05/10/2021

That sinking feeling


China is desperate for more babies. After decades of restricting population growth with its one-child policy, which was imposed in 1980 and gradually eased before being totally scrapped in 2016, the country is now burdened with a rapidly ageing population and spiralling health and pension costs. The government has introduced several measures to boost the country’s flagging fertility rate. Five years ago, it replaced its one-child policy for urban families with a two-child limit; in May the cap was raised to three children per couple. The government has also promised to improve child-care facilities and women’s employment rights. Some local authorities have introduced financial incentives to encourage more childbearing. But so far none of these measures has worked. In 2020, China’s total fertility rate—the number of children, on average, a woman is expected to have—fell to 1.3 births per woman, well below the 2.1 needed to maintain a stable population. The country recorded 12m births, a drop of 20% from 2019.

Now the government seems to have its sights set on curbing abortion. In guidelines published on September 27th, the State Council said it plans to limit the number of abortions carried out for “non-medical” reasons. It offered no specifics on how this would be achieved, but it signalled the government’s concern that the abortion rate in China is too high. Around 9.7m abortions are carried out each year in China, according to official statistics, yielding an abortion rate of roughly 28 per 1,000 women, compared with 13.5 per 1,000 women in America. One reason the rate is so high is that for many years, when the government was keen to limit population growth, the procedure was touted as a quick and “painless” fix for unwanted pregnancies, often advertised on billboards with glamorous pictures of smiling women.

The latest abortion policies are not entirely new. A previous version of the guidelines for “Women’s Development”, issued in 2011, contained similar language. Concrete measures to restrict women’s access to abortion on a national level have so far been limited. But given the state’s history of interfering with women’s bodies—from forced abortions to sterilisations—many Chinese are suspicious of any attempt to dictate their family planning. In 2018 authorities in Jiangxi province introduced rules stipulating that abortions performed after 14 weeks must have signed approval from three medical professionals. Other local authorities have introduced similar policies. There have also been softer-touch approaches to exhort women to bear more children. Rather than encouraging women to delay motherhood, state media now remind them that older mothers are more likely to have babies with birth defects.

But none of these nudges tackle the main reason for China’s declining fertility rate: people want fewer children. Mothers often report being discriminated against at work after they have a child, making the prospect of having another less desirable. And the cost of bringing up a child can be extortionate. A report in 2019 found that a family in Shanghai could expect to spend 840,000 yuan ($119,000) on their little prince or princess from birth to the age of 15. Families that earn less than 50,000 yuan per year spend 70% of their income on their children. In a highly competitive environment for university places and jobs, many parents reckon it better to invest all their resources into one golden child.

It will take many years to undo the cultural changes wrought by the one-child policy, including the view of abortion as a form of contraception. Other countries that have tried to raise fertility rates have shown how hard that can be once small families have become the norm. They have also shown that restricting access to abortion doesn’t lower the number of terminations. It just pushes them underground.

This article is from our Graphic detail section.

Editor's note: Our next Highlight will be published on October 26th.