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Contraceptives and the One-Child Policy

NOTE: All information is what have found out from my own personal experience. It is by no means a definitive look at contraceptive use in China.

One of the things that China is best known for in the West is it’s radical one-child policy. In the 1970’s, with a surging population and stretched resources, China introduced a policy that meant family size was limited and most families could only have one child. The policy has seemingly worked and some estimate that over 200 million births have been prevented since the policy was first introduced, to put that into perspective that’s somewhere around the number of people living in Brazil. China is still the most populous country in the world but it seems like the government was doing something right when it came to slowing the birth rate.

With such a wide-spread family planning policy one would imagine that China has sophisticated range contraception available to it’s people. But as I, and many before me, have found out this is not the case. Sure there are condoms available everywhere, boxes and boxes of them line the tills at pretty much every shop and they have more brands and ‘types’ that I could ever imagine anyone ever needed. But, past condoms, contraception gets a bit sketchier.

In the UK we are blessed with a huge array of contraceptive options and we are taught about them all in school, so I like to feel we are fairly educated on the matter. In China sex is still a bit of a taboo and the idea of sex ed being taught in schools would be completely unacceptable to many Chinese. Students are forbidden to have boyfriends or girlfriends — like a forbidding ever stopped anyone doing anything, especially teenagers – and sex outside of marriage is still frowned upon in many circles, although this is getting more acceptable throughout the country. This means that most grown women know very little about contraception in general. Very few have heard of the pill (except in the morning after capacity) and most female Chinese friends I asked got very coy and sort of refused to speak about it. It seems like contraception is also a pretty big taboo.

So when personal connections failed I took to the internet to see what information I could find. What I found was part baffling and part shocking, and yet I can’t really verify too much of it because no one will talk to me about it!

First thing I found was that many foreigners in China before me had been down this road and struggled to find any information, but that there was information out there to be found! One might assume that with the prevalence of condoms they are one of the most common methods of contraception in China, but that apparently isn’t the case. There are other methods which prefered and which are much stranger to us.

One is something that can best be described as the grandmother of the IUD, it’s a sort of metal ring that is inserted by a doctor and remains there until it is removed. The problem is that it’s ancient technology and has a worryingly high failure rate, not something you want from a contraception. This kind of IUD is becoming less widely used and the modern IUD that we know in the West is more common, but the high failure rate of the “Chinese IUD” would become a theme for Chinese contraception. But, the Chinese IUD is probably one of the less alarming contraception methods to us in the West.

Many Chinese people follow the protocol of “pulling out”, something that we are all taught will definitely not stop pregnancy. Many also use a “periodic abstinence” approach which uses some calculation around the menstrual cycle to find the “safe” time to have sex with no contraception. That idea just scares me, it seems so ineffective that it doesn’t surprise me that abortion is so common here.

The last method I want to mention is sterilization, China has an extremely high sterilization rate and this is in part due to the one-child policy. Once families have had all the children they are permitted sterilization is a relatively cheap and effective method of contraception. A common slogan of the one-child policy was

“if you have one child, IUD please, if you have two children, sterilization please”.

But to me this seems slightly barbaric when other effective options are available, I’ve heard stories of forced sterilization and worryingly I’ve even heard stories of the government taking replacing the contraceptive pill with pills that will sterilize you – although I can’t say how true this really is! This kind of horror story is one of the things that worries me the most now that I am on Marvelon, a contraceptive pill from a Chinese pharmacy, and while I’ve researched as much as I can and it is a brand that is used outside China there’s always that nagging feeling of not really knowing what you’re buying. For now it seems fine and I guess only time will tell any side effects, but my mission to find it has shown me a fair deal about attitudes towards sex and contraception.

China may have come a long way since the early days of the one-child policy (it has since been relaxed to include many exceptions, such as if one parent is an only child a couple can have two children) but they haven’t really come a long way with their understanding and use of contraception. The conservative attitudes of the government filter down to the people and there is a lack of education around the massive number of options that are available. Methods of contraception that are most popular in other parts of the world are ignored for more drastic options (like sterilization), or for less reliable options (like pulling out and periodic abstinence); and those that are most reliable, like the pill, are considered unhealthy in the face of ignorance about them.

To me it is strange how a country with such a strict family planning policy can have such narrow views of contraception, but attitudes are slowly changing. Perhaps over time people will learn more about the options available to them and drastic measures won’t have to be used quite so often.

P.S Anyone who does want the contraceptive pill in China go to your local pharmacy and ask for chang2xiao4bi4yun4yao4 长效避孕药.


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I am originally from London, England but after university I left England looking for adventure. For the last year and a half I have been living and working in China as a TEFL teacher, and travelling at every opportunity that I get. At the moment I am based in Yinchuan, Northern China, which is slightly off the tourist track! My mission is to see as much of the world as possible in the most authentic way that I can, I want to get outside of the typical tourist experience and see places in a more encompassing way than just passing through. I am a big advocate of travel to broaden your horizons and challenge your world view. As well as an incurable wanderlust, I love food and tend to judge a country by how good the cuisine is. Eating my way around the world sounds like a good plan to me!

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