This study examined the effects of family planning use on different generations of Chinese women. The study included a survey of 1,996 women and 506 men, plus 56 focus group discussions with participants representing four groups: older women and older men; women and men of reproductive age; unmarried women and men; and women entrepreneurs.

China

Fertility in China has declined dramatically over the last three decades, due in large part to government policy and a strong family planning program. In 1979, China implemented a policy advocating one child per couple, with some exceptions in rural areas, particularly, for couples having daughters only. The government considers reducing the growth of the population to be an essential step in improving China's economy. Yet, little is known about how the implementation of the family planning program and the government's one-child policy have affected women's lives including their relationships with family, their education and employment opportunities, and their quality of life.

The Women's Studies Project was funded by a Cooperative Agreement to the U.S. Agency for International Development (USAID). However, no funds from the U.S. Agency for International Development were used for research in China. This study was funded by the Rockefeller Foundation. A replication in Yunan Province is planned with funds from The Ford Foundation.

Research Findings

Conducted by the China Population Information and Research Center (CPIRC) in collaboration with the Women's Studies Project at Family Health International, this study examined the effects of family planning use on different generations of Chinese women. Quantitative and qualitative data were collected from four counties in two provinces: South Jiangsu and North Anhui. South Jiangsu, an east coast province with a booming economy and a strong family planning program, has experienced a rapid fertility decline. North Anhui, a province in middle China, has an agrarian economy and a less effective family planning program.

Conducting research in China is difficult, since its citizens are reluctant to criticize the government. Therefore, it is difficult to discern whether study participants voiced their own opinions or gave answers that they thought reflected government policy.

The study included a survey of 1,996 women and 506 men, plus 56 focus group discussions with participants representing four groups: older women and older men; women and men of reproductive age; unmarried women and men; and women entrepreneurs. Researchers found that:

• Family planning use is almost universal. Ninety-five percent of women in South Jiangsu and 80 percent of women in North Anhui used contraception and most said they were satisfied with their current method.

• Smaller family size is equated with economic prosperity -- for the country and the individual family. "We are relaxed in comparison with our parents," said one South Jiangsu woman.

• Family planning use had little effect on marital and sexual relationships. Disagreements about family size were infrequent, and when disagreements occurred, couples generally reached a joint decision via discussion.

• Many older women said they wished family planning had been available when they were younger. They characterized their lives as spent bearing too many children and trying to raise them in poverty. "If family planning had been available earlier, my future would have been different," said one woman from South Jiangsu. "That is my life-long regret. Because I had too many children, I had to quit [teaching]." Another woman from North Anhui said, "Young women are in heaven, and we are on the ground."

• Twenty-five percent of women in South Jiangsu and 10 percent in North Anhui said they had undergone an abortion. Most abortions were due to out-of-plan pregnancies, often caused by failure of the steel ring intrauterine device (IUD).

• As part of the government's family planning program, most female study participants receive quarterly "women's tests," consisting of pregnancy tests or exams, IUD checks, and ultrasound and sometimes pap smears or pelvic exams. Some women considered these to be evidence of quality of care while other women considered them to be inconvenient or embarrassing. A significant proportion of the resources of the family planning program is allocated to this testing program.

• The de facto emphasis of the program on female methods, namely female sterilization and the IUD, posed a barrier to male contraceptive use. A young man from South Jiangsu said, "I wish we had better methods for males."

• Young people said the information they received on sex and reproductive health was too general, and they usually had to wait until marriage to learn details of sex and family planning.

• Gender and generation roles in households in South Jiangsu and North Anhui are changing, but for the most part, women are primarily responsible for household work such as cooking and cleaning. When women work outside the home and gain more economic security, they are accorded more say in household decision-making. A young man from North Anhui commented, "Nowadays, whoever is more capable, with more education and more income, that person will be in charge."

• Young women and men concurred with prevailing gender norms and roles when they talked about their desired attributes in a spouse, saying husbands should be the primary breadwinners and wives should be responsible for household chores.

• Son preference was strong in both provinces although it was stronger in North Anhui. "My mother-in-law said it is inferior to have daughters," said one woman. "If you have a son, even your house will look higher." Although its use is illegal for this purpose, ultrasound is often used to detect a fetus' sex, and abortion performed if the fetus is female. "People use an ultrasound B machine," said one woman in North Anhui. "If it is a female fetus, they don't want it."

• Interestingly, young men were not worried about not being able to find a wife due to the unbalanced sex ratio. One woman in North Anhui said that "even ugly boys can find wives now" because her village was rich.

• Although sons are preferred, some couples said they want daughters because they are easier to raise, less expensive to provide for, and are nicer to their parents in old age. Some South Jiangsu couples saw daughters as an economic benefit; their embroidery skills add to family income. One woman from North Anhui noted, "I have two sons - that's too much burden. They have to go to school and get married. That's going to be expensive."

Recommendations

Family planning is widely accessible throughout China. This study provides information to assist China's State Family Planning Commission (SFPC) in improving the quality of its reproductive health services. The SFPC could enhance quality by:

• Expanding reproductive health services beyond women of childbearing age to include young adults, older women and men.

• Promoting the non-economic benefits of family planning, such as improved quality of life for families.

• Expanding the mix of contraceptive methods beyond IUDs and female sterilization to include newer, more effective IUDs, more short-term methods and vasectomy.

• Providing family planning counseling to post-abortion women on how to prevent contraceptive failures in the future.

• Updating training on reproductive health services for service providers.

• Promoting the value of daughters, through collaborative efforts by policy-makers, providers and community members.

Study Details

For further information about this research, contact the authors, Dr. Gu Baochang and Dr. Xie Zhenming of the China Population Information and Research Center in Beijing, China or Dr. Karen Hardee of The Futures Group International, 100 Capitola Drive, Suite 306, Durham, NC 27713 or via email: K.Hardee@tfgi.com.