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Population Policies in Communist China¹

On November 1, 1954, the State Statistics Administration of the Ministry of Internal Affairs of the People’s Republic of China announced the results of a census—registration taken in major part as of midnight on June 30, 1953. The total population was reported as 602 million. Deleting the 7.6 million Chinese accepted as the population of Taiwan and the 11.7 million other Chinese outside the Mainland left the population of the Mainland as 583 million.… There was also an official statement that a survey of more than 30 million people showed a birth rate of 37 per 1,000 total population, a death rate of 17, and hence a rate of natural increase of 20. If these results are valid, a rate of natural increase of two per cent per year is producing annual increases amounting to more than 12 million.

The initial public reaction to the fact—or belief—that the numbers of the Chinese exceeded 600 million was one of jubilation. There was the ancient identification of numbers with the power of the state, the anticipation of greater power as numbers became greater, pride in China and the Chinese as the most populated of the world’s lands and the most numerous of its peoples, derision of the skeptics who believed China weakened by its numbers. Pai Chien-hua of the Census Department of the Ministry of Internal Affairs acclaimed the 600 million as the "great force for Socialist reconstruction … the most precious of all the categories of capital,"and ridiculed "the bourgeois economists who cling to bankrupt Malthusian theories of population." China, he said, was a country with vast amounts of virgin land and unexplored natural resources where rates of growth in production far exceeded rates of population increase.

THE DEVELOPMENT OF THE POSITION

The propaganda against Neo-Malthusian imperialists and the omnipresent promises of a forthcoming millennium under the Communist order have been new and verbal aspects of the post-revolutionary period.…

One can only speculate as to what happened when the bureaucracy in Peking became immersed in the arithmetic of an overall five-year plan, a twelve-year plan for the development of agriculture, and plans of unspecified durations to educate all children and to extend the beneficent facilities of the state to all mothers. If the rate of growth were really two per cent per year and the count of 583 million for the Mainland population as of June 30, 1953, were accurate, the population would have increased to about 625 million by the end of 1956. There may be considerable debate concerning the population capacity of China under conditions of maximum utilization of modern scientific knowledge. There can be little doubt that rates of natural increase of two to three per cent per year would retard the speed of any concurrent drives for industrialization, for advancing consumption levels, and for raising educational standards.

The population problem faced by Mainland China was similar to that in other Asian countries except that the magnitude was greater and the sense of urgency was stronger. Modernization that included economic development and health activities brought decreases in death rates but left birth rates relatively unaffected. Increasing rates of population growth brought social and economic problems that seemed to have no direct solutions. There was no way whereby birth rates could be reduced quickly and easily to correspond to the lowered death rates. The elimination of growth through deliberate raising of death rates was neither culturally nor politically feasible. The desires of the people for health and life were tremendous; reductions in the crusades to swat flies, kill mosquitoes, eliminate filth, and secure insecticides and antibiotics could not even be considered.

The problem of increasing population had no easy solution, but it was one that could not be evaded. All the sons of the peasants could not be absorbed efficiently in agriculture. Internal developments could provide opportunities for some of them, but continuing absorption of a natural increase such as that to be anticipated in a modernizing China would involve serious difficulties.… The accumulation of people in the villages was not a feasible solution to the problem, for the country needed surplus food from the rural areas to feed the proliferating urban and industrial populations. Moreover, food and agricultural commodities were needed for export in exchange for the materials and products essential to economic development.

… Actions taken between the fall of 1954 and the present indicate substantial movement toward a decision to use the propaganda facilities and the administrative organization of the government to encourage urban and village dwellers alike to practice family limitation. Description and evaluation of the events that have already occurred and of the prospects for future pronouncements and activities are difficult.… The correspondence between directives from Peking and events in the peasant society can be judged only on the basis of the statements of journalists.…

The processes whereby the need for family limitation was accepted in theory and adopted as government policy should be noted in summary form prior to a somewhat more detailed consideration of the arguments in the propaganda, the question of means, and the procedures of implementation.

The hazardous transition from the orthodox Marxian position against "overpopulation" to concern over the burdens of bearing and rearing children was made without jeopardy to the central party organization or the publicized personalities of the regime. The main spokesman on the subject of birth control seems to have ben Shao Li-tzu, a deputy to the National People’s Congress but a late convert from the old regime. He spoke first to the People’s Congress on September 18, 1954. Speculation as to the significance of his cautious statement was ended early in 1955 when people of unquestioned stature in the Party wrote in the official publications of various organizations. For instance, an article on the approach to the problem of birth control appeared in Hsin Chung-kuo fu-nü [New China’s Woman], the journal of the All China Federation of Democratic Women. Chou Ngo-feng, a gynecologist, described the techniques of contraception in Chung-kuo ch’ing-nien [China Youth], the organ of the Communist Youth League. Major theorists defined the problem and divorced the concept of birth control from that of Neo-Malthusianism. A legal basis was prepared that permitted not only contraception but also abortion and sterilization.… An intensive campaign to extend knowledge and practice was ordered by the Minister of Health in early August of this year.

It is difficult to summarize the steps whereby the government of Mainland China accepted the extension of planned parenthood as one of its legitimate functions. There was no population commission, and there is no statement of government policy as such. The movement toward action has been cautious and circuitous. The first public statement, already noted, that of Deputy Shao Li-tzu to the National People’s Congress on September 18, 1954, was much in the tradition of the past: China had great areas but there were calamities of a localized nature. Needs for development were great and the people were backward. An over-large population presented many problems. The difficulty stressed was that of building schools rapidly enough to keep up with the increasing numbers of children reaching school age each year. There were references to the sufferings of mothers with too many children; and denials of Neo-Malthusianism were coupled with references to Lenin. However, the argument proceeded from the national ills to the prescription of birth limitation for families.

The statement of a position that was pure from the standpoint of the Party had to resolve substantial ideological conflicts. The ancient problems of the rice lands presented few difficulties, for the survival of these man-land maladjustments under a socialist organization could be blamed on the iniquities of the old exploitative order. The new problems of the relations between economic development, public health, and rapid population increase were more difficult, for each of these individually was a vaunted goal of the new regime. The solution lay in repudiating Neo-Malthusianism and the economic arguments as to the retarding effects of high rates of growth but accepting birth limitation for personal, family, and party reasons.

The broad position that retains Marx, repudiates Malthus, hurls invectives at Neo-Malthusians, and advocates the limitation of births was presented by Yang Ssu-ying in Hsüeh-hsi [Study] on October 2, 1955. Here, in the party’s major journal for ideological studies, there has been no overt ideological compromise. Indeed, "the Malthusian theory of population is the most reactionary among the theories of the social sciences in capitalist society." There is no absolute overpopulation and there are no general demographic-economic laws. Instead, resting on page 796 of Vol. 1 of Marx’s Capital as issued by the People’s Publishing Press in 1953, Yang Ssu-ying states that "each special form of productive society has a special set of laws applicable to it." The relative population surpluses of the capitalist system were due to the operation of the principle of wealth accumulation in the capitalist society. Under capitalism, there is "a continual increase in the ranks of the proletariat … the supply of labor power surpassing the average needs for labor power on the part of the capitalist." Under the law of socialism, there is a "continuous and rapid increase in population accompanied, however, by a relatively higher standard of material well-being of the populace and by diminishing sickness and mortality rates with simultaneously a full and more rational utilization of employment of people possessing labor power."

Then the theoretical hurdle from anti-Malthusianism to birth control is taken with a jibe:

There are some people who having come across articles on methods of birth control in newspapers and magazines in our country are inclined gleefully to say, "Look! The Communists too need Malthus no less than they need Marx."

The crux of the arguments with reference to family limitation merits quotation:

In giving publicity to notes on methods of birth control our newspapers and magazines had not been inspired by the belief that we were overpopulated. On the contrary, they did so having in mind that our country had been at one time a colonial or semi-colonial country and one that was semi-feudalistic and under imperialist rule so that economically, socially, culturally, and in regard to general welfare facilities we have been rather backward.… Viewed from the standpoint of individual families, the fact that there are too many children in a family unduly increases the burden of the parents and affects adversely their work, their study of political doctrines, and their general livelihood. Similarly the children’s education may be profoundly affected. In view of the above, in order to lessen the difficulties currently facing us, to protect the health of maternity womanhood and finally to ensure that the next generation may be brought up better, we are not at all opposed to birth control. At the same time the publicity given by certain newspapers and magazines to methods of birth control is also necessary as well as proper. This has no point in common with Malthus’ theory at all.…

The conclusion reverts to the campaign against Neo-Malthusianism. Since, it is argued, the circulation of the theory only serves the forces of reaction, "… we should, with firm resolve, refute and continue unceasingly to expose the deceptive nature of this reactionary and fallacious doctrine."

There is substantial evidence that the unbounded optimism of old and the undiluted orthodoxy of the Marxian thesis survive alongside the new duality in demographic argument. Chen Po-ta, one of the theorists of the Party, stated this position in a report submitted to the February 2, 1956, session of the Second Plenary Session of the Chinese People’s Political Consultative Conference:

There are still some people in China who believe the preposterous "theory of overpopulation" of Malthus. The collapse of the so-called law of diminishing returns of the fertility of soil is … a proof of the nonsense of the Malthusian population theory.… There is no sign of overpopulation in China. The truth is that China’s agricultural productive power was seriously damaged by the reactionary rule of foreign imperialists, feudal landlords, and the Kuomintang before China was liberated.… Of course we do not deny the importance of the food question to our work of Socialist construction. The way to solve this question is to change agriculture from the system of individual economy to the system of cooperation.…

The proof of the nonexistence of a real population problem is held to lie in the target for grain production required by the National Program for Agriculture. The plan requires a doubling of grain output in twelve years. Thus, according to Chen Po-ta, "China can provide room for at least another 600 million people. Twelve years later, there will certainly be still greater developments in agriculture."

THE ARGUMENT OF THE PROPAGANDA

Marxian orthodoxy with its refusal to admit overpopulation, surplus population, the pressure of population on resources, or demographic deterrents to capital formation bars many of the arguments for birth control that have been prevalent in the West and in Japan. No appeals for consideration of the fate of the national economy are permissible. There are other differences. In a socialist state where agriculturalists are being moved into cooperatives, fears for old age and desires for children as social security cannot be regarded as forces buoying an overabundant fertility. Health and other family and personal reasons for family limitation remain, together with the duty of the individual to serve the society and the responsibilities of parents for the development of children.

The most concise statement of the basic motif in the birth control propaganda of Mainland China was given in the introduction of the subject to the All China Federation of Democratic Women:

Birth control is to regulate the spacing of childbirth by means of contraceptive methods. It is aimed to protect the health of the mothers and children, so that women can be bodily strong to better serve the cause of Socialist construction and to give full attention and good education to the new generation.

The elaboration of the relationship of maternity to health considers a variety of factors that are similar to the listings of the woes of the poor in the early social surveys of Western countries. In the advice to Communist youth, it is stated that:

… production cannot be brought to a high level at one stroke, and the life of the people cannot be improved speedily on a large scale. During the course of the past several years, the State has paid great attention to the founding of undertakings to look after the welfare of the children and to take care of the health of the women and infants. But this has not completely solved the difficulties encountered by the parents. In some cases the children are not properly developed in embryo due to the ill-health of their mothers, and are born unhealthy or dead. In some cases, because of the bad financial condition and lack of energy of their parents, some children are not nurtured properly. It is particularly true with the young couples who are still in the course of growing up. They need time to learn and their financial capacity is far from sound. To them, the birth of too many children would mean great hardship.

Positive elements predominate in the health arguments, despite the use of tales of over-frequent childbearing, fatigued mothers, stillborn infants, and sickly children. Health is not for its own sake but to permit the mothers to continue their studies or to work for the realization of the new order.

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In the statements on birth control in the party journals, major emphasis is placed on the individual nature of the decision concerning limitation practices. It is the duty of the state, and particularly the medical doctors and the health services, to give information, advice, and guidance to those seeking it. In the writing of the leaders and the theorists, people should be educated concerning the nature and availability of limitation practices, but there should be no coercion.

There are other but less frequent motifs in the fragments of literature that are available. The happiness of married couples is mentioned occasionally. The advocacy of late marriage as a means of limiting fertility is regarded as a trick of the Malthusians; its pernicious effects are said to be obvious. A wide knowledge of birth control, it is held, would permit student marriages, continued study, and progressively greater contributions of individuals to their society.

There are also answers to the common fears of people concerning birth control. Education for contraception will prevent the tragic consequence of the resort to nonmedical abortions. It is recognized that some "demoralized and decadent survivors" of the old regime may use contraceptives in a life of laxity. This, it appears, is neither a problem for the doctors nor a blot on the banners of limited but planned parenthood.…

THE QUESTION OF MEANS

The reduction of fertility can proceed through a variety of means. Institutions or adjustments that keep major classes of a population celibate obviously reduce the proportionate childbearing of the total population. Late age at marriage and deterrents to, or taboos on, remarriage reduce the years of childbearing and so reduce total fertility. Severe malnutrition, debilitating disease, and other factors may lesson rates of conception and decrease the proportion of conceptions carried through to the delivery of a viable infant. Planned actions of individuals may permit coitus without conception, eliminate the foetus prior to independent viability, or destroy the newly born. Many of the factors in the cultural milieu, the social institutions, and the levels of physiological functioning are subject to governmental manipulation and hence may be parts of population policies; but they are not included in the practices referred to as "birth control." That term is limited to the deliberate actions of individuals, those actions having as a consequence the reduction in the numbers of births.

The term "birth control" itself has no internationally accepted meaning other than that implicit in the words themselves. In many cultures it is a generic term that includes contraception (the prevention of conception) and abortion (the elimination of the product of conception). It may or may not include that gamut of practices whose consequence is the death of the infant at or soon after birth. These practices include direct infanticide; exposure, desertion, or other action where death is probable but not inevitable; gross neglect in the period soon after birth; and a generally lessened level of care so that survival becomes less probable.

In Mainland China the problems of terminology and propriety are alike great. Again and again the reference phrase is "birth control and contraception" rather than either used alone. The Chinese language permits a distinction between birth control as a generic term including contraception, abortion, and sterilization, and contraception as the prevention of conception. As in Japan, however, the distinctions tend to be ones of means without sharp ethical or religious connotations. And, again as in Japan, common usage is likely to involve a generic and quite non-specific interpretation.

The discussions of birth control in the party journals and the press are so written that the uninitiated reader is likely to make a facile identification of birth control with contraception. The discussions of birth control as a contribution of modern science refer specifically to contraception. The advice to Communist youth on birth control includes all the standard techniques of modern contraception. Abortion is cited as a harmful practice, a carry-over from the old regime, an evil that will be eradicated as medical doctors with their knowledge of scientific means of contraception replace the untrained and uneducated operators in the field. There is little consideration of infanticide or infant neglect.

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The regulations of the Ministry of Health with reference to abortion are cast in medical and health terms, though with references to the requirements of work and study. As early as 1954 abortion was permitted "… where continued pregnancy is considered medically undesirable, where the spacing of children is already too close, and where a mother with her baby only four months old has become pregnant again and experiences difficulties in breast feeding." At this time, the performance of the operation required the joint application of husband and wife, medical certification, and the approval of the party organization to which the couple belonged. The removal of these latter provisions for certification of need would make the legal situation in Mainland China quite comparable to that in Japan after the spring of 1952 when a similar requirement for certification was removed from the law. It is highly significant, therefore, that when Vice-Minister of Health Fu Lien-chang was questioned by a China Youth correspondent, he stated that it was necessary to ease the restrictions on induced abortions and expressed the hope that "health agencies and medical personnel in all areas will consider the requests and the difficulties of those who apply, and appropriately ease the restrictions when deliberating approval for induced abortions." The Vice-Minister added that his remarks should not be construed as approval of abortion under all circumstances, and that contraception was "the best way of birth control."

The interplay of the familial values of the old society and the economic imperatives of the new emerge in clear focus in the discussions of sterilization and its role in the reduction of family size. Initially sterilization was repudiated as inconsistent with the culture of China; it was argued that Chinese with their love of children and their veneration of family continuity would never accept the permanent elimination of the possibility of having children. Then sterilization began to be mentioned as a means of contraception whose unique advantage was its permanence. Finally there was advocacy of sterilization as the most feasible means of limiting fertility. Sterilization of the male requires a single simple operation. It thus eliminates the continuing burdens on medical personnel implicit in a widespread resort to abortions. Moreover, it solves the serious problem of a use of sparse imported materials for other than industrial purposes which is implicit in a nationwide use of contraceptives. It is also held that sterilizations performed by modern techniques would lessen the pressures placed on hospitals and health services by the high rates of childbearing that now exist.

The limitations placed on sterilization operations by the Ministry of Health are being reduced gradually, although they remain substantial. Sterilization was restricted initially to those having more than six children, then to those having four or more. Regardless of the number of children, though, the operation is limited to families in which the woman is over 30 years of age, in bad health, economically poor, and actively engaged in study.

IMPLEMENTATION

The preparations of theoretical positions and the issuance of laws and regulations are intellectual activities that can be pursued at a distance from the realities of life and death throughout the vast areas of the country. As has been noted earlier, the verbal basis for population policy in Communist China achieved a rather high level of sophistication. The discussions of the acceptability of family limitation and of the means of achieving it, however, are so naive as to suggest that those demographers and public health doctors who were concerned with the problem in the last quarter century of the Nationalist regime are not influential in the councils of the Communists. In the spring of 1955 deputies of the National People’s Congress who made inspection trips to the villages discovered that rural women did not know of contraception but did think that they had too many children. The conclusion from this was simple; all that was needed to produce major reductions in fertility was the spread of knowledge on modern contraception and the provision of supplies.

The problem of means is receiving serious attention; the Minister of Health is reported to be collecting the sacred formulae of the herbalists as a part of research on formulae for contraceptives. The reports and the discussions are curious combinations of modern science and ancient lore. The following formula of advance-herbalist Yeh Hsi-chun, Deputy of the National People’s Congress, was presented seriously:

Fresh tadpoles coming out in the spring should be washed clean in cold well water, and swallowed whole three or four days after menstruation. If a woman swallows fourteen live tadpoles on the first day and ten more on the following day, she will not conceive for five years. If contraception is still required after that, she can repeat the formula twice, and be forever sterile.… This formula is good in that it is effective, safe, and not expensive. The defect is that it can be used only in the spring.

The action program of the government has lagged considerably behind its stated position. In July of 1954 the Minister of Health submitted regulations concerning birth control to the Government Administrative Council for approval, but reports in the following months indicate that there were delays in action programs. In 1955 the National People’s Congress forwarded a proposal for intensive effort to the Minister of Health. In June, 1956, it was announced that a report on birth control had been issued. Then on June 19, Li Te-ch’uan, the Minister of Health, reported directly on her delinquencies to the National People’s Congress:

We have failed to adequately popularize birth control which may be beneficial to the health of mothers and children, to the education program for children, and to the prosperity of our nation. From now on, we must develop our work concerning publicity and education and strengthen our work of providing technical leaders.

Various activities seem to have been undertaken in the period from 1954 to early 1956, however inadequate they may have been. It was reported that contraceptive supplies were on sale at the stores of the government-managed China Medical Company. Educational activities were reported as beginning, the party groups and the cooperative organizations being the channels of communication.

Suspicion that the magnitude of the campaign was limited was implicit in Li Te-ch’uan’s statement to the National People’s Congress on June 19. On August 14, a Radio Peking broadcast carried the announcement that on August 6 the Minister of Health had directed all health offices to push a campaign to spread information about birth control techniques. The campaign will involve the use of publicity posters, special provisions for a wide distribution of supplies, and an educational campaign that will move from doctors through women’s organizations, labor groups, and associations of teachers.

THE BROADER FRAMEWORK

Viewed in the broader perspective of total population policy, the crusade for family limitation appears peripheral to the main goals of the Communists. Industrialization is regarded as the major solution to problems of population and poverty, but the extension of land cultivation and food production is an essential part of the economic developments now in process or contemplated.… The eastern central provinces have very high densities; the northern and western peripheral areas are sparsely settled. The obvious policy implications have been drawn. The densely settled provinces should be sources for the manpower needed to develop the economy and insure the strategic security of the border areas. The Economic Planning Commission has been assigned the task of moving millions of people to resettlement projects that extend from Sinkiang around to the far north.

There are also tremendous drives behind some of the social campaigns. The Marriage Law of 1950 and the subsequent activities designed to eliminate the feudal aspects of family relations are direct assaults on the family system and the ancient role of women. In so far as they penetrate the populations in the rural areas they will transform the bases for family life and reproduction from unquestioned acceptance of the traditional ways to rational striving for individual survival and advancement in the service of the state and its ideals.

It remains to be seen whether the assault on high fertility will achieve a momentum comparable to that of the development and reform programs whose ideological positions are centered firmly in Communist thinking and Chinese national aspirations. It should be noted, furthermore, that genuinely intensive drives for the reduction of births would involve critical choices in the use of sparse personnel and resources. Doctors, other health personnel, and health facilities are too few for the health programs now in process. Work in family planning would have to compete with work in the control of tuberculosis, malaria, and the infectious diseases. If the difficulties involved in population increase were less great, there would have to be considerable skepticism as to whether the Communist leaders would choose to slow the speed of their industrialization and to lessen the intensity of their health campaigns in order to achieve substantial reductions in fertility. Given the present situation, and the realization on the part of the central government of that situation, rational considerations would indicate that priority be given to the reduction of fertility.…

The emphasis in the previous discussions has been placed on the question as to whether or not Communist China would wage a really intensive and adequately supported campaign to reduce fertility through all classes of the population, and particularly in the rural areas. If such a campaign should be waged, there is the further question of its effectiveness. There is no historical precedent for the answer to this question, for no country has waged such a campaign at the beginning of its drive for economic and social transformation. The influence of the legalization of abortions in the Soviet Union at an earlier period was largely an urban phenomenon; Japan’s precipitant drop in fertility came after a century of forced economic development, and it came after national fertility had been declining slowly for perhaps three-quarters of a century.

If an intensive campaign for family limitation had come within the context of the traditional rural society, all the experience of China itself and of other countries in and outside Asia would have indicated a high degree of skepticism as to the possibility either of swift changes in family values or of a rapid acceptance of rational planning of family size. The situation today is not so predictable. Mainland China has a society in revolution. The new order combines the police state and the terror with a driving ideology that is at once political, economic, and social. Vast physical dislocations are occurring alongside changes in the organization of agriculture, redefinitions of the role of women, and major assaults on the Confucian relationships. For some eight years now youth have been subjected to the activities, the indoctrinations, and the controls of a Communist regime. The party organization and its correlated group associations provide channels for contact and influence at the family level even in the remote villages. If the drive to reduce fertility should be intensive and conformity to a small family pattern should be made an objective manifestation of party orthodoxy, there could be powerful pressures on women to avoid additional pregnancies or, if they occurred, to terminate them in abortion.

The future course of the population of Mainland China has become even more of an enigma than its present size and rates of growth. It is possible to discuss the limits within which the future course of that population must lie if one accepts the initial assumption that the Communist state maintains its political control and succeeds in achieving a rate of economic advance somewhat more rapid than its rate of population growth. Given the continuation of health activities in the modern setting, it is not conceivable to the student of population that birth rates could be dropped to the relatively lower levels of the death rates except over a considerable period of time. There are high probabilities that health campaigns to reduce deaths will achieve far greater initial success than campaigns to reduce births, and hence that rates of population growth will increase. This conclusion would remain, whatever the intensity of the present campaigns or of those that may be initiated in the near future. In other words, in the absence of economic collapse, the population will grow much larger than it is at present. The question concerns the amount of the growth, not the fact of growth. If economic development continues as assumed, birth rates will begin to decline in the industrializing areas and among the more educated groups of the population, but that decline will be slow. In the modern world, an increase of one to two per cent per year is not a high rate of population growth. The actual rate may go above three per cent in Mainland China, as it has in less populous countries elsewhere. A many-fold increase in total population is implicit in the Chinese economic-demographic situation—if the economy can support the population that it generates.

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¹ From , 1956, 22:261–274. By permission.