Following a recent trip to China, it is evident that a seismic shift is occurring in the nation’s policies concerning fertility, pregnancy, and abortion. Highly encouraging developments suggest that millions of babies are poised to be saved, modeling in part the successful approach utilized in the United States involving life-changing support for mothers during pregnancy. This transition marks a new era in China, one actively promoting the birth of children after 35 years of policies that mandated population limitation.

For decades, China enforced restrictive birth limits, transitioning from the One-Child Policy to Two-Child and then Three-Child policies. Now facing a severe demographic crisis and needing babies, the government must change course without “losing face” regarding its past policies of forced sterility and abortion. This necessity has led to an equally brilliant, face-saving semantic strategy: framing the change using the phrases “fertility protection” and “fertility enhancement”.

Similar to how opponents of life-affirming laws successfully rebranded abortion as “healthcare”—despite its consistent outcome of death—China has cleverly termed its new anti-abortion stance “fertility protection”. This linguistic approach positively recognizes that abortion reduces birth rates and can cause infertility, effectively becoming a woman-centered, health-oriented approach. Research indicates that between 20 and 25 percent of women who have an abortion may experience difficulty carrying a subsequent pregnancy to term, highlighting the damage abortion can cause to fertility.

The Depth of the Demographic Crisis

The urgent change in policy is directly driven by alarming national demographics. China, alongside the United States, Canada, Russia, and much of Eastern and Western Europe, falls into the category of countries that are losing population, having a total fertility rate (TFR) below the replacement level of 2.1. The TFR necessary to maintain a stable population is 2.1, which accounts for couples replacing themselves (two children) while also factoring in those who do not marry or children who do not survive to adulthood.

Currently, China’s TFR stands at a desperately low 1.02, which is creating—and will continue to create—significant social havoc. While the declining population in the US is supplemented by high rates of immigration, China largely lacks this compensatory mechanism, placing it in a severe downward spiral. The aging population and insufficient replacement rate mean that the economy cannot be sustained, as fewer younger people are available to support the growing number of non-working older people.

The severity of the decline is dramatic. Data confirms that the lines representing the number of babies being born and the number of people dying in China have crossed in the last year or two, meaning more people are dying annually than are being born. In 2022, China’s demographic growth turned downward for the first time. Although the population previously increased over 30 years despite fewer births, this was only due to people living longer due to higher economic standards and better healthcare, a course which has now run out. Consequently, by the end of 2024, China is expected to have 1.3 million fewer inhabitants than at the beginning of the year. India now holds a larger population than China.

Perhaps the most startling prediction comes from the United Nations: based on current demographics, the UN forecasts that China’s population will drop over 50 percent in 75 years. This means the country could fall from 1.4 billion people down to 767 million, a reduction that some living individuals will witness within their lifetime.

Such a massive demographic collapse presents insurmountable economic and social challenges. Fewer people means fewer consumers to buy products like cars or apples, leading to less money circulating and fewer young individuals available to care for the older population. This situation has compelled the government to issue dramatic proclamations, stating that “marriage and child birth are not only a family affair related to personal happiness but also a major event for the survival and development of the country and the nation”. This represents a complete about-face from previous government priorities.

Cultural Resistance to Family Formation

The crisis deepened sharply following 2015, despite the initial change from a one-child to a two-child policy. The steep decline in the birth rate demonstrates that the policy change did not work; a generation of people had been trained to view children as an enemy to personal prosperity and wealth rather than a source of joy and fulfillment.

The government’s extensive propaganda regarding population limitation was highly effective, particularly impacting young people who internalized the mandate to limit family size. This created a deeper problem: the one-child generation now actively rejects and resists both marriage and family formation.

As a result, behind the lack of children is a cultural rejection of marriage. Given that fewer women are already present in the population due to the targeting of baby girls for abortion under the One-Child Policy, the surviving women are increasingly rejecting marriage and, consequently, childbirth. Sobering statistics reveal that 40% of young people possess a negative attitude toward marriage, 40% are neutral, and only 20% hold a positive attitude.

Furthermore, current incentives to promote births are ineffective because the generation is postponing marriage, which naturally delays children. Women increasingly believe they have more lucrative pursuits than getting married, seeing a baby as an “anchor” holding them down, rather than fulfilling a deep part of motherhood. It is important to note that as any society becomes more prosperous and people move to urban areas, they naturally begin to have smaller families due to increased costs and smaller living spaces; therefore, China’s stringent policies may not have been entirely necessary, as this trend would likely have occurred naturally.

A New Model for Intervention

The Chinese government is now fully aware of these statistics and is changing its approach because it needs and desires more babies. The observed policy shift presents an encouraging opportunity for intervention, particularly considering that the US accounts for only 3% of global abortions, leaving 97% of the crisis as a world missions challenge.

The model being introduced draws upon the pregnancy help intervention methods utilized in the United States. However, in China, this model is being adapted to operate within the existing public health infrastructure. Our partners in China, specifically at institutions like the Chingghai Kungla Hospital, have pioneered the establishment of a pregnancy help counseling office inside a communist-run hospital.

Analysis of this model, and others developed subsequently, indicates that mobilizing China’s vast network of hospitals—which number 39,000 nationwide—could be the quickest, least expensive, and most effective resource for fostering the birth of children. This model is now being shared among hospitals across the country.

The core principle of this intervention is based on universal understanding: about half the women who present for an abortion are ambivalent, feeling both a need for and a reluctance toward the procedure. If individuals are provided the time to slow down, think clearly about their desires, and receive practical support, a significant portion will change their minds, a pattern observed globally.

To normalize this concept, hospital leaders were shown evidence that pregnancy help centers are an established global phenomenon, existing across many parts of the world and successfully rescuing mothers. Furthermore, the intervention approach is dual: not only preventing abortions but also helping women who desire pregnancy to conceive. For instance, the company Preom, which operates in many countries, has set a goal to help a million women in China get pregnant this year.

The immediate focus, however, is on helping the 8 to 13 million pregnant women in China avoid abortion. The development of pregnancy centers within hospitals offers a unique opportunity to help a great portion of these women find life-affirming alternatives that save the innocent and provide individuals an opportunity to find God’s provision for their lives.

This movement is gaining rapid momentum. What previously took four or five years to develop a handful of centers is expected to accelerate significantly. The new hospital model is anticipated to see growth at a rate of 25, 50, and perhaps 100 centers opening every year, quickly spreading across China. This success in China is expected to generate data that can be used to influence and create a mass movement in other countries facing similar challenges, such as India. The ultimate goal is the great work of the gospel of life, rescuing the most vulnerable where abortion is most concentrated.

This article is adapted from the episode transcript.