BEIJING – China performs more abortions than any other country in the world, about 13 million a year, mostly for young single women who aren't using contraception. One expert says the figures show many Chinese now consider the cheap, widely available procedure an acceptable form of birth control.
In a rare disclosure of family planning statistics — which are considered state secrets — the official China Daily newspaper reported Thursday that about 13 million surgical abortions are performed in Chinese hospitals and 10 million abortion pills are sold every year. The pills can induce an abortion very early in pregnancy, and are commonly referred to as the morning-after pill.
The report said the real number of abortions is believed to be even higher since many are done outside of hospitals in unregistered rural clinics.
Ma Xiaonian — a well-known sex therapist who hosted a popular sex-focused talk show that was pulled off the air in 2007 for being too racy — said that the abortion figures showed the inadequacy of China's sex education.
"Young women don't know how to protect themselves when protection is most needed," he said. "Secondary school kids (aged about 13-16) are already having abortions. ... So it's not too early to start giving them sex education at that time but often they don't even get it until college."
Sex education is a part of school curriculums in China, in which students learn about sexually transmitted diseases including AIDS, but discussions about sex are vague and condom use is rarely addressed.
The China Daily article called the widespread use of abortions "an unfortunate situation" but did not directly say whether abortions were on the rise. No year-to-year statistics were given.
The most recent figures available for abortions in China come from the World Health Organization and the Guttmacher Institute, which estimated that China performed 9 million such procedures in 2003, more than any other country. Russia had the world's highest abortion rate, with 53.7 per 1,000 women between the ages of 15 and 44, the 2007 report said. China's rate of abortions was about 24 for every 1,000 women, it said.
Therese Hesketh, a lecturer at the Centre for International Health and Development at University College London who has extensively studied family planning policies in China, said the 13 million figure sounded accurate, if perhaps a little low. She said there is little doubt that abortion figures have risen in China as attitudes toward sex have liberalized.
Chinese have become much more open about sex amid the sweeping economic and social reforms of the last several decades, and today are generally accepting of premarital sex. Sex shops selling erotic toys, books, condoms and lubricant are commonplace. Web sites, books and movies with graphic sexual content are all widely available, though pornography is technically banned.
"Sexual mores have changed ... women, couples are having sex more and earlier," Hesketh said.
The China Daily report said about 62 percent of the abortions each year were done on single women aged between 20 and 29 years old and quoted Wu Shangchun, a government official with the National Population and Family Planning Commission, as saying that nearly half of those undergoing abortions reported using no contraception when they conceived.
Sterilization and the use of intrauterine devices, or IUDs, for women are widely promoted — and subsidized — forms of contraception for married women. Condoms and birth control pills are also used.
Hesketh said her impression is that young Chinese adults know their contraception options but are simply choosing not to use them because they know that morning after pills and surgical abortions are available if they get pregnant.
The procedures are "completely non-taboo, almost a form of contraception really," she said.
The Madian Gynecological Hospital in Beijing said the cost for a surgical abortion at their facility was between 300 to 400 yuan ($44-$59) and patients were not required to leave their name or identification number.
Whereas women in other countries might go ahead with an unplanned pregnancy, Hesketh said, the one-child policy has also made Chinese women "very choosy about when they want to have a baby."
"They want to control it, want to have the baby when it's convenient, like when they have enough money or have a big enough home, and if it's an inconvenient time, they won't go through with it," she said.
China imposed strict birth controls in the 1970s, limiting most couples to just one child. The government says its family planning controls — sterilization, contraception and abortion — have prevented an additional 400 million births over the past three decades.
Chang Yongjie, an official with the commission's Science and Technology Research Center, said he was not able to confirm or comment on the China Daily report. He said no one else was available because most of the commission's staff had just gone on a two-week holiday.