China’s shifting cultural norms regarding sexuality are at odds with existing state healthcare coverage.
by Rachel Will
"Carry out birth planning for the revolution" (IISH / Stefan R. Landsberger Collections)
“Carry out birth planning for the revolution.”
The standard issue propaganda poster, along with its countless similar replications, was a patriotic call for birth control in the name of productivity and health. China was already short on food and resources, and with the country’s population exploding, the future looked positively slim. The government’s earliest efforts to control the burgeoning populace came in the form of these slogans and national dictums, which later expanded to include contraceptive use.
“20 years ago if you went to the rural villages, you could see the slogans on the wall that read, ‘if you have one child, IUD please, if you have two children, sterilization please,’” describes Kaining Zhang, a research physician at the Yunnan Health and Development Research Association. “There is still a very strong influence [from that] policy.”
Today, attitudes towards sexuality and reproductive health have dramatically shifted in China. The once taboo topics have been the subjects of national campaigns to increase sexual health awareness, and a survey by Renmin University shows that more than half of all respondents think premarital sex is acceptable.
Government policy and more traditional viewpoints remain deeply influential on Chinese attitudes toward contraception and birth control. Yet with rapidly changing world views and sexual habits among China’s younger generations, outdated policies have created a shortage of free state health services for millions.
Methods and trends
China has one of the highest rates of contraceptive use in the world with 84.6% prevalence among women who are currently married or in union. In comparison, the United States has a 78.6% prevalence, and China’s next largest neighbor, Japan, reports 54.3% prevalence. The high figures owe much to China’s vast network of family planning centers and other government initiatives in local communities that followed the implementation of the One-Child policy in 1979.
China’s family planning policies target married women, emphasizing permanent means of birth control, though a multitude of birth control options are available through retails stores. Individuals can visit family planning service stations in both urban and rural areas to access free birth control methods.
Sterilization has a 28.7% usage rate and is typically recommended to women following the birth of a second child. Intrauterine devices (IUDs) have a 40.6% usage rate, and though not permanent, are often promoted by state health services over temporary methods.
“There is a heavy emphasis on IUDs and sterilization, this may be a barrier [to contraceptive use] and people perhaps not wanting to use either of these two methods and finding themselves pregnant,” says Amy Tsui, Director of The Bill & Melinda Gates Institute of Population & Reproductive Health.
Read more at US-China Today