23 million abortions a year

New survey reveals ignorance about contraception


Instructions needed

You would think that the Chinese know all about contraception.

After all, they have had to respect strict family planning policies for almost 40 years.

But it turns out that many of them know very little about birth control.

A recent survey by the state-funded Huakun Women’s Life Research Centre found that 80% of adults had misconceptions about sex. More than a third relied on withdrawal as their preferred method of protection and 4% believed it is impossible to get pregnant if women shower after sex.

The survey, which questioned people between the ages of 20 and 40, also found that women were reluctant to use oral contraceptives, despite the fact they are readily available without prescription.

Only 6% of female respondents had ever used them.

Less surprisingly, the incidence of unwanted pregnancies was high – 18% of respondents said they had been in a relationship where the woman had had a termination.

Speaking to the China Daily, Liu Ping, deputy head of the Huakun Centre, said a “lack of knowledge” was leading young people to take unnecessary risks.  She also said the findings helped explain the “rising numbers of abortions”.

As readers of Week in China will know, sex education is a tricky topic in the world’s most populous nation. For years it was largely ignored, meaning that many young adults have sketchy understandings of how human reproduction works and other areas of sexual health.

In recent years there have been moves to educate children about sex in schools but they have met with a mixed response. In May a pilot scheme in Hangzhou had to be pulled when parents objected to the “graphic” nature of the textbooks. Yet the material then sold out in other places as more liberally minded parents took the chance to teach their children about the facts of life.

With abortion rates rising among teenagers and unmarried women, and sexually transmitted diseases such as syphilis making a comeback, the government wants to get people practicing safer sex.

However, as in the past, it conflates the idea of unmarried sex with “immorality”, and in a public health blueprint released last year it even lumped casual sex in with drug taking.

“We need to strengthen the management of teenagers, women of child-bearing age and the migrant population and improve intervention on high risk behaviours,” it said.

Historically China’s vast network of family planning clinics has focused on married couples, offering long term and permanent contraceptive solutions such as intrauterine devices, tubal ligation and vasectomies (though in reality China has one of the world’s lowest vasectomy rates because men rarely agree to the procedure).

But as the age when sexual activity starts has fallen – most Chinese now lose their virginity in their late teens or early twenties – many young people are falling though the gaps. Unmarried women and teenagers now account for more than half of China’s abortions. Figures vary but government hospitals carry out 13 million procedures a year. And another 10 million terminations are thought to take place in private clinics or by women taking abortion pills.

Amazingly abortion clinics can advertise on television while condom makers cannot.

Ads for clinics promise “painfree” and “dreamlike” procedures, leading people to underestimate the potential effects of repeat procedures.

Many use abortions as a form of contraception, say doctors, not realising that multiple operations can lead to infertility.

Yet there is some evidence that things are changing. Condoms sales are soaring – China produced 18 billion last year.

Perhaps the biggest growth area is oral contraceptives. In 2005 only 2% of women used them, although take-up has improved with each new survey, even though many women are wary about hormones in the pill. Some fear taking it will make them fat.

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