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China's Family Planning Program is Just the Beginning

The Bush administration has all funding for family planning in its crosshairs

In July 2002, the Bush administration caused rejoicing in its rightwing base by rescinding $34 million that Congress had appropriated for UNFPA, the United Nations Population Fund. The move was a major escalation in the torture of a thousand tiny cuts that ultra-conservatives are inflicting upon family planning programs worldwide. It was based on charges that UNFPA was complicit in forced abortions and sterilizations in China.

The argument was that the move would punish both China and the agency. None of the punishers mentioned collateral damage to women and families in the 150 other countries where UNFPA supports reproductive health and education programs, but that may have been the point. The cut’s formal justification involved such creative twists and turns in logic and ethics that it was clear the decision came first and the reasoning came later.

A State Department team was sent to China to investigate the charges and found UNFPA to be clean. It recommended the funds be released. So did a bipartisan panel of British Members of Parliament. It didn’t matter. The real target was family planning, so the cut was made. An administration legal analysis made that clear by presenting the following tortured rationale: UNFPA was supplying computers to China; the computers were easing government operations; one of those operations involved a “Social Compensation Fee” levied upon families having more than the allowed number of children; some women may have had abortions to avoid that fee; so therefore, UNFPA “supports or participates in the management and implementation” of a policy of coerced abortions. The 1985 Kemp-Kasten Amendment permits spending cuts under that finding, so the deed was done.

"...[A]s the 1960s flower children might have put it, take care of the people and the population will take care of itself. "

Clearly, the reality of whatever is going on in China was irrelevant to the decision. But what exactly is going on in China? UNFPA itself suspended operations there from 1995 through 1997 in order to wring promises from the Chinese government that coercive practices would stop in the areas where UNFPA was trying to work. News reports continue to document female infanticide, sex-selective abortions and other abuses, and the Social Compensation Fee raised enough concern that UNFPA wrote a worried letter calling it “a negative element” back in February 2002. With 1.3 billion people, China tilts the world in just about everything, so its family planning reality merits real scrutiny.

And what about UNFPA? What is its real agenda? It started working in China in 1979, helping to carry out the first scientific census in 1982, training demographers and public health officials, bringing in foreign professors and setting up population science curricula in 22 research institutions. Its influence has been strong: in 1993, UNFPA and the World Health Organization supported a study comparing new copper-bearing iuds to the old steel-ring ones most Chinese women were using. The study found that by switching to the new devices, China could avoid 41 million unintended pregnancies in 10 years, along with 26 million abortions and 14 million live births. Two weeks later the government ordered the switch nationwide.

The following year, 1994, brought the watershed International Conference on Population and Development (ICPD). Meeting in Cairo, 179 countries agreed on a revolutionary new approach to family planning. Gone were the old demographic targets for population levels and quotas for family size that China and other countries had lived by. The new standard was individual need. Educate people, especially girls and women; give them rights and information and options for their lives beyond childbearing; let them choose freely the number and spacing of their children; give prenatal counseling and skilled care during childbirth; and just stand back and watch fertility rates decline. Or as the 1960s flower children might have put it, take care of the people and the population will take care of itself.

UNFPA got the conference mandate to go forth and carry out this new gospel. Since 1994, it has supported programs worldwide that offer comprehensive reproductive health education and services, not just family planning. But the Vatican and the right wing were suspicious—“reproductive health services,” they argued in Cairo and ever since, is code for abortions, and abortions must be stopped. Under that logic, UNFPA must be stopped, too. And China, where history is fogged and information is sketchy, is one good place to do it.

The situation is complicated. What influence, if any, does UNFPA’s small $3 million program in 32 Chinese counties have on China’s family planning officials, and in what direction? Chinese government hard-liners are known to oppose the whole idea of voluntary family planning or voluntary anything, fearing a return to rising birthrates that would threaten the ability to feed, clothe and employ a burgeoning population. What are those officials trying to do? And what does China’s family planning program really look like?

Interfaith Delegation

The questions fascinated an interfaith group of nine prominent US religious leaders, ethicists and representatives of faith-based organizations—Christian, Jewish and Muslim—and in September 2003, they went to China to see for themselves.

Delegation members were not babes in the woods. “We don’t kid ourselves that we saw everything or got a comprehensive view,” said Frances Kissling, president of Catholics for a Free Choice, which organized and funded the ten-day trip. “We did see enough to understand how services are delivered and we talked off the record with a couple of hundred ordinary people, enough to feel certain we were hearing genuine views.”

"'We aggressively recommend use of the rhythm method. ..," reported Ma Yang Lin, secretary-general of the Chinese Patriotic Catholic Association. "

Before departing, the delegation met with State Department officials, members of the team that had gone to China, UNFPA officials and congressional staff. They tried but failed to meet with UNFPA’s chief critics, including Rep. Christopher Smith (Republican, New Jersey) and the Population Research Institute, the group behind the coercive abortion allegations cited by the Bush administration. They assembled several hundred pages of background documents and actually read most of them. Once in China, they hired their own interpreters and provided their own transportation, and they made all the major decisions and most of the minor ones themselves about where to go and whom to talk to.

They started, of course, with Chinese religious leaders. There are five main faiths in China—Buddhist, Taoist, Muslim, Catholic and Protestant—and senior leaders from all five met with the delegation at a Beijing Buddhist temple. They followed the official line: the government population program is essential to lift the Chinese people from poverty and bring individuals a better standard of living. What do the priests and ministers tell their flocks when there’s a conflict with articles of faith?

“We aggressively recommend use of the rhythm method, but we don’t stop our members from using other methods” of contraception, reported Ma Yang Lin, secretary-general of the Chinese Patriotic Catholic Association.

Asked what advice she gives women or couples with unplanned pregnancies, Gao Ying, Standing Member of the China Christian (Protestant) Council, was animated in her response: “We tell women the choice is theirs on what to do, and that they have the right either to continue the pregnancy or seek its termination.”

So far, so good, albeit predictable from such tightly controlled groups. Members of nongovernmental organizations who met with the delegation at the Ford Foundation’s Beijing offices seemed more candid. Rapid change has eroded the government’s past control over all aspects of life, they said, and ordinary people now often criticize government officials, even reporting abuses to higher authorities. Ambition for better lives is spreading fast, and that’s the real driving force behind the growing support for small families.

“Deng Xiaoping said, ‘It is glorious to get rich,’ so everyone wants to work hard and get ahead,” a Beijing computer technician told the group later. “That’s why people now want one or at most two children. Even me.” The mother of an eight-year-old daughter, she said she and her husband were both single children so they were permitted to have a second child. “But we just want one.”

The delegation was to hear that sentiment repeatedly. Still, they wondered how much of it was genuine and how much came from subtle—or not-so-subtle —official pressure. China’s factories used to post women workers’ menstrual data, for example. Was that still going on?

Widespread Progress

To see village life, the nine delegates split into three groups for separate visits to three widely scattered provinces: Gansu in the west, a priority area for poverty alleviation; Ningxia Hui Autonomous Region in the northwest, where many Muslims live; and Hubei in central China, a major industrial center that includes Wuhan. Everywhere were wall slogans: “Girl, boy—both equally good.” “Control the size of the population. Improve the quality of living!” “Small Family Equals Riches!” “Family Matters, Nation Matters, Everything Under Heaven Matters: Planning Birth is a Big Matter.” Other posters deplored spitting or exhorted harmony among ethnic groups, or listed individual tax payments or contributions to local mosque renovation. Propaganda was rampant, but it didn’t seem threatening.

Village visits fell into a pattern. The groups first talked with officials of the National Population and Family Planning Commission and local political leaders, then with family planning clinic personnel and patients, and finally with villagers in their homes and on the streets. Officials showed charts and graphs of declining abortion and birth rates and were generally predictable in their enthusiasms, but this did stand out: China’s bureaucracy —including its leadership—wants to move to a fully voluntary family planning program nationwide.

The officials differ on how fast to move, but they have seen from UNFPA’s projects that it works: people given a choice on childbearing don’t necessarily become breeding machines, and they stop resenting the family planning workers. “It’s a better way of working, and clients prefer it too,” said one official in Gansu’s Yongjing county. Local leaders in Hubei’s Songzi county showed off their $456,000 project to bring voluntarism to the area’s 200,000 households. “In the past the people were hostile, but now our workers are quite popular because they are viewed as providing a real service,” one said.

This mood change is nowhere part of UNFPA’s sales pitch, but it came up over and over. Even Chinese bureaucrats want to be liked. Asked whether the Social Compensation Fee might make them unpopular again, the Songzi officials said no, because they invoked it only to discourage pregnancy and imposed it on sliding scales based on ability to pay. “Usually people who have an out-of-plan child can afford it,” the mayor said. “We do have discretion to set the figure. In practice we collect less [than authorized].”

Villagers confirmed this, shrugging off the fee. An accountant in Hubei’s Hong Shi village, with a 13-year-old daughter, said she knew of very few cases where it had been levied, and one who had paid a lowered fee over time. In Beijing, a shopkeeper said it was not coercive. “How can you say that? If I get rich and have money to buy a car and contribute to the traffic jams and pollution, shouldn’t I pay something more than my friend who still rides her bike? If the government charges me for buying a car, am I being coerced?”

"It's a window on the world. UNFPA is speeding the change process. "
- Ma Xiufen, director, Ningxia Family Planning Commission, Yinchuan City

Muslim women meeting with the delegation in Ningxia Hui’s Lingwu county endorsed the new approach, saying they were particularly pleased at its attention to their overall health. Earlier, they said, they associated family planning with birth control alone and were ashamed to bring up other issues. But UNFPA staff people said they spend much time explaining the concepts of contraceptive choice and privacy and why they are important, trying at the same time to discourage the “choice” of having only baby boys. Prominent notices at a clinic in Hubei’s Xiong Kou township warned that hospital personnel were barred from revealing the sex of a fetus after an ultrasound test.

“If UNFPA was not here, progress would be slower and more painful,” said Ma Xiufen, director of the Ningxia Family Planning Commission in Yinchuan City. “It’s a window on the world. UNFPA is speeding the change process.” At the end of their trip, the interfaith delegation members agreed with that assessment. [See Delegation Findings in box below.]

The delegation recommended that constructive engagement become the US policy toward China’s family planning program. Monitoring should continue, and US funding for UNFPA should be restored and even increased. The group said the Kemp-Kasten legislative language that allowed funding to be cut should be revised to make it clear that an agency must take part directly in managing a coercive program before it risks losing US support. Meanwhile, UNFPA and the Chinese family planning agency should be more active in presenting their side of the story to the world.

The delegation reserved its final recommendations for the religious community. UNFPA and the Chinese agency should reach out to people of faith in China, keeping in mind the official limits on their work, the group said. At the same time, US religious congregations and faith-based groups should speak out on behalf of UNFPA and other UN agencies whose programs coincide with their core values. “General support for the United Nations, while important, has done little to blunt the vehement and unprincipled recent assaults upon UNICEF, UNIFEM, UNAIDS and other groups, as well as UNFPA,” they said.

“We very much believe that UNFPA is a very positive force within the Chinese family planning program,” said CFFC president Frances Kissling. “Will President Bush turn a deaf ear to the voices of leaders of religious and faith-based organizations who are not right wing? There is no involvement of the UNFPA in anything that is remotely coercive within China and in fact they are engaged in creating quality, women-centered, choice-oriented programs. The members of this delegation urge the US government to change its policy and engage more directly with the Chinese family planning program and give it greater assistance.”

Delegation Findings

At the end of their trip, the interfaith delegation members prepared a formal report which included the following findings:

  • It is reasonable to be concerned about and to monitor China’s family planning policies and practices; it is even more important to assist and engage the Chinese on these matters. The US government’s approach of criticism and punishment does nothing to change the situation.
  • China is taking active steps to end the use of coercion in its family planning activity. Force or threats are barred and penalized by law, and there was no credible evidence of physically coercive practices.
  • UNFPA has been and remains a major force and a vital catalyst in achieving China’s transition to a fully voluntary and non-coercive family planning program. Although UNFPA’s spending is tiny compared to China’s overall effort, its influence has been enormous— and popular: 90 counties competed for the 30 new slots in UNFPA’s 2003-2005 program, and more than 800 counties have adopted aspects of the voluntary approach.
  • Abortion and sterilization rates are declining as contraceptive choice increases, in some cases by a factor of ten. At 30 per 100 live births, official national abortion rates approach the US rate, according to the Alan Guttmacher Institute, and are much lower than the US rate in UNFPA’s project counties, at 11 per 100 live births.
  • Contrary to the Bush administration analysis, UNFPA in no way “supports or participates” in managing or implementing China’s family planning program, including the Social Compensation Fee. In fact, UNFPA has been pressing for the fee’s elimination since it was created.
  • The language that US officials and other critics use in describing the fee is factually and ethically wrong, but the fee remains a negative element in the Chinese family planning program. While neither “crushing” nor “draconian,” as the Bush administration described it, the fee is still a barrier to free choice and has outlived any usefulness it may have had. UNFPA’s program of quality contraceptive options, education and counseling provide better incentives for family planning.
  • The desire for small families is becoming the norm in China, chiefly for economic reasons. Intense government propaganda plus a booming economy and rapid social change are transforming China in many ways, but the shift is common worldwide wherever women are being educated and integrated into the workforce. Chinese in this way sound very much like Americans: they want their children to have opportunities they lacked.

The full report is available here.

Joanne Omang is a writer, novelist and former reporter for the Washington Post.

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