China quietly cuts back on vasectomies to stop falling birth rates

February 9, 2017 was not one of Hu’s better days. Unbeknownst to him, family planning authorities in his home county in Yunnan, a province in southwestern China, had learned that he was the father of four children – three by one wife and one by his second, after a divorce.

When he returned to celebrate the Lunar New Year, they swooped. He was at a party at a friend’s home when several officials dragged him away, accused him of violating the two-child policy, and forced him to have a vasectomy.

“The family planning officials said I had disturbed their normal work and told me, ‘You must agree with us today, since you’re here,’” he told the English-language magazine Sixth Tone. “If I didn’t agree, they said, they would detain me and my wife for 15 days, then force me to get a vasectomy upon my release.”

Five years on, Mr Hu must feel a bit indignant. Because nowadays the fashion amongst China’s family planners is to refuse to give men vasectomies. They appear to be panicking over China’s plummeting birth rate and declining population growth .

The China bureau chief of the Washington Post, Lily Kuo, reports that hospitals are refusing to do the operation. There is no official ban, but suddenly the procedure is no longer available. According to official figures, the number of vasectomies performed nationwide fell from 149,432 in 2015 to 4,742 in 2019.

Twelve public hospitals contacted by The Washington Post, including facilities in Shanghai, Beijing and Guangzhou, said they no longer offered the procedure. Six hospitals said they still perform the surgery, but one said it was no longer available to unmarried men.  

“Couples and single men who sought the procedure said doctors and hospital staff refused, telling them they would regret the decision later. Some asked for documentary proof of marriage and evidence that couples had already had children before going ahead with the surgery.”

In May last year China announced that couples could have up to three children. But this does not appear to have sparked a baby boom. In fact, the birth rate continues to fall inexorably.

And, according to The Washington Post, the announcement has actually panicked some couples who do not want children. They fear that the government might restrict access to abortions and contraceptives after its overnight conversion to pro-natalism.

Zhou Muyun, a 23-year-old from Guangzhou, and his girlfriend are living together but do not want children. “The more I learn about vasectomies, the surer I feel about my decision. We want to have sex, not children,” he told The Washington Post. But he was turned down by two hospitals. Doctors told him that he was too young and would regret his decision.

So what comes next? If young couples decide to have only one child, or refuse to have any at all, what will China’s government do? Family planners have decades of experience in forcing men and women not to have children. Will they force them to have children?

There are historical precedents. In early mediaeval China, to encourage population growth, the authorities actively encouraged early marriages and tried to simplify wedding ceremonies. One historian records recommendations made by an official named Zhou Lang to the Emperor Xiaowu (430-464):

He urged the government to reinforce laws that forbade infanticide and encouraged early marriage. He proposed that if girls were not married at the age of fifteen sui [years], their parents should be punished. He also suggested that betrothal gift expenses be curtailed and marriage rites be simplified. Finally he recommended that legal actions be brought against those who put off marriages for whatever reason. “

Harsh and oppressive? Yes. Unbelievable in modern China? Given the current government’s track record in family planning, no. Not at all.

The rest of the world will be watching. Countries from Japan to Iran to Estonia are desperately trying to boost their birth rates -- without success. If China's coercive pro-natalist policies work, other governments might be tempted to copy them.


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