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China's one-child policy: the economic choices and consequences faced by pregnant women


  • Doherty, Jim P.
  • Norton, Edward C.
  • Veney, James E.


This paper addresses the important issue of the effect of China's one-child policy on prenatal and obstetric care utilization. The paper provides the first detailed empirical approach to this question, exploiting a unique high quality household survey. China officially codified a set of rules and regulations in 1979 governing the approved size of Chinese families, commonly known as the one-child policy. The policy imposed economic and social costs on families failing to adhere to the family size limits. In particular, the policy raised the price of obstetric medical services for unapproved pregnancies in comparison to approved pregnancies and imposed fines on families with unapproved births. Using data from an eight-province longitudinal household survey (The China Health and Nutrition Survey), we investigate whether or not the one-child policy's financial penalties were associated with the avoidance of obstetric care by pregnant Chinese women with unapproved pregnancies. The one-child policy variables of particular interest were a dichotomous measure of the approval status of the pregnancy, a continuous measure of the fine imposed upon families with unapproved births, and a continuous measure of the prices of prenatal care and delivery services net of any subsidy available for approved births. The results partially confirm the hypotheses that the one-child policy's economic and social costs caused women to forego seeking modern obstetric care services. The fine was found to be a significant deterrent to the utilization of prenatal care. Additionally, the unapproved-status of a pregnancy was strongly negatively associated with the use of obstetric care. However, higher prices were not consistently found to be a significant deterrent to the use of obstetric care.

Suggested Citation

  • Doherty, Jim P. & Norton, Edward C. & Veney, James E., 2001. "China's one-child policy: the economic choices and consequences faced by pregnant women," Social Science & Medicine, Elsevier, vol. 52(5), pages 745-761, March.
  • Handle: RePEc:eee:socmed:v:52:y:2001:i:5:p:745-761

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    Cited by:

    1. Anderson, Gordon & Leo, Teng Wah, 2013. "An empirical examination of matching theories: The one child policy, partner choice and matching intensity in urban China," Journal of Comparative Economics, Elsevier, vol. 41(2), pages 468-489.
    2. Bredenkamp, Caryn, 2008. "Health reform, population policy and child nutritional status in China," Policy Research Working Paper Series 4587, The World Bank.
    3. Bredenkamp, Caryn, 2009. "Policy-related determinants of child nutritional status in China: The effect of only-child status and access to healthcare," Social Science & Medicine, Elsevier, vol. 69(10), pages 1531-1538, November.
    4. Yang, Juhua, 2007. "China's one-child policy and overweight children in the 1990s," Social Science & Medicine, Elsevier, vol. 64(10), pages 2043-2057, May.
    5. Anson, Ofra, 2004. "Utilization of maternal care in rural HeBei Province, the People's Republic of China: individual and structural characteristics," Health Policy, Elsevier, vol. 70(2), pages 197-206, November.


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