Effects of China’s one-child policy on contraceptive decision-making in the US: A mixed methods study
Awarded 2021
Complex Family Planning Fellowship Research
June Ng, MD
Albert Einstein College of Medicine

In 1980, China implemented a one-child policy to curb population growth they believed would stifle the standard of living in the aftermath of the Cultural Revolution. This was implemented through mandatory intrauterine devices for women with one child, abortion for “unauthorized ” pregnancies, and permanent contraception for couples with two or more children. A lack of choice or education, heavy monetary incentives for compliance, and extreme slogans through posters, television, and theater incited mass protests and murders of family planning workers. While the one-child policy was replaced in 2015, those who emigrated from China may still feel its effects, especially with respect to contraceptive decision-making. Previously published studies already point towards a population that is less trusting and more risk-averse, and in China, people rely overwhelmingly on the external/male condom and rhythm/withdrawal methods. We propose a mixed-methods study consisting of quantitative online surveys and semi-structured telephone interviews to answer the question of how the one-child policy impacts the contraceptive decision-making of people of the Chinese diaspora living in the United States. Our primary objective is to describe the one-child policy’s impact on the contraceptive decision-making of Chinese persons in the United States, and our secondary objective is to identify associations between contraceptive choices and several demographic or experiential factors. We hope that our results can further the understanding of global historical events as one of many factors contributing to contraceptive decision making and improve appreciation for implications of reproductive coercion on healthcare.