The unsustainable growth of the global population needs to be halted through informed voluntary action, including empowerment of women, family planning and increased use of modern contraceptives. Coercive population policies such as those used for 35 years in China, in India 1975-77, and more recently in Peru, are unacceptable and must be condemned. But many millions of women and couples around the world face pro-natalist forms of coercion, such as being forced to give birth to unwanted children, in the absence of contraceptive services and legal abortion. All countries have some population policy, whether explicit or implicit: all attempt to influence fertility levels and population size, in various ways. What makes a population policy sustainable and sound? In this first blog on the topic, we take a look at the history of coercive policies.
By Frank Götmark
A large literature on coercion in the population context documents brutal historical actions against childbearing women and couples in several countries. In the recent book “Reproductive States”, edited by Solinger & Nakachi1, there are historical examples from Germany, USA, Japan, India, Egypt, Iran, Brazil, Nigeria, Russia, and China. The most infamous example is the so called “one-child policy” in China, reviewed by Tyrene White2. The policy formally began in 1979, but did not imply “only one child”; two children were often allowed in rural areas, and the content of the policy changed considerably over the decades, partly because of opposition. The policy ended in 2015, when Chinese leaders had begun to worry about future declining population.
The major decline in fertility rate occurred before the one-child policy – from about 6 children per woman in the mid-60’s to 2.5 in 1980. Moreover, according to Martin King Whyte and co-authors3, coercion was common before the one-child policy, during the marked decline in fertility between 1970 and 1979 (see references, graphs for fertility and contraceptive use in their publication).
The brutal actions by the communist regime during (and before) the one-child policy were by no means necessary for reducing fertility. The replacement fertility level of 2.1 children per woman or less could have been achieved through a voluntary family planning (FP) program, as in South Korea, Iran and elsewhere. Tyrene White describes, for the period 1979-1983, how strict enforcement of birth quotas was handed down to each city, county, neighborhood and village. Birth permits were needed and combined with periodical gynecological exams; if an “unplanned” pregnancy was detected, abortion was often more or less enforced. Those who tried to escape faced severe penalties, including fines and loss of employment2.
In some villages, women who refused abortion were subjected to endless meetings where they were berated, intimidated, and threatened into cooperation. At worst, women were forced into trucks and taken to headquarters for abortion, sterilization, and/or insertion of an IUD (intrauterine device). Insertion of IUDs became standard after childbirth. Villagers, at the time dependent on child labor in farms, resisted in various ways, by hiding, bribery to get a birth permit, attacking or killing FP officials, or by female infanticide (over time, sex-selective abortion became more common). The resistance, especially in rural areas, led to changes in the policy in 1984, and to other changes later on, but coercion continued2.
India, pioneer in family planning – and in coercion
India, another example, is different in being a democracy. Its large and growing population was highlighted already 1916 in Wattal’s book The population problem in India4,5. In Reproductive States, Ahluwalia & Parmar6 describe how FP started in India in the 1950’s when the state adopted the rhythm contraceptive method (“safe periods”) and the first national birth control program in the world. The health minister, Rajkumari Amrit Kaur, a Ghandian and Catholic, was only willing to support rhythm, the church-approved method. But use of a necklace to count differently colored beads (one color for safe days) met with several problems among the many illiterate people in rural areas – some even thought it was sufficient to just wear it. This program is seen as a failed experiment, but showed a greater demand for information on FP than was expected6.
In the next FP phase from the early 1960’s, the IUD was central, and the US-based Ford Foundation and Population Council were deeply involved. IUDs were first smuggled into India, as “Christmas ornaments”. The authorities hesitated regarding the IUD, but in 1965 the state decided to promote the method. IUD use boomed; after two years, 2 million women bore IUDs. However, health and medical conditions were poor; the IUD led to problems for many women, and the program declined rapidly after 1967. In 1972, India backed out of the program.
The experience of IUDs was different in South Korea and Taiwan, mainly due to better FP programs. In India, the state, its population experts and providers unfortunately focused on targets instead of on the well-being of women6. Many Indian women came to associate the IUD with problems.
Programs for sterilization were also considered. Starting in 1970, the government set up vasectomy camps to add sterilization as a contraceptive method and to slow population growth. The first camp was set up in Kerala in 1970, where a month-long session led to 150,000 men being vasectomized. The state transported people to camps, set up as festive fairs or mela. These also meant free meals, entertainment, gifts and 45 rupies per vasectomy. The focus on men is unusual in the history of FP (tubectomy on women also occurred, but was less common). Several camps followed; one in Gujarat, for example, led to 222,000 vasectomies6.
According to reports sterilization camps were immensely popular in the first years after the introduction. The festival atmosphere, that men got more payment than women for contraception, and mass media attention contributed to success. This lasted to the so-called “National Emergency”, declared by Indira Ghandi in 1975, mainly due to economic problems. The “Emergency” between June 1975 – March 1977 is also linked to mass-sterilization of men; estimates range from 8,3 to 11 millions6.
Ahluwalia & Parmar describe how top-down targets for vasectomies were set, with high quotas. In several states, civil servants such as teachers and police officers were threatened with arrest or job loss unless they had a vasectomy. Also, predawn raids were conducted to get hold of men for vasectomies, and occasionally people were killed in conflicts.
Robert Gillespie, one of TOP’s three mentors, visited India during the Emergency (1975-1976). His view is that reported numbers and impacts were exaggerated, perhaps to satisfy Sanjay Gandhi, Indira Gandhi’s son, who pressed for more vasectomies. Before he came to India, Robert had worked in Taiwan and Iran with well-designed voluntary FP programs, and found India a contrast. His judgement is supported by a detailed description of events and effects of the Emergency by Gwatkin7 in 1979, who wrote:
”In sum, the Indian family planning program clearly involved coercion. The duration of such activities was relatively brief, probably lasting no more than a few weeks in any one location; they were concentrated primarily in a few parts of the country relatively close to New Delhi; they doubtless affected no more than a very small portion of India’s total population. But at the same time, the available evidence suggests strongly that the frequency of indisputably coercive practices significantly exceeded the “isolated incident”; that many thousands of people at the very least experienced extremely unpleasant treatment at the hands of police and other government authorities; that millions more were subjected to strong indirect social pressures, feared they might experience direct coercion, and altered their normal activities in order to avoid it. ”
Gwatkin estimated that given roughly 100 million Indian couples of reproductive ages, the number of couples protected by sterilization was increased during 1976-77 from 14 percent to 21 percent.
Ahluwalia & Parmar do not describe what women with many children thought about vasectomies. During a visit to India at the time, TOP’s mentor Carl Wahren met a female physician who explained that many women breathed a sigh of relief. He also noted that many coercive actions were driven by extra payment to officials on the basis of the number of vasectomies they achieved. Carl condemns the actions taken by the politicians, and refers to how successful FP programs combine “bottom-up” efforts and support from politicians and other leaders, like in South Korea.
Another review by Harkavy & Roy5 of Indian FP programs describes the problems of a single national approach to such a large country and population, with contrasting social settings among the states. In those with social setting favorable for FP such as Punjab and Kerala, the uptake of contraception was twice as high as in states with social setting unfavorable for FP (e.g. Uttar Pradesh, Rajasthan). The authors conclude that “despite its weaknesses, the Indian family planning initiative of the 1960s and 1970s had significant achievements”. But the coercive vasectomies during the Emergency should be condemned.
Two misleading books
The book “Reproductive States” contains valuable information in many of the chapters, but its subtitle is misleading (“Global perspectives on the invention and implementation of population policy”). The book excludes the many successful FP programs in developing countries 1960-1990 and today, and excludes environmental effects of population growth. Thus, no chapters describe, for instance, South Korea, Singapore, Thailand, Indonesia, Bangladesh, Tunisia, Rwanda, Costa Rica or other Latin American countries (except Brazil). Iran and its successful and voluntary FP program 1988-2010 is only treated in passing, despite its obvious relevance.
In their Introductory chapter, the editors Solinger & Nakachi say they were inspired by, and repeatedly cite, a highly influential book from 2008 by Matthew Connelly, “Fatal misconceptions”8 (ca 500 pp.). Connelly is a professor of history at Columbia University (USA), with a mission to debunk the view that many environmental, political, social and other problems are caused by excess people (a statement in the Acknowledgements). He dedicates the book “To my parents, for having so many children”. Matthew Connelly was himself number eight.
Connelly’s book describes eugenics, racism, xenophobia, and coercive population policies and actions such as the ones above. Connelly’s thesis is that “the West” (mainly the US) conspired to force population control on the Third World. In a review, the demographer John Cleland9 found this idea “bizarre and fundamentally flawed”. He remarked, “To equate efforts to reduce population growth with coercion is to ignore the fact that most poor countries pursued clear demographic objectives by entirely voluntary means.” Carl Wahren remarked that “I was never contacted, despite being literally cited several times in the book, and easily available for questions.” In another detailed review of the book, the reproductive scientist Malcolm Potts10 concluded that it provides a dangerously misleading description of the history of international family planning programs.
The experienced demographer and researcher, John C. Caldwell11, reviewed Connelly’s book for Science and found it interesting but “deeply flawed” and “a lawyer’s argument”. How come? In the Preface Connelly states “…it really comes down to values”. Yet, he is not clear about his values (“This book will not try to settle existential questions”, p. xi). Presumably, freedom of human reproduction without any form of external influence or interference is a major value for Connelly. Population growth is solved just by educating women, not by FP, according to him. He mentions some problems with growing populations in passing, but emphasizes the “sanctity of life”. Human life, that is. Other forms of life and ecosystems that we all depend upon are hardly mentioned in the book, in spite of its length.
For readers interested in the many successful FP programs in history, the book by Robinson & Ross12 can be recommended, free online.
1Solinger, R. & Nakachi, M. (Editors) 2016. Reproductive states. Global perspectives on the invention and implementation of population policy. Oxford University Press, Oxford.
2White, T. 2016. China’s population policy in historical context. Pages 329-368, in Solinger, R. & Nakachi, M. (Editors) 2016. Reproductive states. Global perspectives on the invention and implementation of population policy. Oxford University Press, Oxford.
3Whyte, M.K. et al. 2015. Challenging myths about China’s one-child policy. The China Journal, No. 74 (July), pages 144-159. https://pubmed.ncbi.nlm.nih.gov/31431804/
4Wattal, P.K. 1916. The Population Problem in India: A Census Study. Bennett, Coleman and Company, Bombay.
5Harkavy, O. & Roy, K. 2006. Emergence of the Indian National Family Planning Program. In: Warren C. Robinson and John A. Ross (Editors). The Global Family Planning Revolution: Three Decades of Population Policies and Programs, pp. 301-324. The World Bank, Washington, DC. Free online at https://openknowledge.worldbank.org/handle/10986/6788
6Ahluwalia, S. & Parmar, D. 2016. From Gandhi to Gandhi: Contraceptive technologies and sexual politics in post-colonial India, 1947-1977. Pages 124-155 in Solinger, R. & Nakachi, M. (Editors) 2016. Reproductive states. Global perspectives on the invention and implementation of population policy. Oxford University Press, Oxford.
7Gwatkin, D.R. 1979. Political Will and Family Planning: The Implications of India’s Emergency Experience. Population and Development Review, Vol. 5, No. 1 (Mar., 1979), pp. 29-59. https://www.jstor.org/stable/1972317?seq=1#metadata_info_tab_contents
8Connelly, M. 2008. Fatal misconception. The struggle to control world population. Belknap Press & Harvard University Press.
9Cleland, J. 2008. Review of Connelly’s book, in Population and Development Review, Vol. 34, No. 3 (September), pp. 560-561. https://www.jstor.org/stable/i25434702
10Potts, M. 2008. Review, “Fatal Misconception: The Struggle to Control World Population”, in Population and Development Review, Vol. 34, No. 3 (September), pp. 560-561. https://bixby.berkeley.edu/publication/review-of-connollys-fatal-misconception-the-struggle-to-control-world-population/
11Caldwell, J.C. 2008. A polemic against control. Science 321, 1043. https://www.google.com/search?q=A+Polemic+Against+Control+John+C.+Caldwell
12Warren C. Robinson and John A. Ross (Editors), 2006. The Global Family Planning Revolution: Three Decades of Population Policies and Programs, pp. 301-324. The World Bank, Washington, DC. Free online at https://openknowledge.worldbank.org/handle/10986/6788