China is the most populated country in the world. In 1979, The Chinese State Council adopted a policy that mandated that every married couple were permitted to have one child. They did this in order to bring the population growth rate to a more manageable level (Potts 2006). Deng Xiao-ping felt that without the policy that the economy in China would not be able to support an acceptable standard of living and as of 2006, China’s economy had seen a 7-8% per year growth in their economy over that previous decade (Potts 2006). The feeling is that the policy may (or may not) have helped to lift around 150 million people out of poverty (Potts 2006). The one-child policy officially ended in 2016. The critical medical anthropological theory wants to know what inequalities and political, economic, or social power lead to better or worse outcomes for particular groups of people? In other words, it asks the big question of who benefits and who suffers (Gabriel 2019)? In China, during the one-child policy, the government used its power to control the birthing practices of its population. This essay will look at the effects of this policy. There is statistical evidence that the one-child policy was never needed, there was a leveling out of the population growth prior to the policy being implemented. As a result of this policy, the aged population out numbers the working population, there is a massive overpopulation of men to women, 

China holds the world’s largest population. It has a current population of 1.420 billion (Worldometers 2019). According to statistics from 2012, when the population was 1.377 billion – at that time, 6% of the population was under the age of 5 while 22% of the population was under the age of 18 (Unicef 2019). In 1970, the fertility rate was 6.25. The median age was 19.3. The population had increased by 20.4 million people from the previous year. That was a 2.68% change. In 1980, when the One-Child Policy was implemented, the fertility rate was 3.0, less than half of what it had been ten years prior. The median age was 21.9. The population had increased by 1.54% from the previous year (Worldometers 2019).  The one-child policy began in 1980 and continued until 2016. Currently, to date in 2019, the fertility rate is down to 1.61. The median age is 37.3. The population has increased by just over 5 million people, that is a .035% increase from last year. It is estimated that by 2025 China will lose the rank of having the highest population in the world, with an estimated median age of 40.6 (Worldometers 2019). With these statistics, it may be evident why experts say the one-child policy was never needed. The fertility rate had dropped significantly prior to the policy being implemented. There had been efforts prior to the policy being implemented to encourage voluntary use of birth control to curb off the population growth. Perhaps those voluntary actions helped to have the numbers take a natural correction. Currently there are governmental concerns that the population will not grow sufficiently to support its current economic standing. Of note are the statistics relating to the median age of the population, they continue to steadily rise.

As noted above, the statistics show a continual rise in the median age in China.  A lingering result of the one child policy in China is that there is an aging population that needs to be cared for. Currently, the aging population is greater than that of the younger, working population (Wang et al. 2016). The burden of caring for the aging falls to all of Chinese society but specifically to individuals in the aging population’s family. It is tradition that males inherit the property and they are responsible for caring for their elder family members. Due to the one child policy, the burden of caring for two parents and possibly a grandparent or two falls to one male heir. Where if more children had been born, the burden would fall to several of the children in the family. The stress on the single child in the family to be able to make enough money to support multiple generations is tremendous. 

Additionally, there is a vast difference in the ratio of men to women. As of 2016 there were an estimated 33.6 million more men than women in China (Britannica 2019). This imbalance is due to the preference of male children to female children. The lack of females is putting a strain on men finding women to marry and to have children to continue the familial lineage. 

The policy officially ended on January 1, 2016. The restrictions now allow for each family to only have two children. They no longer are required to apply for permission from the government to have a child. They are now required to report the birth after the fact (Wang et al. 2016). The forced family planning included millions of sterilizations and abortions. In 1983, there were about 21 million births, about 14 million abortions ad about 20 million sterilizations performed. The sterilizations were performed more on females than males. Additionally, it is reported that almost 18 million IUD insertions were performed (Wang et al. 2016). And in an about face, the government is now offering incentives to couples to get pregnant (Kuo 2019).

From a feminist theoretical approach, where the big questions asked are: how does gender impact the situation? And is the inequity present due specifically to gender (Gabriel 2019)?  This policy is specific to women because it was their reproductive systems that were being regulated. However, another problem that arose from this one-child policy was that in the event that a couple had a girl, they were often times abandoned or their births were hidden from the government.  There were some opportunities that female babies were adopted out to couples in other countries. In the instances where female children were hidden, they were “off the books”, they were illegal within their own country.  It led to issues of them going to school and gaining an education as well as the inability to get a job or health insurance or be married.  

For over a generation, women were, at best, forced to ask for approval to get pregnant and, at worst, forced in to having an abortion or being sterilized or having an IUD inserted. There are cultural implications to be explored that came about as a result of this policy. In a country where traditional cultural expectations include a strong family and kinship lines – there are major repercussions from this policy that exist today. The long-term fallout from the one-child policy may prove to be something China cannot overcome. They are facing major issues of an increasing ageing population and not enough young people to support it. They have a major imbalance in the ratio of men to women.  In answering the big question presented with the critical medical anthropological theory, the answer is the Chinese government had and has the power over the reproductive intentions of a nation.  They have the power and the Chinese citizens were forced to comply. 

Potts, Malcolm. China’s One Child Policy. BMJ (Clinical Research Ed.). August 19, 2006. Accessed July 26, 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550444/.

Gabriel, Cynthia. ANP 270, Week One, Lecture 4 (Lecture 1.4). Introducing Theory 3, Critical Medical Anthropological Theory.  July 2019. 

Wang, Feng, Baochang Gu, and Yong Cai, The End of China’s One-child Policy; Brookings. July 28, 2016. Accessed July 26, 2019. https://www.brookings.edu/articles/the-end-of-chinas-one-child-policy/

Britannica, The Editors of Encyclopedia. The Effects of Chinas One-Child Policy; Encyclopedia Britannica. Accessed July 26, 2019. https://www.britannica.com/story/the-effects-of-chinas-one-child-policy

Kuo, Lily. Can China Recover from Its Disastrous One-child Policy? The Guardian. March 02, 2019. Accessed July 26,2019

Global Health – Centers for Disease Control and Prevention. Accessed August 10,2019. https://www.cdc.gov/globalhealth/countries/china/default.htm