What can be learned from the Chinese experience in response to infertility.

OBJECTIVES: The aims of the study were to reviews the history of China's population policy since 2011, and draw lessons from the Chinese experience in response to infertility. METHODS: Data from the Chinese infertility status survey report (2009) and national statistical yearbooks (2009-2019) are used to assess the severity of infertility and reproductive centers shortage in China. Lessons from China was informed by a review of existing literature. RESULTS: The proportion of couples suffering from infertility in China increased to 12.5% (166.8 million in 2009) from just 6.89% (86.6 million in 1988) two decades earlier, while the number of reproductive centers was one for every 3.1 million citizens. The total costs per live birth for medically assisted reproduction in Chinese public fertility clinics was 30,000 yuan in 2012. Among infertile couples, unemployed patients accounted for the largest proportion (21.9% in 2014). Currently in China, health regulations permit oocyte donation only from infertility patients who have 20 or more mature oocytes, of which at least 15 must be kept for their own treatment. CONCLUSION: It is necessary to integrate the reproductive health care of infertile people into the national public health service. In addition to relieving their economic burden, national policies should guide and support enterprises to guarantee employee medical leave for infertility. Growing numbers of bereaved older women who have lost their only child make it imperative to reconsider liberalizing the regulation of oocyte donation in China.

Assessing the impact of the "one-child policy" in China: A synthetic control approach.

There is great debate surrounding the demographic impact of China's population control policies, especially the one-birth restrictions, which ended only recently. We apply an objective, data-driven method to construct the total fertility rates and population size of a 'synthetic China', which is assumed to be not subjected to the two major population control policies implemented in the 1970s. We find that while the earlier, less restrictive 'later-longer-fewer' policy introduced in 1973 played a critical role in driving down the fertility rate, the role of the 'one-child policy' introduced in 1979 and its descendants was much less significant. According to our model, had China continued with the less restrictive policies that were implemented in 1973 and followed a standard development trajectory, the path of fertility transition and total population growth would have been statistically very similar to the pattern observed over the past three decades.

California's Sterilization Survivors: An Estimate and Call for Redress.

From 1919 to 1952, approximately 20 000 individuals were sterilized in California's state institutions on the basis of eugenic laws that sought to control the reproductive capacity of people labeled unfit and defective. Using data from more than 19 000 sterilization recommendations processed by state institutions over this 33-year period, we provide the most accurate estimate of living sterilization survivors. As of 2016, we estimate that as many as 831 individuals, with an average age of 87.9 years, are alive. We suggest that California emulate North Carolina and Virginia, states that maintained similar sterilization programs and recently have approved monetary compensation for victims. We discuss the societal obligation for redress of this historical injustice and recommend that California seriously consider reparations and full accountability.

Stratified reproduction, family planning care and the double edge of history.

PURPOSE OF REVIEW: There is a growing clinical consensus that Medicaid sterilization consent protections should be revisited because they impede desired care for many women. Here, we consider the broad social and ideological contexts for past sterilization abuses, beyond informed consent. RECENT FINDINGS: Throughout the US history, the fertility and childbearing of poor women and women of color were not valued equally to those of affluent white women. This is evident in a range of practices and policies, including black women's treatment during slavery, removal of Native children to off-reservation boarding schools and coercive sterilizations of poor white women and women of color. Thus, reproductive experiences throughout the US history were stratified. This ideology of stratified reproduction persists today in social welfare programs, drug policy and programs promoting long-acting reversible contraception. SUMMARY: At their core, sterilization abuses reflected an ideology of stratified reproduction, in which some women's fertility was devalued compared to other women's fertility. Revisiting Medicaid sterilization regulations must therefore put issues of race, ethnicity, class, power and resources - not just informed consent - at the center of analyses.

Publicidad farmacéutica y género: anuncios de la "píldora" en España (1964.1985) / No disponible

No disponible

Foucault, fields of governability, and the population­family­economy nexus in China.

It was only in the early twentieth century that China discovered that it had a population, at least if a population is understood not as a simple number of people but instead in terms of such features as variable levels of health, birth and death rates, age, sex, dependency ratios, and so on­as an object with a distinct rationality and intrinsic dynamics that can be made the target of a specific kind of direct intervention. In 1900, such a developmentalist conception of the population simply did not exist in China; by the 1930s, it pervaded the entire social and political field from top to bottom. Through a reading of a series of foundational texts in population and family reformism in China, this paper argues that this birth of the Chinese population occurred as a result of a general transformation of practices of governing, one that necessarily also involved a reconceptualization of the family and a new logic of overall social rationalization; in short, the isolation of a population­family­economy nexus as a central field of modern governing. This process is captured by elaborating and extending Foucault's studies of the historical emergence of apparatuses (dispositifs) into a notion of fields of governability. Finally, this paper argues that the one-child policy, launched in the late 1970s, should be understood not in isolation from the imposition of the "family-responsibility system" in agriculture and market reforms in exactly that period, but as part­mutatis mutandis­of a return to a form of governing that was developed in the first half of the twentieth century.

History of the Chinese Family Planning program: 1970-2010.

BACKGROUND: China launched a nationwide family planning program offering birth control methods and family planning services in the 1970s. Promotion of the widespread use of long-term contraceptive methods has been one of the program's core strategies. This paper reviews the history of China's Family Planning Program at the national level from 1970 to 2010. Special attention is paid to the history of contraception policy. STUDY DESIGN: This study provides an overview of the last four decades of the Chinese Family Planning Program. Programmatic goals are highlighted during different time periods, with special attention being paid to the role of contraceptive use and the history of contraceptive policy. RESULTS: The Chinese Family Planning Program has experienced several transitions. It has evolved from the 1970s period of moderate policy, represented by wan, xi, shao (late marriage and childbearing, birth spacing and limited fertility), through the strict one-child policy of 1979 to the early 1990s. From the mid-1990s to the present, a relatively lenient policy has been in force, characterized by client-centered informed choice. CONCLUSIONS: The success of the Chinese Family Planning Program has long been heavily dependent on policies advocated by the central government, including programs promoting contraception to reduce fertility rates. The Program also depended on a logistical support system, including organizational safeguards and free provision of contraception and family planning services.

Between reforms and birth rates: Germany, Japan, and family policy discourse.

This paper examines the development of employment-oriented family policy in Germany and Japan, two countries united by conservative welfare legacies and very low birthrates, through a close analysis of discourse. Why have recent reforms in Germany moved well beyond those in Japan despite remarkably similar "human capital" discourses? The relative strength of interpretative patterns­in this case, discursive patterns that successfully frame family policy reform as an economic imperative­and the role of employers are identified as critical explanatory factors. Further comparative attention is called to the role of the state as a guarantor of new family policy entitlements.

Policy experiment in Russia: cash-for-babies and fertility change.

Population decline in modern day Russia is alarmingly steep: Russia loses approximately 750 thousand people each year. To combat population decline, the Russian government instituted aggressive pro-natalist policies. The paper evaluates the capacity of new policies to change women's reproductive behavior using a socio-institutionalist theoretical framework, which analyzes the gendered interaction between the states, the labor market, and family. The paper arrives to a disappointing conclusion that while efforts to improve fertility are quite aggressive, new policies do not challenge gendered hierarchies neither in public nor in private spheres, which will further depress fertility rates of Russian women.

The impact of conservative discourses in family policies, population politics, and gender rights in Poland and Turkey.

This article uses childcare as a case study to test the impact of ideas that embody a traditional understanding of gender relations in relation to childcare. Conservative ideas regard increasing female labor market participation as a cause of decreasing fertility on the functioning of a set of general policies to increase fertility rates. It looks into the Polish and Turkish contexts for empirical evidence. The Polish context shows a highly institutionalized system of family policies in contrast to almost unessential institutions in Turkey. Formally, the labor market participation of women is much lower in Turkey than in Poland. Yet, given the size of the informal market in Turkey, women's labor participation is obviously higher than what appears in the statistics. Bearing in mind this divergence, the article suggests Poland and Turkey as two typologies for studying population politics in contexts where socially conservative ideas regarding gender remain paramount. We qualify ideas as conservative if they enforce a traditional understanding of gender relations in care-giving and underline women's role in the labor market as an element of declining fertility. In order to delineate ideational impact, this article looks into how ideas (a) supplant and (b) substitute formal institutions. Therefore, we argue that there are two mechanisms pertaining to the dominance of conservative conventions: conservative ideas may either supplant the institutional impact on family policies, or substitute them thanks to a superior reasoning which societies assign to them. Furthermore, conservative conventions prevail alongside women's customary unpaid work as care-givers regardless of the level of their formal workforce participation. We propose as our major findings for the literature of population politics that ideas, as ubiquitous belief systems, are more powerful than institutions since they provide what is perceived as legitimate, acceptable, and good for the societies under study. In the end, irrespective of the presence of institutions, socially conservative ideas prevail.

The expansion of health houses and fertility outcomes in rural Iran.

Iran experienced a dramatic decline in fertility from 1984 to 2001, which was most rapid in rural areas. Although many attribute the decline to the government's active participation in providing family planning services, most services were provided after the initial fertility decline that took place after 1984. We assess the extent to which timing of exposure to basic healthcare is related to fertility outcomes. We estimate the association between a woman's age of exposure to a health house (clinic) and number of children, using the 2001 Iranian Household Expenditure and Income Survey and the 2006 Iranian Census, and the location and dates of operation for each rural health house. We also look at the probability of a woman's giving birth one year after a clinic opened in her village. We use Poisson and logistic multivariate regressions and we control for individual, household, and village characteristics. Exposure to a health house in a woman's most fertile years (20-34) is associated with an 18 percent decrease in number of children ever born relative to those exposed after age 40. This negative association gets progressively stronger as length of exposure increases. Our findings suggest that early exposure to health services in rural areas contributed to Iran's fertility decline.

Women, microcredit and family planning practices: a case study from rural Ghana.

This paper examines the influence of informal banking club participation on family planning practices in rural Ghana. Research from Asia suggests that family planning practices are improved by club participation. This study examines this thesis in an African context, using rural Ghana as a case study. A sample of 204 women (19 years and older) was drawn from Abokobi village, Ghana. Multivariate analyses of direct, mediating and moderating effects of women's demographic background characteristics, membership status and length, and women's empowerment status as predictors of family planning practices are assessed. Findings suggest that club membership and membership length is not associated with family planning practices; however, age, education level, number of children and empowerment status are.

Yearning, learning, and conceding: reasons men and women change their childbearing intentions.

People's childbearing intentions change over the course of their reproductive lives. These changes have been conceptualized as occurring in response to the realization that an individual is unlikely to achieve his or her intended fertility, because of constraints such as the "biological clock" or lack of a partner. In this article, we find that changes to child-bearing plans are influenced by a much wider range of factors than this. People change their plans in response to the wishes of their partners, in response to social norms, as the result of repartnering, and as the result of learning about the costs and benefits of parenthood; there are also differences between the factors that influence men's and women's decision-making. In a departure from existing studies in this area, we use a flexible analytical framework that enables us to analyze increases in planned fertility separately from decreases. This allows us to uncover several complexities of the decision-making process that would otherwise be hidden, and leads us to conclude that the determinants of increases in planned fertility are not simply equal and opposite to the determinants of decreases.

Family policies in OECD countries: a comparative analysis.

This article discusses the diversity of family policy models in 28 OECD countries in terms of the balance between their different objectives and the mix of instruments adopted to implement the policies. Cross-country policy differences are investigated by applying a principal component analysis to comprehensive country-level data from the OECD Family database covering variables such as parental leave conditions, childcare service provision, and financial support to families. The results find persistent differences in the family policy patterns embedded in different contexts of work-family "outcomes." Country classifications of family policy packages only partially corroborate categorizations in earlier studies, owing to considerable within-group heterogeneity and the presence of group outliers. The Nordic countries outdistance the others with comprehensive support to working parents with very young children. Anglo-Saxon countries provide much less support for working parents with very young children, and financial support is targeted on low-income and large families and focuses on preschool and early elementary education. Continental and Eastern European countries form a more heterogeneous group, while the support received by families in Southern Europe and in Asian countries is much lower in all its dimensions.

The German social democratic party (SPD) and the debate on the fertility decline in the German Empire (1870~1918).

This paper aimed to examine the debate over the fertility decline in the German Empire, focusing on the role of the SPD. During the German Empire, the fertility rate dramatically declined and the growing awareness of a continuous decline in the birth rate prompted a massive debate among politicians, doctors, sociologists, and feminist activists. The fertility decline was negatively evaluated and generated consciousness of crisis. However, it was not the only way to face this new phenomenon. Indeed, the use of birth control among the upper class was interpreted as a part of a modernizing process. As the same phenomenon reached the working class, it suddenly became a social problem and was attributed to the SPD. The debate over the fertility decline in imperial German society ridden with a fierce class conflict was developed into a weapon against the SPD. Contrary to the assumption of conservative politicians, the SPD had no clear-cut position on this issue. Except for a few politicians like Kautsky and the doctors who came into frequent contact with the workers, the "birth strike" was not listed as the main interest of the SPD. Even Clara Zetkin, the leader of the Social Democratic women's organization viewed it as a concern of the individual person which could not be incorporated in the party program. The women's organization of the SPD put priority on class conflict rather than issues specific to women. As a result, the debate over the birth rate decline within the SPD was not led by the women themselves. There could have been various means to stimulate the birth rate. Improvement in the welfare system, such as tax relief for large families, better housing conditions, and substantial maternity protection, could have been feasible solutions to the demographic crisis. However, Germany chose to respond to this crisis by imposing legal sanctions against birth control. In addition to paragraphs 218-220 of the German criminal law enacted in 1872 which prescribed penal servitude for anyone who had an abortion or people who helped to practice it, Paragraph 184.3 of the civil code was enacted in order to outlaw the advertising, display, and publicizing of contraceptives with an 'indecent' intention, although selling or manufacturing contraceptives was not forbidden. Such a punitive approach was especially preferred by the government and conservative parties because it was easy to implement and "cheap" in comparison with the comprehensive social welfare program. What made the SPD different from other conservative parties was the fact that the SPD opposed the government's attempt to prohibit contraception by means of strengthening a penal code. According to the SPD, it was not only morally unacceptable, but also technically impossible for the government to intervene in family limitation. Moreover, politicians from the SPD criticized that such a punitive policy targeted the working class because the upper echelon of the society could easily evade the ban on contraceptives. However, the SPD did not proceed to draft comprehensive social welfare measures in order to fight the fertility decline. The miserable condition of working class women remained as an invisible social phenomenon even within the SPD. The German women who could not find the proper means to practice contraception were driven to have abortions. Annually, hundreds of the women were accused of practicing abortion and imprisoned. In sum, German society ran about in confusion and did not know how to properly respond to the unprecedented decline in fertility. By defining the fertility decline just as a social disease due to moral decay and influence of socialism, German society lost a chance to rationalize itself. Given that women, the main actors, had no way to take part in the debate over this issue, it is not surprising that German society fought against the symptom of the disease, not against its root.

The German Social Democratic Party(SPD) and the Debate on the Fertility Decline in the German Empire (1870~1918) / 의사학

This paper aimed to examine the debate over the fertility decline in the German Empire, focusing on the role of the SPD. During the German Empire, the fertility rate dramatically declined and the growing awareness of a continuous decline in the birth rate prompted a massive debate among politicians, doctors, sociologists, and feminist activists. The fertility decline was negatively evaluated and generated consciousness of crisis. However, it was not the only way to face this new phenomenon. Indeed, the use of birth control among the upper class was interpreted as a part of a modernizing process. As the same phenomenon reached the working class, it suddenly became a social problem and was attributed to the SPD. The debate over the fertility decline in imperial German society ridden with a fierce class conflict was developed into a weapon against the SPD. Contrary to the assumption of conservative politicians, the SPD had no clear-cut position on this issue. Except for a few politicians like Kautsky and the doctors who came into frequent contact with the workers, the "birth strike" was not listed as the main interest of the SPD. Even Clara Zetkin, the leader of the Social Democratic women's organization viewed it as a concern of the individual person which could not be incorporated in the party program. The women's organization of the SPD put priority on class conflict rather than issues specific to women. As a result, the debate over the birth rate decline within the SPD was not led by the women themselves. There could have been various means to stimulate the birth rate. Improvement in the welfare system, such as tax relief for large families, better housing conditions, and substantial maternity protection, could have been feasible solutions to the demographic crisis. However, Germany chose to respond to this crisis by imposing legal sanctions against birth control. In addition to paragraphs 218-220 of the German criminal law enacted in 1872 which prescribed penal servitude for anyone who had an abortion or people who helped to practice it, Paragraph 184.3 of the civil code was enacted in order to outlaw the advertising, display, and publicizing of contraceptives with an 'indecent' intention, although selling or manufacturing contraceptives was not forbidden. Such a punitive approach was especially preferred by the government and conservative parties because it was easy to implement and "cheap" in comparison with the comprehensive social welfare program. What made the SPD different from other conservative parties was the fact that the SPD opposed the government's attempt to prohibit contraception by means of strengthening a penal code. According to the SPD, it was not only morally unacceptable, but also technically impossible for the government to intervene in family limitation. Moreover, politicians from the SPD criticized that such a punitive policy targeted the working class because the upper echelon of the society could easily evade the ban on contraceptives. However, the SPD did not proceed to draft comprehensive social welfare measures in order to fight the fertility decline. The miserable condition of working class women remained as an invisible social phenomenon even within the SPD. The German women who could not find the proper means to practice contraception were driven to have abortions. Annually, hundreds of the women were accused of practicing abortion and imprisoned. In sum, German society ran about in confusion and did not know how to properly respond to the unprecedented decline in fertility. By defining the fertility decline just as a social disease due to moral decay and influence of socialism, German society lost a chance to rationalize itself. Given that women, the main actors, had no way to take part in the debate over this issue, it is not surprising that German society fought against the symptom of the disease, not against its root.