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China Will Let Families Have More Kids, But Many Women Can’t

The end of China’s one-child policy, which the state-run news agency announced Thursday, will raise the cap, permitting families to have up to two children. But it comes too late for millions of Chinese women who were pressured to be sterilized.

China’s one-child policy, put into effect in 1980 at a time when the country’s leaders feared the economic pressure of overpopulation, has affected urban families most dramatically. The policy allowed exceptions for some ethnic minorities, rural families, families whose first child was a girl, and families where both parents were only children. As a result, 65 percent of Chinese families were exempted from the policy, though they still had to prove their eligibility to a bureaucrat to be permitted more than one birth.

In some cases, parents simply flouted the rules. In a 1995 survey of six counties, researchers found that there were 22 percent more girls in villages than were officially recorded, enough to balance the gender ratio among children under 18. (Nationwide, the policy has resulted in wildly unbalanced gender ratios, with 117 boys born for every 100 girls, according to the 2000 census.)

Although some families may have evaded the controls, women in China still faced pressure to use contraception, to limit pregnancies and to have abortions. A 2001 survey of nearly 40,000 Chinese women found that a second pregnancy was six times as likely to end in abortion as a first pregnancy.

1st 46.8% 44.1% 3.6%
2nd 38.7 31.3 25.9
3rd 37.1 29.0 29.5
≥4th 33.6 25.6 35.0

The one-child policy played a role in married Chinese women using longer-term contraception than the methods used by married women in America — and in many cases, those methods were irreversible. In 2001, married Chinese women were most likely to use an IUD for contraception (46 percent), according to government surveys. IUDs are an easily reversible form of contraception, but the next most common form of contraception was permanent sterilization (37 percent), and another 8 percent of women relied on their husband’s sterilization. Only 6 percent of married women used condoms, and 3 percent relied on an oral contraceptive pill. Using China’s 2000 census numbers (those closest to the time of the survey) to make a ballpark estimate, that means more than 200 million couples had one partner sterilized.1

Many of those women probably didn’t freely choose sterilization. Eighty percent of the married Chinese women surveyed said that they had had no choice about what form of contraception to use, and had done whatever their official family-planning worker told them to do.

In the United States, where women ostensibly are under less government pressure to choose a specific contraceptive method, a CDC survey from 2006 to 2010 found that married women who were using contraception were most likely to choose female sterilization (30 percent) or male sterilization (17 percent) as their contraceptive method. The pill was the second most common form of contraception (19 percent), followed by condoms (15 percent). IUDs (7 percent) were much less commonly used than in China.

Although the rules have been loosened going forward, the impact of the one-child policy will linger for families in China, as children born under the old policy grow up without siblings, and parents who were pressured into sterilization miss their chance to benefit from the new opportunity.


  1. Assuming only one partner was sterilized, not both.

Leah Libresco is a former news writer for FiveThirtyEight.