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Abortion in China

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Abortion in China is legal and generally accessible.[1][2][3] Regulations vary depending on the rules of the province, in Jiangxi non-medically necessary abortions after 14 weeks of pregnancy are not allowed while throughout most of China elective abortions are legal. In 2021, China's State Council as well as the non-governmental organization responsible for family planning announced policy guidelines with the goal of reducing non-medically necessary abortions by increasing women's access to pre-pregnancy healthcare services.[4][5][6][7] Sex-selective abortions are illegal nationwide as it leads to an imbalanced sex-ratio.

In the past, virtually universal access to contraception and abortion for its citizens by a national government service was a common way for China to contain its population in accordance with its now-defunct one-child policy.[8] It was scaled back when the policy was removed in 2015 in favor of a two-child policy and in turn was replaced by a three-child policy in 2021.[9] In 2022, the National Health Commission announced that it would direct measures toward reducing non-medically necessary abortion through a number of measures, including expanded infant care services and local government efforts to boost family-friendly work places.

History

In the early 1950s, the Chinese government made abortion illegal other than when 1) the mother had a preexisting condition, such as tuberculosis or pernicious anemia, that would cause the pregnancy to be a threat to the mother's life; 2) when traditional Chinese medicine could not settle an overactive fetus and spontaneous abortion was expected; and 3) when the mother had already undergone two or more Caesarean sections.[10] Punishments were written into the law for those who received or performed illegal abortions.[10]

In 1953, the Ministry of Health prepared the Regulation of Contraception and Induced Abortion which extended access to the services.[11] Later, in 1954 and 1956, the law was extended to include other pre-existing illnesses and disabilities, such as hypertension and epilepsy, as well as allowed women working in certain types of occupations to qualify.[10] Women who had already had four children and became pregnant four months after giving birth to their last child also qualified for an abortion.[10]

These restrictions were seen as the government's way of emphasizing the importance of population growth.[10] The scholar Nie Jing-Bao explains that these laws were relaxed in the late 1950s and early 1960s with the intent of reducing the number of deaths and lifelong injuries women sustained due to illegal abortions as well as serving as a form of population control when used in conjunction with birth control.[10]

By the 1970s, abortion was officially termed a "remedial measure" for realising China's goals of controlling the population.[12]

As a result of abortion legalization in China (and India), a majority of Asians have legal access to abortion services.[13] In 2004, Guizhou enacted a ban on abortions in non-medically necessary cases after 14 weeks of pregnancy.[14]

In Jiangxi, pregnant women older than 14 weeks are required to obtain approval from three medical professionals stating that the procedure is medically necessary.[15][16][17]

In 2021, The China Family Planning Association, an official party-backed non-governmental organization and China's chief administrative authority, the State Council, published new national guidelines with the goal of reducing abortion for non-medical reasons.[6] The organization recommended that provincial governments should aim to reduce the number of abortions performed for "non-medical purposes" and promote instead alternate methods of contraception and birth control, and increase spending on social programs aimed at improving access to pre-pregnancy health care services and post-childbirth family planning services.[18] However, restrictions on birth control methods have occurred, such as the limiting of access to vasectomies and contraception.[19][20] That change in policy is seen by many analysts as being motivated by the declining birth rate in China.[21]

In August 2022, the National Health Commission announced that it would direct measures toward "reducing abortions that are not medically necessary."[22] The announced support measures include improvements with regard to insurance and taxation, improvements for education and housing, and encouraging local governments to boost infant care services and family friendly workplaces.[22]

Statistics

Percentage of conceptions which led to abortion in China

In 2018, The National Health Commission of China reported that more than 9 million abortions are performed annually in China,[23] down from approximately 13 million annually as of 2015.[24][25] For 2020, the number of abortions in China dropped further, to just under 9 million.[26]

The Guttmacher Institute, a research organization that promotes abortion rights, released a study in which it estimated China's abortion rate for the years of 2015-2019 was at a rate of 49 abortions per 1000 reproductive-aged women, one of the highest rates in Eastern and Southeastern Asia.[27]

Sex-selective abortion

Main article: Sex-selective abortion § China

The practice of pre-natal sex determination and sex-selective abortions in China for non-medical reasons are illegal.[28][29] It is argued that sex-selective abortion continues to be one of the key factors in the notably imbalanced sex-ratio in China, as the imbalance cannot be explained solely by the underreporting of female births or by excess female infant mortality.[30] In 2001, 117 boys were born to every 100 girls.[30] These trends are explained by the persistence of a preference for sons in Chinese families.[31]

In 2005, the government began an Action Plan consisting of ten policies with the aim of normalising the sex ratio of newborns by 2010.[32] Under this plan, sex-selective abortion was outlawed, as was prenatal sex diagnosis, and harsher punishments were implemented for violating both. Other policies include controlling the marketing of ultrasonic B machines and improving the systems used by medical and family planning organisations to report on births, abortions and pregnancies.[32]

Family planning

The importance of abortions as a family planning tool is evident through the extensive implementation of medical abortions (abortion induced by pills, which can be performed in early pregnancy) in China. China legalized abortion in 1957 under the Minister of Health, Li Dequan.[33][34][35] In the decades since, abortion pills have been produced in China on a large scale.[36] The practice remains highly promoted by Chinese doctors due to its high efficacy rates (90-97% for domestically produced mifepristone, 95% for domestically produced RU-485)[37][38] and its much less invasive nature compared to surgical abortion. Since then China has banned mifepristone (RU-486) tablets, citing safety concerns.[39]

See also

References

  1. ^ "World Population Policies | Population Division". www.un.org. Retrieved 2022-06-24.
  2. ^ "The World's Abortion Laws". Center for Reproductive Rights. Retrieved 2022-06-24.
  3. ^ Miller, Claire Cain; Sanger-Katz, Margot (2022-01-22). "On Abortion Law, the U.S. Is Unusual. Without Roe, It Would Be, Too". The New York Times. ISSN 0362-4331. Retrieved 2022-06-24.
  4. ^ Reuters (2021-09-27). "China to reduce abortions for 'non-medical purposes'". Reuters. Retrieved 2022-06-27. {{cite news}}: |last= has generic name (help)
  5. ^ "Abortion Law: Global Comparisons". Council on Foreign Relations. Retrieved 2022-06-24.
  6. ^ a b "中国计划生育协会印发工作要点：2022年开展未婚人群人工流产干预专项行动". www.muyingjie.com. Retrieved 2022-05-04.
  7. ^ "China tightens abortion controls as population crisis looms". Financial Times. 2021-09-27. Retrieved 2022-05-28.
  8. ^ Hesketh, Therese; Lu, Li; Xing, Zhu Wei (2005). "The Effect of China's One-Child Family Policy after 25 Years". New England Journal of Medicine. 353 (11): 1171–1176. doi:10.1056/NEJMhpr051833. PMID 16162890.
  9. ^ "Abortion Law: Global Comparisons". Council on Foreign Relations. Retrieved 2022-06-24.
  10. ^ a b c d e f Jing-Bao, Nie. Behind the Silence: Chinese Voices on Abortion Lanham, ML: Rowman & Litterfield Publishers, 2005.
  11. ^ Law in the People's Republic of China: Commentary, Readings, and Materials. BRILL. January 1989. ISBN 9780792300557.
  12. ^ Nie, Jing-Bao. Feb 2010, “Limits of State Intervention in Sex-Selective Abortion: The Case of China,” Culture, Health and Sexuality, Vol. 12, Iss. 2, p. 206. Retrieved 3 Sept 2010.
  13. ^ Staff, F. P. "Roe Abolition Makes U.S. a Global Outlier". Foreign Policy. Retrieved 2022-06-24.
  14. ^ "China: new rules to prevent sex-selective abortions raise fears". The Guardian. 22 Jun 2018. Retrieved 15 April 2022.
  15. ^ "China: new rules to prevent sex-selective abortions raise fears". The Guardian. 22 Jun 2018. Retrieved 24 June 2022.
  16. ^ "CHINA – Jiangxi province has restricted abortion after the 14th week of pregnancy because of the sex ratio imbalance". International Campaign for Women's Right to Safe Abortion (SAWR). Retrieved 2021-06-24.
  17. ^ Yee, Vivian. "China's Vow to Reduce Abortions Sparks Public Worries". The New York Times. Retrieved 2021-06-24.
  18. ^ "中国计划生育协会印发工作要点：2022年开展未婚人群人工流产干预专项行动". www.muyingjie.com. Retrieved 2022-06-27.
  19. ^ "In need of a baby boom, China clamps down on vasectomies". Washington Post. 9 Dec 2021. Retrieved 15 April 2022.
  20. ^ "China quietly cuts back on vasectomies to stop falling birth rates". MercatorNet. 8 Jan 2022. Retrieved 15 April 2022.
  21. ^ "China to reduce abortions for 'non-medical purposes'". Reuters. 27 Sep 2021. Retrieved 9 March 2022.
  22. ^ a b Master, Farah; Zhang, Albee (2022-08-16). "China to discourage abortions to boost low birth rate". Reuters. Retrieved 2022-08-16.
  23. ^ Reuters (2021-09-27). "China to reduce abortions for 'non-medical purposes'". Reuters. Retrieved 2022-06-29. {{cite news}}: |last= has generic name (help)
  24. ^ "High abortion rate triggers fears for young women - China - Chinadaily.com.cn". 2022-04-26. Archived from the original on 2022-04-26. Retrieved 2022-06-29.
  25. ^ Report: China aborts 13 million babies a year". Burlington, Vermont: Burlington Free Press. 31 July 2009. pp. 2A.
  26. ^ "Supreme Court Ruling on Abortion Strikes a Chord in China". WSJ. Retrieved 2022-07-06.
  27. ^ Bearak, Jonathan Marc; Popinchalk, Anna; Beavin, Cynthia; Ganatra, Bela; Moller, Ann-Beth; Tunçalp, Özge; Alkema, Leontine (2022-03-01). "Country-specific estimates of unintended pregnancy and abortion incidence: a global comparative analysis of levels in 2015–2019". BMJ Global Health. 7 (3): e007151. doi:10.1136/bmjgh-2021-007151. ISSN 2059-7908. PMC 8943721. PMID 35332057.
  28. ^ Nie, Jing-Bao. Feb 2010, “Limits of State Intervention in Sex-Selective Abortion: The Case of China,” Culture, Health and Sexuality, Vol. 12, Iss. 2, p. 205.
  29. ^ Junhong, Chu, June 2001, “Prenatal Sex Determination and Sex-Selective Abortion in Rural Central China,” Population and Development Review, Vol. 27, Iss. 2, p. 262.
  30. ^ a b Hesketh, Therese . Lu, Li. Xing, Zhu Wei, Sept 2005, “The Effect of China’s One-Child Family Policy After 25 Years, The New England Journal of Medicine, Vol. 353, Iss. 11.
  31. ^ Junhong, Chu, June 2001, “Prenatal Sex Determination and Sex-Selective Abortion in Rural Central China,” Population and Development Review, Vol. 27, Iss. 2, p. 267.
  32. ^ a b Nie, Jing-Bao. Feb 2010, “Limits of State Intervention in Sex-Selective Abortion: The Case of China,” Culture, Health and Sexuality, Vol. 12, Iss. 2, p. 207.
  33. ^ Unsafe Abortion and Women's Health: Change and Liberalization. Routledge. 9 March 2016. ISBN 9781317004202.
  34. ^ Occasional Monograph Series. Interdisciplinary Communications Program, Smithsonian Institution. 1976.
  35. ^ Military Medicine. Association of Military Surgeons of the United States. 1957.
  36. ^ Ulmann A (2000). "The development of mifepristone: a pharmaceutical drama in three acts". J Am Med Women's Assoc. 55 (3 Suppl): 117–20. PMID 10846319.
  37. ^ "Family planning in China: RU-486, abortion, and population trends". U.S. Embassy Beijing. 2000. Archived from the original on 11 March 2002. Retrieved 14 September 2006.
  38. ^ Wu S (2000). "Medical abortion in China". J Am Med Women's Assoc. 55 (3 Suppl): 197–199. PMID 10846339.
  39. ^ "RU-486 abortion pill sales banned by Chinese agency". Baptist Press. 2001. Retrieved 1 July 2022.
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