ABORTIONS IN CHINA: RATES, COSTS AND CLINICS THAT PERFORM THEM

ABORTIONS IN CHINA

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Population control promotion
Abortion has been legal in China since 1953, although sex-selective abortions were banned starting in 1994. China was the first country to approve mifepristone, the abortion-inducing drug also known as RU-486, and by the late 1990s it was widely available — by prescription and on the black market — all across China. The government estimated that 9.2 million abortions were performed in 2008, up from 7.6 million in 2007. But the count only includes those done at hospitals. State media has reported the total could be as high as 13 million. If accurate, that would give China one of the highest abortion rates in the world. [Source: Mark McDonald, New York Times, July 30, 2009]

Abortions at registered clinics in China cost about $88. Wu Shangchun, a research official with the National Population and Family Planning Commission, told China Daily that about 10 million abortion-inducing pills are sold annually in China. China has mobile abortion clinics — vans equipped with a bed, body clams, suction pumps and other tools used to perform abortions. Among the other heroic deeds performed by a pilot, one Chinese newspaper reported, was the fact that he "persuaded his wife, pregnant for the first time, to have an abortion."

According to the Encyclopedia of Sexuality, published in the early 1990s, in China, abortion as a secondary measure to terminate an unwanted pregnancy is not only a legal right, it is even a legal responsibility. If a woman already has a child, she will be asked to terminate her unplanned pregnancy by abortion in the first trimester and even as late as the second trimester. Generally speaking, in mainland China one third of pregnant women have undergone an abortion. From 1985 to 1987, 32,000,000 abortions were done, 80 percent of these pregnancies being the result of failed contraception. [Source: Zhonghua Renmin Gonghe Guo, Fang-fu Ruan, M.D., Ph.D., and M.P. Lau, M.D. Encyclopedia of Sexuality =]

There were an estimated 9.6 million to 9.85 million abortions each year from 2014 to 2020. The One-Child Policy was ended in 2016.From 1995 to 2013 there were generally around 6 million to 7.5 million abortions each year. From 1982 to 1993 the figure was were generally between 9 million and 15 million abortions each year. [Source: Historical abortion statistics, PR China compiled by Wm. Robert Johnston, September 6 2021 johnstonsarchive.ne ]

Websites and Sources: Illegal Births, Legal Abortion ncbi.nlm.nih.gov ; China.org article China.orh ; Family Planning info asianinfo.org ;



History of Abortion in China

Alexa Olesen of Associated Press wrote: “The country legalized abortion in the 1950s, but it did not become common until the government began enforcing a one-child limit to stem population growth. From fewer than five million abortions a year before 1979, the number jumped to 8.7 million in 1981, a year after the policy was launched. It peaked in 1983 at 14.4 million before coming down as Beijing relaxed the policy to allow rural couples a second child if their first was a girl. An aggressive, and often coercive, prevention campaign also reduced abortions. In 1983 alone, authorities sterilized 21 million people and fitted 17.8 million women with intrauterine devices. The next year, abortions declined sharply to 8.9 million.” [Source: Alexa Olesen Associated Press, January 10, 2011]

"It used to be that Chinese women only had an abortion if the foetus had birth defects or if they got pregnant after having their first child," an anaesthesiologist told AP. "Society is different now. It's much more open, too open actually, and puberty is starting much younger, but schools and parents are not discussing these things with the kids." [Source: Alexa Olesen Associated Press, January 10, 2011]

Until the 1990s, doctors asked for women's marital status at abortion clinics, which were part of the family planning system that limited urban couples to one child. Now, government data shows that nearly two thirds of women who have abortions are between 20 and 29, and most are single. [Source: Reuters, July 30, 2009]

High Number of Abortions in China

According to government data released in August 2009, 13 million abortions a year are performed in China, mostly on single young women. The true figure is thought to be much higher. The numbers included only abortions performed at hospitals and did include those done at unregistered rural clinics, where a lot of abortions are performed, or medication-induced abortions. According to the data about 10 million abortion pills are sold every year and half the women who get abortion used no contraception. [Source: China Daily]

Even the official figure shows a marked increase in Chinese abortions, based on statistics from 2003, the last year for which reliable data are available. In a joint report, the World Health Organization and the Guttmacher Institute put the number of abortions in China at 9 million, out of a total of 42 million worldwide that year. In the United States, which has a population less than one-quarter that of China, official figures from the Center for Disease Control show there were 820,000 abortions performed in 2005, excluding California, Louisiana and New Hampshire for which no figures were provided. [Source: Reuters, Mark McDonald, New York Times, July 30, 2009]

The rate of abortion in China — about 24 abortions for every 1,000 women between the ages of 15 and 44 — is far from the world’s highest. Russia has by far the highest rate at 53.7 per 1,000, according to the United Nations Population Division. Some two million abortions are performed each year in Russia, which has a population of 142 million. China’s population is 1.3 billion.

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birth control poster

“More than eight million induced abortions are performed in China every year, 50 percent of them not being the woman's first, according to a survey, Xinhua News Agency reported.The more abortions a woman has, the more likely she is to suffer from diseases caused by abortions, said Cheng Linan, an expert with the Chinese Medical Association. About 88 percent of the infertile women in China have experience of abortion. [Source: Chen Yingqun, China Daily, September 27, 2011]

The rate of miscarriage for those who have repetitive abortions is 2.5 times that of women who have never had an abortion, and their rate of premature delivery is 5.44 times that of women who have had one abortion.

Reasons for the High Number of Abortions in China

Nearly half of the women who had abortions had not used any form of contraception, About 60 percent of the women who have abortions are between 20 and 29 years old, and most are single. ]Some single women may also be driven to seek abortions because under current laws unmarried mothers cannot get a "hukou" or household registration card for their child. Without one it is extremely hard for Chinese citizens to get access to education, healthcare and other public services. [Source: Reuters, July 30, 2009]

A Chinese cultural preference for sons, combined with the state’s longstanding one-child policy, has resulted in a widening use of gender-selective abortions and an imminent generation of excess men, according to a recent report in the online British Medical Journal. There are now 32 million more Chinese boys than girls under 20, the researchers found, an imbalance that is expected to widen over the next 20 years. [Source: Mark McDonald, New York Times, July 30, 2009]

The number of abortions has risen dramatically with the one-child policy. Statistics for the country as a whole are difficult to come by. But there is some regional data. In surveys conducted in Shanghai in 1987 and 1991, some 47 percent of married women questioned had at least one abortion; and more than third (36.8 percent) of those who had abortions had at least two. Abortions are performed even after the sixth month of pregnancy if the babies are "outside the plan." [Source: U.S. News and World Report]

Lack of Education and Abortions in China

Officials blamed a low level of sex education among young people for the widespread use of abortion in China. More than 70 percent of callers to a pregnancy phone line at a Shanghai hospital knew almost nothing about contraception, China Daily reported. Only 17 percent were aware of venereal diseases, and less than 30 percent knew that HIV/AIDS could be transmitted sexually. Sex is no longer considered taboo among young people today, and they believe they can learn everything they need from the Internet, Yu Dongyan, a gynecologist, told the paper. But it doesn’t mean they’ve developed a proper understanding or attitude toward it. [Source: Mark McDonald, New York Times, July 30, 2009]

Reuters reported: Such a high number of million abortions are carried out in China “in part because there is little education about contraception or disease for the rising numbers of young people who are having sex, state media said. Fewer than one in three callers to a Shanghai hotline knew how to avoid pregnancy, and only one in five were informed about venereal disease, the official China Daily quoted a survey by the city's 411 Army Hospital saying. [Source: Reuters, July 30, 2009]

Birth control information is mainly given to young couples. Sun Xiaohong from the education department of Shanghai's family planning authority said it was difficult to promote sex education in schools because some teachers and parents thought it would encourage teenagers to become sexually active. Ordinary web users in China will be banned from surfing sex-related medical and research websites from July, amid an Internet crackdown on pornographic online content, that threatens to make information about sexual health even harder to access.

Views on Abortion in China

Alexa Olesen of Associated Press wrote: “Chinese can be brutally frank when it comes to abortion. Many feel a foetus is not a person until after it is born - an attitude Beijing sociologist Li Yinhe associates with the country's once-high infant mortality rate. Frequent miscarriages and infant death hardened families to the point that babies were not traditionally named until 100 days after birth, she said.” "Luckily, in Chinese culture people generally feel that before the actual birth, you do not yet have an actual person, so we have cases of induced abortion at seven and eight months along," Li said. "I think this is to China's advantage from a population control point of view ... China has absolutely no need for the so-called 'right to life' argument, no need to introduce ideas about abortion as murder and so on." The mainland's few anti-abortion campaigners are usually Buddhists or Christians. But their activities are low-key because the government keeps a tight rein on grass-roots organizations and religious groups. [Source: Alexa Olesen Associated Press, January 10, 2011]

Evan Osnos wrote in The New Yorker: There had always been a vast and curious gap between the way abortion was perceived in the United States and in China. For years, the Chinese public had looked on, with some confusion, at the fact that it’s a litmus-test issue in America. In China, it was a largely unremarked-upon feature of life, despite growing steadily from 1979, when the government began its policy to curb the growth of the world’s largest population. By 1983, the number of abortions had nearly tripled, to 14.4 million,and, that year, the government relaxed the policy to allow rural families a second child if the first was a girl. [Source: Evan Osnos, The New Yorker, June 15, 2012]

Today, family planning is promoted by a vast system that dispenses contraceptives and keeps track of births, but it mainly focusses on married couples. Partly because contraceptives were not as actively promoted to unmarried people, hospitals had described an uptick in voluntary abortions by single women in recent years, and services were advertised as ‘safe & Easy A+.”

"P eople in China never rallied as actively as you might expect around Chen Guangcheng, the blind lawyer who was persecuted by local officials for trying to stop forced abortions and sterilizations, eventually taking refuge in the American Embassy, and going to the United States with his family as a visiting scholar at N.Y.U. It was also one reason why Chen’s fervent embrace by American conservatives, who saw him as a comrade-in-arms in the abortion debate, had always been a curious fit. His campaign to protect the rights of women and individuals from abuse by an authoritarian state shares more philosophical D.N.A. with liberalism than with the religious right. In that sense, Chen had always attracted an odd alliance of admirers, and I’ve half-wondered if there won’t come a day when he will point out in his relentlessly honest way that, actually, he was not in favor of policy that deprives people of control over their own bodies.

More Young Women Getting Abortions in China

The abortions rate among young, single women is rising. Alexa Olesen of Associated Press wrote: “Official figures show abortions are increasing, and the media and experts say many, if not most, of the abortion-seekers are young and unmarried. That is a change from the past, when abortion was used mainly to enforce the government's one-child-per-couple limit.[Source: Alexa Olesen Associated Press, January 10, 2011]

“Many blame the trend on newly liberal attitudes towards premarital sex and on lagging sex education. Bureaucratic red tape and social stigma deter single women from having a child on their own, and laws bar women from marriage until they are 20, making teen pregnancy virtually unheard of . These factors and a lack of stigma surrounding abortion, or "artificial miscarriage", as it's known, have helped make it a relatively cheap, widely available option for birth control. Today, students are clearly a client base: the Beijing Modern Women's Hospital offers a government-subsid ized "Safe & Easy A+" discount abortion package at 880 yuan ($135). Others advertise in college handbooks.”

"The moral outrage over having a child before marriage in our society is much stronger than the shame associated with abortion," said Zhou Anqin, the manager at the clinic in Xian, which performs about 60 abortions each month, mostly on students aged 24 or younger.

A United Nations-funded survey of 22,288 Chinese aged 15-24 by the Peking University Population Research Institute in 2009 found that two-thirds were accepting of premarital sex but that most "had very limited levels of sexual reproductive health knowledge." The survey found 22 per cent had had sex before; of those, more than 50 per cent used no contraception during their first sexual encounter.

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birth control poster

Chinese Abortion Clinic

Alexa Olesen of Associated Press wrote: “The leaf-strewn road divider in Eternal Peace Road hides a grim secret: numerous tiny foetuses lie in unmarked graves dug by women from the abortion clinic across the street. The staff at the small clinic in the heart of this ancient city of Xian do not bury most of the foetuses - only those that have reached three or four months, when they clearly resemble miniature babies. “This big,” says anaesthesiologist Liu Jianmin, using her thumb and index finger to measure out the length of a lipstick tube. The burials are a gesture of respect for lives cut short, she adds, and the patients are not told.”[Source: Alexa Olesen Associated Press, January 10, 2011]

“The two-storey facility, which opened in 2007, is one of five operated in China by Marie Stopes International, a London-based not-for-profit group that runs hundreds of clinics globally promoting safe abortions, HIV testing and other services. The foetuses that are not buried are discarded as medical waste, as they are in the United States.”

Online adverts and cheery brochures advertise "painless artificial miscarriage", private recovery lounges and post-surgery massage to help shrink the swollen uterus back to normal size. "These kids today have it so easy, they get a pinch and fall asleep, no suffering," says the anesthesiologist, who herself underwent an abortion without pain medicine in 1982, standard practice at the time. "If they felt it, they wouldn't get pregnant again."

Young Chinese Woman Getting an Abortion

Alexa Olesen of Associated Press wrote: “In a ground-floor examination room, a nurse rubs the sonogram wand over Nancy Yin's belly as Yin, 20, stares at the wall, looking away from the image on the machine: a nearly three-month-old foetus with arms, legs and a quick heartbeat. Yin, a student, started having sex with her boyfriend in March. The couple never used contraceptives, she says, because she “didn't feel comfortable with it.” Her parents never talked to her about birth control, nor was it discussed in school. [Source: Alexa Olesen Associated Press, January 10, 2011]

As a nurse checks her blood for signs of infection, Yin seems embarrassed but firm in her decision. "I considered having the baby," she says. "But it's not possible. I am in school and I've got to graduate." Later, Yin leaves with a bag of pills and an abortion appointment three days later. The manager, explains that the pills will kill the foetus and soften Yin's cervix. "It's like preparing the ground before you pull out a sapling," she says. "If you pour water on the ground first, it will loosen the soil and make it much easier."

“Marie Stopes frequently sees repeat customers. Zhang Jie, 22, warms herself by a space heater in the recovery room after her second abortion in two years. A petite woman with blue-tinted contacts, Zhang works as a salesgirl and hopes to open her own fashion shop one day. She says she wants a baby when she is older and has some savings, but not now.” [Source: Alexa Olesen Associated Press, January 10, 2011]

Backstreet- Dentist-Abortion Clinic Guangdong's Fengzhong County

The Chinese novelist Ma Jian wrote in The Guardian: “In Guangdong's Fengzhong County, I had my teeth cleaned in an unregistered backstreet clinic that provided services ranging from dentistry to abortion. The doctor's face was caked in thick foundation that creased into fine lines when she smiled. When my painful ordeal was over, I climbed out of the broken chair, spat into the basin and said: "I have friends in London who'd love to adopt a Chinese baby, and here you are aborting them every day …" [Source: Ma Jian, The Guardian, May 6, 2013 ^*^]

"Most of the women who come to me for abortions would carry to term if I found them a rich couple to buy their child," she said, counting the notes I had handed her. "The government orphanages sell baby girls for 40,000 yuan [£4,250], and they're usually undernourished or deformed in some way. I sell healthy newborns for half that price, but not to foreigners – they can only buy from the state." ^*^

"I read in the papers a few years ago that the police near here stopped a van, searched the boot and found 28 baby girls tied up in black plastic bags," I said, rubbing my sore gums. "One of them had already suffocated to death. The hospital staff who sold them to the gang were tracked down and executed." "Those child traffickers have no conscience – they sell babies by the batch," she said. "I sell on a strictly one-to-one basis. I'm performing a good deed, and I only take a small cut. The fine for having a second child has risen to 10,000 yuan [£1,060]. No couple wants to spend that amount of money on having a second girl. When I give the women an ultrasound and they discover it's a girl, I always tell them that, these days, girls and boys are equal. I have one daughter, and she's just given birth to a little girl herself, and we're all perfectly happy." ^*^

“A few days later, while walking along the banks of the Pearl river, I saw a dead baby lying in an opened black plastic bag. I had seen discarded foetuses in China many times before: purple lumps of flesh lying on rubbish heaps or inside communal dustbins. But this was a pale, fully grown, newborn baby, with the umbilical cord still attached. A passerby had spotted it, and was prodding it with a wooden stick. ^*^

In a small village in remote Guangdong, a contact took me to her local family planning centre, and told the director that I was a state reporter from Beijing. He took me to his office and we talked for hours. Backlit by a dusty window, he leaned over his desk and showed me the record book that meticulously charted the menstrual cycles and pelvic examination results of every woman of childbearing age in the village. He said 98 percent of the 280 women were fitted with IUDs. Every three months, he broadcasts an announcement through the village summoning every woman for a mandatory ultrasound to check that her IUD is still in place. ^*^

"How do you know when a woman is menstruating?" I asked him. "She has to report her cycles to the family planning monitor assigned to her street," he said, his silhouette now black against the bright window. A) "And how do they know she isn't lying?" B) "If the monitors suspect anything, they'll rummage through the woman's bins to check for soiled sanitary towels." A) "And what if you discover she's fallen pregnant without permission?" B) "We set to work on her." A) "What do you mean?" B) "We persuade her to have an abortion. If she refuses, she must pay a fine – three times her annual salary. A few years ago, the county authorities insisted we meet our targets, so we couldn't let anyone off. We had to round up every woman who was pregnant without permission and bring her here for a termination." A) "What if they refused to come?" B) "There were four of us – they didn't stand a chance!" He grinned and sucked on his cigarette; then his face dropped, and he fell silent. "My cousin was six months pregnant at the time. I had to drag her here myself and oversee the termination. She won't speak to me, even to this day …" ^*^

“Before I left, he took me to the adjoining room and showed me the ultrasound machine and the steel table on which abortions are performed. I stared for a while at the stirrups hanging loosely on either side and at the large plastic bucket on the ground. In the far corner of the room was a faded poster proclaiming: "Girls are as good as boys." ^*^

Forced Abortions in China

There have been many reports of forced abortions n China. In some places women must have regular check-ups to make sure they are not pregnant. If they are pregnant they are forced to have an abortion. There have reports of the families of women having their houses torn down and their fields taken away after the women refused to get abortions

Unauthorized pregnancies are sometimes ended with the injection of lethal chemical through the mother's stomach and into the fetus's brain, followed by an abortion. This technique is used even at nine months. If a baby is then born alive, he or she is given an another injection that causes death.

Forced abortions and sterilizations were common in the early days of the one-child policy but were made illegal. Even so the practice continues because failure to meet birth control quotas could spell doom for the careers of local officials.

In the city of Linya in Shandong Province peasants have been forced to have abortions by local government officials worried about meeting their population control quotas. There have been reports of officials who raided homes there and forced couples with two children to undergo sterilizations and women carrying a third child to have an abortion, in some cases days before their due date.

Image Sources: 1) University of Washington; 2) ElizabethinChina blog; 3) Abotion rate map Robert Johnson.

Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, National Geographic, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.

Last updated September 2021


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