economic
development was the key to reducing birth rates” (White 2002).
This enabled the central government to defer the cost of the
plan to local governments, often ignoring the effectiveness
and compassion with which it was carried out. Though this view
gained a great deal of legitimacy, the State Family Planning
Commission has since returned to the theory that was supported
by economic successes in controlled areas. In its report to
the Fifth Asian and Pacific Population Conference, China proudly
announced that it had "averted" 300 million births
or more in the past 30 years. According to this report, the
"achievement has helped to relieve the pressure of population
on resources and environment and to promote economic development
and raise the standard of living of the people" (Asian
and Pacific Population Conference). In short, China's birth
control policy is something the government plans to continue
to implement well into the mid-21st century, as it has officially
had great success.
Though population control is important, several
factors of Chinese society have led to serious problems with
the plan and its implementation. Two very acute internal problems
are that of an increasing male to female gender ratio and an
aging population. Throughout history, Chinese couples have exhibited
a strong preference for male children. In the countryside, it
is simply more useful to have a male child to help with labor
on the land. "As a couple's desired number of children
declines as a consequence of modernization, or due to factors
of policy and other socioeconomic constraints, the demand for
children with higher quality increases" (Peng 27). Higher
quality in this case means male, and due to the effectiveness
of chorionic villus sampling to determine the sex of a fetus,
voluntary abortions of female children and even cases of abandonment
of females after birth rose sharply. Though now illegal, this
practice continues and has led to a markedly skewed gender ratio,
especially in the rural areas ("Challenges and Problems").
In 2001, there were 41 million more males than females in China's
population of 1.2 billion. Nineteen of every twenty-four births
that year were boys ("Coercive population control in China"
24). The consequences of this are far reaching, and if left
unattended, may permanently affect the health and status of
women in China. This both encourages discrimination against
the "undesirable" sex, and creates a scramble on the
marriage market. A lack of respect for women can be seen in
the implementation of family planning itself. A surgeon in South
China admits that he performs 300 tubal litigations for every
four vasectomies, and his "backwards" male patients
will not be convinced that a vasectomy might be more effective
(Shanor 51). If the practice of sex-selection continues, "the
proportion of males will quickly tower over the proportion of
females, leading to a vaster network of women trafficking as
men scramble to find wives" ("Coercive population
control in China" 24).
In order to combat this rising crisis, the
government has not only illegalized gender selection, but has
also launched a campaign against an old custom that is "tantamount
to launching a narrowly defined cultural revolution" (White
58, 1990). They have condemned traditional phrases such as "men
are superior to women," as well as the practice of female
infanticide with which it is associated. This traditional preference
for sons is described through propaganda campaigns as feudal
and decadent (White 58, 1990). The "single-daughter household"
policy has also helped, but breaking down ancient conceptions
will be a long-term effort.
As a result of its population control policies,
another problem China faces in the near future is that of an
aging population. Though a baby boom is still possible as women
from a period of high birth rates enter childbearing years,
it is increasingly likely that China will soon enter into the
status of an "old" population. As of 1994, Shanghai
earned this distinction, making it is feasible that by the mid-21st
century an aging workforce and shortage may emerge throughout
the rest of China (Peng 24). A comparison of the 1990 census
and a one percent population sample survey in 1995 reveals that
the ratio of the population that is dependent upon support has
increased from 49.86 percent to 50.22 percent ("Challenges
and Problems"). In urban areas, the development of a social
security system and a medical insurance system address this
problem, and a quarter of the workforce is entitled to pensions.
In rural areas family support is still relied upon as the primary
means of providing for elderly dependents. Family support has
been the traditional system in China, and the government continues
to encourage it, but it is becoming a more difficult task. Children
without siblings must bear the cost of caring for their parents
alone, and for young couples this often means the two children
must care for four elderly parents. This burden usually falls
to the wife, as the husband is still seen as the main provider
(Peng 25). Providing for these parents as well as their own
children simultaneously has become more difficult as young couples
busy themselves with trying to succeed in China's new economy.
Growing numbers of senior citizens live alone,
and for these it is even more difficult to obtain sufficient
living arrangements and social support. It is estimated that
2 million seniors need this care, and by 2040, this number will
reach ten million. The central government's response to this
is an attempt to strengthen social programs in response to the
United Nations' "Everyone shares regardless of age"
plan. The government plans to guarantee health care, to establish
an old-age services network and to expand the number of homes
for the elderly in townships and villages. Where the funding
for such programs will be found, remains to be determined (Asian
and Pacific Population Conference).
The central government has faced criticism
surrounding its implementation of the family planning policy.
It has been accused of overzealous practices and has accused
local officials in its stead. However, much of the responsibility
for this implementation lies with the mobilization campaign
and the accompanying corruption. In the 1980s, cadres who did
not implement the new policy were used as negative models and
criticized publicly. It is no surprise that local leaders were
more than willing to meet their quotas by whatever means possible.
Special medical teams were sent in to insert intrauterine devices
(IUDs) or to perform abortions and sterilizations. In rural
areas, "cadres held as many as nine or ten mobilization
meetings per year" (White 59, 1990), and in extreme situations,
women were forced to undergo abortions or attend endless mobilization
meetings without compensation.
After 1984, when township governments were
given the responsibility of staffing a family planning cadre,
the employment of such experts often ceased. The central government
was not paying them, but the township government was not eager
to put them on their payroll either, resulting in the abandonment
of the post in many cases. In addition, "Beijing's disavowal
of coercion and rigidly uniform implementation . . . simply
[gave] them greater leeway to interpret guidelines in ways that
suit[ed] local preferences" (White 70, 1990). Those that
remained often used family planning as a fundraising tool, exacting
heavy penalties for excess children rather than trying to prevent
births by encouraging birth control. This money was then invested
in local projects such as road building, rather than given to
the central government (White 71, 1990).
After the responsibility for implementation
was transferred to the local level, cadres found it was more
lucrative to participate in the local markets than to enforce
the population control policies, and therefore blatantly ignored
infractions. Many cadres violated the one-child policy from
the start. Those who personally opposed the program made it
possible for their family members to have more than one child
without repercussions, and in some cases did so themselves.
Clearly, China faces great challenges internally,
but this is not where the difficulties end. The international
outcry against human rights violations in the PRC nearly barred
the nation from entering the World Trade Organization, and in
January of 1998, the United Nations Population Fund (UNPFA)
signed a four-year agreement with Beijing entitling them to
work closely in 32 counties ("Challenges and Problems").
This program has reported great progress in these counties and
in much of the nation. China's apparent compliance with international
mandates has not satisfied the government of the United States,
which insists that gross violations of human rights are still
occurring under the nose of the United Nations. Because of this,
the United States stipulates that any aid money it gives to
the UNPFA must not be used in China, and is considering withdrawing
aid from the program entirely ("Challenges and Problems"
6).
Calling forth researchers and eyewitnesses,
the House of Representatives Committee on International Relations
heard stories of forced abortions and sterilizations in large
numbers. Josephine Guy testified:
We saw a 19-year-old and learned that she
was too young to be pregnant according to unbending family
planning policy. While she was receiving a non-voluntary abortion
in an adjacent room, her friends told us that she, indeed,
desired to keep her baby, but she had no choice, since the
law forbids it (2).
This took place in a county where the UNFPA
has declared coercion does not exist, in one of the 32 counties
where the central government has agreed it shall not. The official
stance of the Chinese government is that coercion is illegal
throughout the nation.
On September 1, 2002, the Chinese government
made a new step forward in solving its problems by enacting
the Law on Population and Family Planning. Though little was
changed in the policy that already existed, creating an official
framework for operations may affect implementation, and Chinese
officials appear optimistic.
The new law represents a shift in direction
of the family planning program. The government has chosen to
focus on increasing the quality of family planning professionals
and educating the masses about birth control. The ultimate goal,
according to officials, is improving people's livelihoods in
a way that does not violate human rights. Under this new law,
"those who implement birth control policies by taking oversimplified
and uncivilized ways may be sued and punished" (Hu). Jiang
Zemin himself has declared that the purpose of this law is to
end coercive abortion in China ("Women's Rights and China's
New Family Planning Law").
Along with a new law, the State Family Planning
Commission has also undergone a makeover of sorts. In order
to move its focus to combining a study of population development
and family planning, its name has been officially changed to
the National Population and Family Planning Commission. Though
its responsibilities remain for the most part the same, the
minister of the commission, Zhang Weiqing, believes that this
change will give the commission more credibility to carry out
its mandate ("State Family Planning Commission Renamed;
Unveils New Sign").
The nation does have much to accomplish, however,
in moving toward a more humane control over the population.
Professionals in charge of implementation have learned much
of their expertise through trial and error, and many remain
to be educated. Only fourteen percent of family planning professionals
have a college background ("Challenges and Problems").
Advanced levels of competence in the areas of advancing science
and technology are even more rare, and though the State Family
Planning Commission recognizes the need for enforcement of training,
funding and resources to find a practical solution remain scarce.
The government is taking advantage of what flexibility it does
have, however, and "since 1998, more than 100 high-level
Chinese officials in charge of family planning have been sent
to the United States and other countries to receive training
on welfare and mother and child health care" ("New
Law Guides Family Planning in China").
The UNFPA has assisted as well, by training
Ph.D candidates and assisting China in upgrading facilities
and contraceptive factories. A representative of the UNFPA declared
that in approximately fifteen years of work, China became "totally
self-sufficient in high-quality international-standard modern
contraceptives" (3).
This does not appear to be entirely true though, as China lags
far behind modern nations in availability of user-controlled
devices. With continued work however, this goal may indeed be
accomplished.
Notable changes are taking place in China.
Reports indicate that incidents of induced abortions were 53
percent less in 2001 than in 1990. In test areas, the number
of users of irreversible methods such as sterilization is in
decline, while the number of reversible contraceptive (such
as intrauterine devices) users is increasing (Asian and Pacific
Population Conference). The Chinese government has also begun
to encourage user-controlled methods with a promise to lift
the ban placed on advertisements for condoms at an undetermined
point in 2003. Currently, the average man in China buys three
condoms a year, and at least one is likely to have defects.
The government has acknowledged that this statistic needs to
improve, not only for birth control purposes but also for HIV/AIDS
prevention ("Condom Conundrum"). The first emergency
contraception center for Chinese girls also opened at the Chongqing
Family Planning Hospital, where emergency contraceptives are
available as well as the free insertion of IUDs. These means
are effective within seven days of intercourse, according to
the center. The center still does perform abortions if pregnancy
does occur, however ("Emergency Contraception for Teenage
Girls"). Now that options for birth control are increasing
in China, the government is faced with the challenge of encouraging
people to take advantage of the diversification.
The most effective way to make a successful
change in the family planning system is to educate the people
about their options, and the new policy of the State Family
Planning Commission mandates this. People who can make informed
decisions about birth control and personal health care are more
likely to follow the system. The new policy emphasizes educating
people about the increased regularity of services in China,
as well as dissemination of knowledge: "efforts should
be made to publicize the scientific knowledge, to introduce
widely the 'informed choice' approach in the selection of contraceptives,
and to promote new techniques and new products in order to satisfy
the needs of the people" (Asian and Pacific Population
Conference). Pilot areas, such as Fujian and Zhejiang provinces,
in which the "informed choice" system has been implemented,
are performing very well. Cases of sterilization are decreasing,
and because the incentive program has not ceased though the
direction of the program has changed, "in Sichuan, more
than five million rural couples who have chosen to follow family
planning have been assisted to get out of poverty" ("New
Law Guides Family Planning in China").
There are still challenges to be faced, especially
in China's middle and western areas where funds are scarce and
implementing quality care services is difficult. These regions
lag far behind the eastern regions in development of services
for family planning. The central government is transferring
funds to the west in order to assist family planners. It is
also working to "equip them with vehicles, training technical
services personnel, and encourage the eastern regions to assist
the western regions” (Asian and Pacific Population Conference).
There are those within the international community,
such as the United States Government, who are skeptical as to
whether or not the new Law on Population and Family Planning
will have any long reaching beneficial effects on China and
human rights. They believe that bringing into law a policy that
has existed for decades will do nothing to change implementation.
However, China is clearly on the road to becoming more successful
at recognizing the basic human rights of its people. Though
progress must still be made to educate and to protect the families
of China, this policy is not going to disappear, in spite of
what the international community might encourage. The family
planning law is stringent, but it has now been formalized and
standardized in a way that will force supervision. The fact
that the central government has admitted to a problem with coercion
is a huge step from which many other reforms can and will emerge.
China is proud to estimate that "by the year 2050 China's
population will no longer be the largest in the world and its
living standards will be equal to those of moderately developed
countries" ("New Law Guides Family Planning in China").
It will be using its established population control policy to
further this goal, and with development and regularization should
come more efficient and less objectionable practices. TBJ
NOTES
1. India tried a similar forced sterilization
program that was so violently opposed the backlash helped to
topple the regime of Indira Gandhi. Comparatively, China has
succeeded in both persuading and forcing couples to use birth
control techniques. (Banister 9) >> RETURN
2. "Challenges and Problems"
12; Josephine Guy is the Director of Governmental Affairs for
America. >> RETURN
3. Congressional-Executive Commission
on China 14. This statement was issued by Stirling Scruggs,
Director, Information and External Relations Division, UNFPA.
>> RETURN
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