History of Medicine
As one of the most populous countries in the world, China saw the need to have a strong family planning policy. The country launched 3 family planning campaigns: in 1956-1957, 1962-1966, and 1971 to the present, in order to control population growth. These campaigns—especially the third one—were remarkably successful. China’s population was 22 percent of the world in 1949 with 541.7 million people, and 20 percent in 1999 with 1.26 billion.
Rapid population growth posed serious challenges to meeting China’s socioeconomic demands. Debate about family planning began in the mid-1950s. Those in favor emphasized that family planning would improve the welfare of mothers and children and promote socioeconomic development. This message was publicized through popular media from the 1950s through the 1980s. During the Cultural Revolution of 1966-1976, the meaning of family planning was tied directly to revolutionary goals. But in the 1980s and 1990s, the policy shifted, emphasizing increased quality of the population, healthy babies, and good care of children.
China began its third family planning campaign in the early 1970s, emphasizing wan, xi, shao (晚, wan, late marriage; 稀, xi, longer birth spacing; 少, shao, fewer children). Unlike previous campaigns, the third was pursued consistently and effectively, providing a variety of birth control means, coupled with rewards and penalties. As a result, the general fertility rate dropped significantly, from 5.75 children per woman in 1970 to 2.12 in 1985. Two-children families were promoted through public education campaigns before the start of the one-child policy in 1978. Administered by local governments, the one-child policy program was more effectively carried out in cities than in the countryside. Since the 1990s, China’s market economy has caused millions of young farmers to migrate to cities for work. That migration led to the changing pattern of births in the rural countryside to fewer children.