The Walking Incubator: The Role of Women in Population Health and Regulation

Today, we live in a world more populated than ever. The number of people on Earth continues to increase from our current population of 8.2 billion being projected to reach as high as 10 billion by 2060 (United Nations). However, this growth is not evenly distributed, with many lower-income countries likely to experience the biggest population booms of the 21st century. In contrast, industrialized countries’ birth rates are projected to continue to decrease, with many reaching a level where their overall population will decrease in the near future. These population growth rate disparities have huge economic and social implications for these countries, leading to extensive legislative action to course-correct, if possible. However, these laws often fail to account for the social impacts on women and how they are viewed in society. Population limitation policies, while intrusive to all, are especially invasive to women’s bodies and their autonomy in society. Given they are the ones birthing children, any policies impacting reproductive freedom will take a toll on their bodies, whether that be through abortions, sterilization, or birth control options. On the other hand, some may say that restrictions on reproduction also can give women more freedom in how they live their lives without the pressure to have children. In contrast, societies that heavily encourage reproduction in order to increase the population often provide mothers with abundant child care resources at the cost of their choice to have children in the first place, reducing the women to a conduit for children that are valued more than the mothers themselves. This paper will focus on the ethics of population regulation, the difference between regulations that seek to limit growth and those that seek to seek to promote growth, and the impact of population regulation on women in society. Specifically, I will be exploring the ethical implications of population regulation and population limitation through the bioethical principles of autonomy, nonmaleficence, and beneficence, the value of equality, and the framework of deontology to explore the duty women have to society, their children, and themselves when making reproductive decisions and whether we as a society should seek to influence these highly personal decisions. 

Introduction

Concerns over overpopulation have been in writing since 1798, when Thomas Malthus released his book An Essay on the Principle of Population. Malthus argued that human populations would grow exponentially faster than their environment and food sources could support them, creating an overpopulation crisis. The population would then be lowered through three widespread factors: disease, famine, and war, leading to millions of global deaths (Minnesota Libraries Publishing Project). His fears about overpopulation influenced countless population policies aimed at artificially lowering birth rates, increasing political stability, and regulating who could and could not have children. The most famous of these policies was China’s One Child Policy, which limited almost all couples to a single child without incurring massive penalties. While most countries have not gone as far as China in restricting the number of children a couple can have, many have used tools such as family planning and providing birth control to lower their population rates. While fears of overpopulation have continued to evolve, it is undeniable that we are living in a very different reality than people like Malthus imagined. The global population is predicted to reach as high as 9.7 billion by 2050, but the growth rate is predicted to slow down quickly after that (United Nations). Some models even predict that the population will begin falling as early as 2060 (Taylor and Mathew). Many wealthier countries are already experiencing population decline, with as many as 27 countries encountering a one percent decline (United Nations). 

Population decline also brings many new problems for humanity. While it may seem better for the environment on the surface, vast disparities in carbon emissions per capita between nations lead to vastly different impacts on emissions through birth prevention. For example, although India ranks as third in the world when it comes to emissions, the amount of carbon dioxide emitted per citizen is much lower than many other countries below it, like Saudi Arabia, making the decline of its population much less effective in culling climate change there than in the latter country. Population decline not only fails to present a foolproof solution to climate change, it also presents immense challenges to the economic and social systems that led to it in the first place. This can be seen best in countries like South Korea, which harbor a total birthrate rate of 0.7 children per woman, far below the replacement rate of 2.1 children per woman. If this trend continues uninterrupted, the country’s infrastructure, ways of life, and economy could collapse in a matter of decades. Small villages and hospitals will be shut down and abandoned as people are forced to move into the cities due to a lack of residents, leaving behind ghost towns of empty structures. The economy will begin to crash as the workforce shrinks, depriving South Korea of its next generation of innovators and leaders.  Modern economies are built to function with a large working population that is constantly renewed; a smaller workforce leads to economic stagnation and the closing of businesses that cannot hire workers. Without new workers, the share of the population held by retirees will only increase, placing pressure on younger workers and the government to sacrifice larger and larger amounts of time and money to take care of senior citizens. Culture will break down and an epidemic of loneliness of epic proportions will begin, with less than 1 in 10 Koreans being under the age of 25 by 2060 (Çenet). In order to counteract this, many countries with declining populations have begun to offer increased benefits to would-be-mothers, such as tax cuts, increased maternal leave, and a better support system (Young). These policies are often championed over or considered against immigration policies, which have the same effect in practice but are often seen in a very different light than population policies. This is due partly from the symbolic nature of population, where a country’s population and birth rate of native citizens is often linked to its power and influence. Through this lens, many view immigration as a poor replacement that jeopardizes the interests of native citizens, and would prefer a more nativist approach towards population growth (Hiebert). To fully understand these policies and some of their consequences, it is important to look at governmental case studies, so that we can observe what truly occurs when these laws are implemented in society. 

Case Study 1: Population Limitation in Practice

When it comes to population limitation, there is not a more infamous example than China and its One Child Policy, which, as the name suggests, limited the majority of couples to one child. China’s One Child Policy was introduced in 1979, with the goal of limiting total population size to 1.2 billion by 2000 (Hesketh et al. 1171). It was implemented due to various circumstances, including a previous famine that killed millions due to a lack of sufficient food. Scared of another famine and lacking the safety nets to support the rapidly growing population, governmental officials began to enforce a policy of one child per woman, a rule that persisted until 2016. Today, China credits the One Child Policy with reducing the population by as many as 250 to 300 million. However, many critics point out that less coercive population control measures the country had implemented had been working to reduce the birth rate as well. Propaganda surrounding the idea of “later, longer, fewer” encouraged mothers to have less children and wait longer in between each birth.

Furthermore, many historians argue that increasing access to birth control and abortions would have lowered the birth rate regardless of governmental coercion (Flinn). They argue that the Chinese birth rate could have realistically been brought down without a totalitarian policy like the One Child Policy. For example, voluntary education programs related to the “later, longer, fewer” ideology implemented prior to the One Child Policy had the effect of halving the Chinese birth rate, from 5.9 children per woman to 2.9 children per woman (Flinn). However, it is hard to argue that these societal changes would have brought down the birthrate to the same extent that the One Child Policy did, as it was able to affect the entirety of the nation’s population. It is impossible to go back and confirm one way or another whether a famine would have occurred based on theoretical policy; all we can assess are the extensive impacts of the policies that were implemented. As stated by Stuart Gietel-Basten, a demographer at the Hong Kong University of Science and Technology, "There is only one China and there is only one one-child policy, so it is kind of impossible to say the real effect of that was [of the policy]" (Feng). Regardless of its necessity, China’s One Child Policy did have significant impacts on the population of the country, shattering previous family dynamics to create a very different society than before. 

By restricting childbirth and moving to break expectations of motherhood, China’s One Child Policy helped to liberate women from their sole role as housewives and mothers. From the 1980s to the 2000s, women and young girls were able to access far more resources in their youth and careers. During China’s One Child Policy, literacy rates for young girls rose from 82% to 97%, nearly rivaling that of young boys (Hagedorn and Zhang 6). In addition, the ratio of girls to boys attending primary, secondary and tertiary school increased to or above 100%, reflecting a massive societal upheaval in who could access education (Hagedorn and Zhang 7). While literacy rates naturally rose during this period due to increased industrialization and literacy programs, the One Child Policy ensured that more girls had increased access to education in comparison with their male counterparts. With fewer children being born overall, girls no longer needed to be pushed aside as much in school for the benefit of a larger male population. In addition, young girls no longer needed to marry as early as possible to have and raise many children, opening up years in their 20s to continue pursuing their education and establish themselves in the professional world.

One study found that the One Child policy led to an average increase of 1.28 years in schooling for Chinese women compared to Chinese men, making up 53% of the total gain in education between 1950 and 1980 (Grabmeier). This led to a whole new generation of working women who achieved great success in their careers, creating new dynamics and opportunities within their families and relationships. This group often falls into what people in China call “leftover women”, a group of women who prioritized their career and remained unmarried by their late 20s. Children born during the One Child Policy were often referred to as ““little emperors and empresses”, because of the unprecedented level of attention and nurturance provided (Falbo and Poston 1993)” (Hagedorn and Zhang 5). Due to the lack of other children, both boys and girls were able to reap more benefits out of their parents’ economic gains. However, this gain was especially impactful for young girls, who were often forced to sacrifice educational opportunities for the benefit of their brothers. Now, as the only child, they did not have to compete with their siblings for attention and money, allowing them greater educational and, later, career opportunities. In addition, without being forced into childbirth as their ultimate goal, women had more freedom to start careers and work to provide for themselves and their families. Without the societal pressure to have many children, women had increased freedom in their adult life. This, along with the fact that they had access to more education in their childhood and more of a pressure to support their family, increasingly pushed women to the workforce. Instead of being confined to being a housewife or contributing to a family farm, women had the opportunity to work in more white-collar jobs in urban environments, giving them more economic independence within their relationships. As said by Hagedorn, “Included among the outcomes of the one-child family policy, was the release of women from the expectation and norm of rearing large numbers of children. Thus the policy allowed women to have gainful employment, empowered female status in the family, and weakened the overall preference for sons” (5). Just like men, women began to embrace work not as a right, but a necessity in order to have financial control over their own lives. As put by one working mother in China, “I only have myself to rely on...I must have my own career and not give it up for anything” (Qian). 

Due to the destruction of societal expectations around having children, women began to embrace equality and pursue more equitable relationships with the men in their lives.Without the societal pressure to have a larger family, women could contribute more economically, equalizing their financial status in their relationships. As demonstrated above, not only did rates of education rise for women, but they became more equal with those of men. This is especially important given that in many cases women are viewed as unequal even once they receive the opportunity to work outside of the home. However, women growing up during the One Child period hold strong beliefs that, despite the bias towards men, “women and men can enjoy the same level of achievement at work or in other aspects of life, and they are capable of performing as well as men—if not better” (Hagedorn and Zhang 12). Not only does this encourage women to try out for the same careers as men, it inspires them to establish equality within their own relationships with men. In an interview with five women born during the One Child Policy it was shown that “[t]he daughters staunchly believe that both husbands and wives should be equal contributors to the family” (Hagedorn and Zhang 13). 

While the One Child Policy started an important cultural shift around childbearing, women in China still suffer from objectification and governmental control over their bodies. As mentioned earlier, the term “leftover women,” used to refer to women who prioritize their career over marriage, is often used in a derogatory manner, classifying these women as undesirable or naive for ignoring the standards of marriage. The short film Single in China  demonstrates some of the societal standards around marriage very well, where girls and women feel pressured from all angles to find a partner and get married earlier (Shlam and Medalia). Even the government helps to force women into marriage, seeing it as an important indicator of social stability. In fact, many aspects of One Child Policy further encouraged sex selection against women, as the limitation to one child meant that families had to choose between having a girl or a preferred boy. Enforcement of the One Child Policy not only heavily punished women for having children over the allowed amount, but also violated many through nonconsensual abortions and sterilizations (Fong 68). While the enactment of the One Child Policy liberated many mothers from child birthing expectations, families still held a preference for boys over girls, due to their perceived inferiority in society.

Most families had many children partly to ensure they had a boy that could work for the family; however, with the one child policy, families could no longer do this to ensure a male heir. While some rural parts of China allowed for two children to circumvent this, families began to dispose of girls in order to try again for a boy. This mainly occurred through sex-selective abortions performed once the gender of the baby was known, an illegal practice that “[was] known to be widely carried out, helped by a burgeoning private sector” (Hesketh et. al.). However, sex-selective abortions were not the only way families demonstrated their preference for a son over a daughter. Starting in the 1970s and continuing through the 1990s, there was a rise in child abandonments that disproportionately affected girls over boys, due to the patriarchal bias against daughters at the time. This led to an increased number of girl babies arriving at Chinese orphanages, sending many women into the foster care system. The gender gap still holds enormous consequences for China today for both genders. In China, both women and men often experience external pressure from their families, the government, and society to get married, settle down, and have children.

However, the excess of men compared to women has created an imbalance between supply and demand, making it more difficult for people to find partners. Men who cannot find a partner by what is deemed an acceptable age are subject to worse mental health and more disruptive behavior towards the other sex, often experiencing outbursts of anger and violence towards women who did no wrong to them. There has been an increase in human trafficking and kidnappings done by men, who aim to secure a partner at all costs, regardless of the intentions of the women involved; to some men, the woman is simply a symbol of status, not an individual with autonomy and choice. An lack of supply also means that the demand for commercial sex work has also risen, potentially leading to the increased spread of sexually transmitted diseases (Hesketh et. al.). 

The Chinese government controlled fertility across China through a network of family planning officers, who strictly enforced the One Child Policy for all. Usually, fines would be used to punish families that violated the plan; however, the fines were designed to be unaffordable as they were 5 to 10 times the family’s annual income. In cases where the couple could not afford the fines, officers would take possessions from the house and sell them off for a profit - actions that one officer referred to as “persuasion” rather than coercion (Fong 67). These fines were only the tip of the iceberg in coercive policies present in the country. Officers often had to convince women to get sterilizations, despite their intense distrust of the process and how it was carried out by the government. Sterilizations were specifically favored due to their almost 100% success rate at reducing births. This led to over 20 million sterilizations, “more than the combined populations of the three largest US cities” (Fong 68). However, sterilizations did not solve the problem of women who became pregnant against the wishes of their government. In cases of illegal pregnancies, family planning officers would coerce women into obtaining abortions with the same urgency, inducing as many as 15 million abortions in one year (Fong 68). Even after birth, officials would take brutal action, with reports from officers at the time describing doctors as “inject[ing] poison into [the child’s] skull and the child died and it was thrown into the trash can” (Fong 74).  Officials would go as far to kidnap elderly family members of disobedient women, either leaving them to stand in the snow or jailing them for months to “convince” the women to relent (Fong 75). 

China’s One Child policy undoubtedly had a huge impact on the country and its demographic growth, as it completely reshaped family structures for an entire generation of citizens. By limiting the amount of total children born, the government unintentionally helped to elevate opportunities for young girls, as they no longer had as much male competition for education and work. In addition, the societal push against reproduction led more women to hold jobs outside of the home, as they were no longer relegated to childcare to the same extent as before. However, the policy still committed immense harm against women, as they were forced to undergo invasive abortions and sterilizations under the threat of violence against them or their loved ones. The one-child barrier also led to an increase in sex-selection for male children through abortions and abandonments, skewing the gender balance and leading to ripple effects of gender-based violence today. China’s One Child Policy demonstrated that population regulation has extremely widespread effects and should not be undertaken lightly; what may have seemed like a simple solution to a problem became a defining part of China’s future as a superpower and as a nation of families. 

Case Study 2: Population Growth Requirements in Practice

In terms of population regulation, China presents important lessons about the rippling effects of influencing demographics, offering both cautionary tales about the potential for government-sponsored exploitation and a manual for how to enact lasting change on society. However, to truly understand the potential of population regulation as a tool and weapon, we must examine both sides of the coin, and study the effects of population growth alongside its opposite. Unlike China, there is no easy example to reach for when looking for a suitable example of regulation pertaining to population growth. While many countries today implement more modest policies leveraging monetary benefits for increased childbirth rates, it is necessary to study the most extreme examples of regulation, in order to comprehend the full potential impact of these policies when brought to their maximum power. If extreme population limitation relies on the universal usage of abortions and sterilizations, then its opposite must include the illegalization, if not the criminalization, of abortions. One such policy that includes this criteria is Decree 770, passed in 1967 in the often overlooked country of Romania. From 1965 to 1989, Romania was under the control of Nicolae Ceausescu, a communist dictator aligned with the Soviet Union. His reign held all the typical hallmarks of communist autocracies: censorship of free expression, an unstable and volatile economy, and the formation of a personality cult around him and his family (Wilson Center for Scholars). Romanians at the time suffered greatly from these policies, as they became extremely impoverished and often lacked basic necessities, such as medical care. Ceausescu aimed to completely rebuild Romanian society in a “socialist fashion” (Woodrow Wilson Center for Scholars), demolishing historic buildings in order to rebuild Romania’s capital. These ideas of reform extended to domestic policy. In 1967, he banned abortions, with few exceptions, in order to further increase his country’s power in the world, aiming to bring Romania’s population all the way from its current number of 19 million to 25 million people (Meadows). However, his efforts were not just limited to abortion prevention; he attempted to reward parents for their efforts, with varying degrees of success. 

Under Ceausescu, pregnant women were not only provided with monetary benefits for having children, but also hailed as heroes for fulfilling their duty towards a stronger society for all. In order to encourage reproduction and honor women who took up the duty of childbirth for the good of the nation, a number of family and maternity benefits were enshrined in law, with the goal of supporting women enough for each to have the desired amount of children. State allocations of funds were awarded for each child a mother birthed, with the exact numbers differing based on the total number of children in the family, the order the children were born in, and the total income of the parents. These allocations could serve either as extra income for the parent or as allowances for the children themselves until they turned 16 or 18. The government additionally made these extra funds nontaxable, allowing families to take greater advantage of the money provided. In addition to these flat monetary benefits, social systems were created and expanded for working women, mothers, and children; this included governmental assistance for disabled and widowed moms, medical coverage for pregnant women, and additional preschool resources available to the kids of working parents. All of these benefits were seen as rewards for citizens who upheld their duty to the state and its prosperous growth. These kinds of policies are relatively common around the world in different governmental welfare states. However, in those welfare states, reproductive benefits purely serve those who wish to have children, and have no bearing on the childless. In contrast, Romanian policy establishes reproduction as a primary duty for all citizens, punishing those without kids for their social failures. Citizens without children that were 25 years or older were seen as abandoning their duty to support their community and state. In order to make up for this lack of duty, these citizens were taxed on a monthly basis “to equalize social contributions” (Kligman 72). These punishments heavily pushed families towards reproduction unlike contemporary subsidy policies, something that was further carried out through Ceausescu’s rhetoric surrounding motherhood. In addition to these monetary benefits, Ceausescu made sure to champion women who had many children as heroes of the state, worthy of recognition and praise due to their fulfillment of his wishes. Different titles were created and given out to women to go above and beyond this duty: mothers received the “Maternity Medal” for having 5 to 6 children, the order of “Maternal Glory” for having 7 to 9 children, and the classification of “Heroine Mother” for having 10 or more children (Meadows). 

While Ceausescu’s  praise may have come from a place of genuine admiration and gratitude, there is no denying that his embrace of motherhood stemmed from sexist beliefs that women were only made to bear children and advance the desires of others. Ceausescu himself described raising children as “the highest patriotic citizens’ duty…the greatest honor and most important social role for women.” While he recognized mothers as heroes for fulfilling their societal duty for the population, he also emphasized through his beliefs and policies that it was the only way a woman could live her life, calling it a “predestined role” for every woman in Romanian society (Kligman 71). By doing so, he reduced every woman to one purpose for the benefit of others. Under Ceausescu’s beliefs, women hold no dreams besides that of motherhood, no burdens besides those of upset children, and no joy unless it is derived from reproduction (Meadows). This grossly simplifies the state’s perception of women and ignores the countless problems all of them face in their day to day lives.

The state’s goal of objectifying women and reducing them to their reproductive value came into full view when they banned almost all abortions. Under Decree 770, the cheap and accessible abortions present in the country became illegal, denying women almost any control over their bodies. Previously, abortions could be accessed at walk-in clinics for only $2, leading to an abortion rate four times the amount of live births occurring (Meadows); these statistics were shattered with the passage of Decree 770. The only exceptions to this policy were for women that were over 45 who could no longer have children easily and women who had five or more children, as they were seen as already having fulfilled their maternal duty to society. This decree, and the intent behind it to use the bodies of women to create a larger population, completely reduced all Romanian women to nothing more than a tool of the state. The only way to gain any kind of agency back was to either fulfill the state’s expectations or become useless to them, placing women in a corner where they were forced to sacrifice their rights in order to go on with their lives. Fundamentally, this policy valued the lives of children more than those of mothers. By banning abortions, the state removed a core aspect of women's healthcare just so they could guarantee more births, sacrificing the health, autonomy, and well-being of women in pursuit of more kids. While communist propaganda at the time often portrayed men and women as equals, the gaps between the genders only grew during Ceausescu’s reign. The lack of access to both abortion and birth control undermined female autonomy while giving men more power over their partner, given the lack of options they now had to deal with an unwanted pregnancy. In addition, the government passed laws allowing hiring discrimination against women to continue, under the excuse that the physical differences between the sexes limited their opportunities in the workforce. In reality, discrimination blocked almost all women from having high-ranking positions within their company (The Bite). This lack of financial opportunity further infringed on their reproductive autonomy, as it made women more dependent on the financial rewards given out for birthing a child. 

In contrast with China, where the demographic impacts of the One Child Policy continue to echo today in Chinese family structure, the commitment to high birthrates failed to outlive Ceausescu’s reign, or even last until its end.With the passage of Decree 770 in 1966, the Romania birth rate doubled shortly afterward in 1967. However, the birth rate immediately began to drop afterwards, almost reaching its previous lows only 10 years later. This drop was the result of a maternal mortality rate three times higher than before 1966, with the main culprit being attempted illegal abortions and the medical complications that followed soon after. Even so, the sharp birth rate increase in 1967 had a measurable impact on the country; entire school systems and health systems had to readjust to having classes at twice the size as normal, only to have to resize again once the decreasing birth rate caught up to them (Meadows). After his demise in 1989, Decree 770 was reversed in 1990, leading to a huge spike in legal abortions that, by summer of 1991, outnumbered live births 3 to 1 (Kligman 407), as people were once again able to access abortions that were safe with lessened risk. In the present, the population of Romania has continued to decrease after peaking in 1990; it now sits just above 19 million, barely different from the Romania that Ceausescu inherited. Ceausescu’s approach to population control asks us to consider what duty each of us holds to our government and how we should consider our actions within a larger community, a topic that will now be explored within my ethical analysis. 

The Question of Autonomy

When discussing the ethics of population regulation of any kind, autonomy is often one of the most considered values, as establishing limits on someone’s ability to reproduce freely always infringes on their bodily autonomy. Reproductive decisions are often considered some of the most impactful, and subsequently, some of the most personal decisions a person can make, given that individuals are deciding whether they want to be responsible for a new life. Because of this, governmental policy over reproduction has the potential to greatly infringe on a person’s autonomy, especially that of women. This is especially important because having a child is such a momentous decision that carries a lot of impact; most parents have to heavily consider factors like their location, support structure, and economic status when deciding whether to have children or how many they can have. By taking that choice away, governments risk either sadling parents with kids they cannot support or stifling their desire to have multiple children. This reproductive right, while not recognized over the course of history, is a right often given by governments to each individual. People’s rights to make medical decisions is recognized in law, and only removed when the judgement of that person is deemed to be impaired; otherwise, people have the bodily autonomy to choose what they feel is best for them at that moment. Just as each person can make medical decisions over their body, they also can make a choice about the creation of new ones. However, autonomous decision making is not always what is best for society. Utilitarianism, a framework often employed in governmental policy, decrees the most ethical action as the one that does the most good for the most people, regardless of the harm to the minority.  Following this framework, the best thing for most people would be governmental regulation of population, either growth or limitation, in order to reduce the damages to the country. This is because population regulation benefits the nation universally, by curtailing the potential for widespread suffering and disaster through economic crises and famines that could occur otherwise. By limiting the amount of children born, the government reduces resource consumption and waste, while ensuring that everyone can be provided for in the long run. In cases where population growth decreases, encouraging childbirth can prevent economic stagnation and depression, strengthening the workforce and guaranteeing that millions of retirees can be supported for the rest of their lives (Internet Geography). Population growth and limitation hold much more potential to do good for a large population than inaction does, supporting the idea that regulation is necessary to support the needs of a nation (Population Matters).

In addition, it is important to draw a distinction between coercion and other tools that governments use to shape population policy, looking at the means used to achieve governmental goals rather than just the outright consequences. While it is unanimous that requiring a certain number of children to be born takes away personal autonomy, the line gets blurrier when we look at other examples of population regulation. For example, China, which once feared a crisis of overpopulation, now faces the opposite problem, with a birth rate of only 1.67 by 2015 and a population that began to shrink in 2022 (McCartney et. al.). 

However, instead of requiring families to birth a certain number of children to raise the population, it has implemented a variety of policies meant to incentivize people into having kids, the majority of which carry a net benefit. For example, family planning officers, once used to police childbirth, now help to provide helpful resources such as free health examinations for women before marriage. These kinds of approaches are common across the globe in countries trying to raise their birth rates, and often include tax cuts and additional funds for daycare and schooling. On the opposite side of the spectrum, countries with high birth rates have often aimed to introduce increased access to birth control and family planning services, giving the population more resources to regulate their reproductive choices. For example, starting in 1970, Thailand implemented programs increasing access to contraception, health facilities, and education for the general public (Population Matters). These policies did not use coercion or bribery, yet they successfully lowered the country’s total fertility rate from 6 to just 1.3 (Walker). Both of these measures have a clear goal in mind, but it is hard to argue that they infringe on the autonomy of citizens as they are still able to make decisions about their own health without consequence if they defy the encouraged choice. This is further supported by the fact that these measures often have limited success in implementation, especially in the case of incentives for having children; destroying economic barriers only convinces those who want kids, not those who had no intention of doing so in the first place. While it can never be justified to completely remove individual autonomy over reproductive decisions, population regulation can still be used to benefit society without compromising freedom of choice. 

The Potential Harms of Limitation and Growth Encouragement

Under the bioethical principle of nonmaleficence, encouraging population growth could be more ethical than encouraging population limitation as “to do no harm” would be to not harm the unborn child in any way through an abortion. In order to have a society where limitation is encouraged, abortion has to be a safe, cheap, and available option that every woman can use if needed or desired. However, different belief systems, such as Catholicism, exist that view abortion as a sin, as they believe that life begins at conception rather than at birth, thus making abortion more akin to murder in the eyes of that church. This view is subjective, but it still holds weight for women affected by population regulation policies, as a woman who shares this perspective will not only feel they are committing harm to their child, but will commit harm to themselves through their emotional distress at defying their own values. In contrast, pushing for childbirth only results in the creation of a new life, rather than the destruction of a potential one. However, there are many opposing arguments to this perspective. 

First, encouraging more childbirth does not always align with doing no harm. In terms of harm committed on the expectant mother and her partner, having a child, especially if coerced into it, carries a huge emotional and physical weight that can affect her life greatly.

Parenthood is filled with stress, and pushing couples towards it could “do harm” by damaging their mental and emotional health. Furthermore, this harm has the potential to be exacerbated in the case of a single parent, where one person has to navigate the challenges of parenthood alone and without support. This can lead to a lack of financial, mental, physical, and emotional support for the future child, impacting their self-esteem and confidence, impeding their ability to access resources such as education, and leaving them without a reliable support system. However, by only applying population regulation towards married couples, the government risks alienating single parents and reducing the worth of individual women. For example, many single moms in China are denied access to public health care and maternity leave insurance, benefits that married couples are able to access. This makes it so being a single parent is perceived as an undesirable trait rather than simply another form of parenthood, denying further support for children that may need it (Stevenson). In addition, carrying a child to term can also be more harmful to the child. While people debate about how aware the baby is while in the womb, it is well accepted that once born, babies can feel pain like any other person. There are many cases where, due to a disability or genetic condition, a baby can be born alive but will die shortly afterward, normally not without pain or suffering. In cases like this, to do no harm would be to prevent this harm from occurring by getting an abortion, something that would be heavily discouraged in a society that encourages population growth over population limitation. 

Having more children, in contrast to having less, can also cause more harm to society as a whole. While the difference of one child does not have a huge impact on a shrinking population, the birth of even one more baby can have a drastic effect on resource consumption. As said by Greg Bognar, a professor of Practical Philosophy at Stockholm University ,“it is rarely acknowledged that the worst thing you can do to the climate is to have children” (320). If this is in fact true, then under the value of nonmaleficence, an individual would be committing more harm to the environment simply by having a child.

One, two, or three more people means more coal burned to keep the lights on, more water used to create wasteful clothing, and more carbon dioxide emitted from food production.

This consumption threatens to accelerate climate change, leading to increased global impacts from hurricanes and tsunamis to wildfires and droughts (IPCC). Through this lens, encouraging more births commits more harm than limitation as it burdens our already strained planet even further. It also worsens inequalities globally, as the wealthy countries sponsoring births create climate disasters that largely impact developing nations that lack the tools to rebuild and recover. By encouraging people to have less children, countries can reduce their consumption instead and better protect their civilians from the worst of climate change. 

In addition, having a child can greatly impact a woman's autonomy, social status, and opportunities available to her. Women who have kids are often forced to sacrifice their career in order to raise their children, which impacts their ability to be financially independent in their relationships. Even if they are able to continue working, they will likely receive less opportunities for promotion due to societal perceptions around working women and the lack of time they have to commit to the job. By having a child, women can experience personal harm to their career prospects and their ability to make decisions that best benefit them. When considering children in a nation without population regulation, career sacrifice is simply a fact that one must consider when making reproductive decisions; however, by requiring that all women make this choice, population regulation harms many individuals’ ability to provide for themselves and their child financially. 

Another important concern is how the living conditions of parents should be taken into account when encouraging population growth. Governmental measures, even those less oppressive than China’s and Romania’s, can still place social burden on women to have children, leading to the possibility of children being born that the parents cannot support with their current economic situation. Encouraging growth would be unethical under these circumstances as it would force women to raise their children under extremely stressful situations and lead to more custody changes for young kids, something that can have a massive impact on the mental health of both the parents and children throughout their life. 

While it may seem that more harm is being committed by preventing the creation of new life on the surface, the variety of potential impacts just one child can have leads to many potential harms that can be committed by encouraging excessive reproduction in a society. Having more children inherently places more burdens on both the parents and society as a whole, as both have to adapt to the existence and needs of a burgeoning population. Both population limitation and population growth encouragement hold the potential to cause great emotional and mental harm to women, but they cannot experience financial burdens from a child that does not exist. In addition, having more children also correlates to an increase in resource consumption, potentially worsening the realities of climate change, pollution, and scarcity. Due to these wide considerations that factor into the existence of harm, including religious beliefs, it is challenging to find an ethical consensus where either abortions or having more children is judged as more unethical under non-maleficence. This is because there are a variety of different harms that can occur from either action, with each one being measured at all different levels based on the individual situation of the person. 

The Potential Good Found in Limitation and Growth Encouragement 

When considering the principle of non-maleficence, it is also important to examine the sister principle of beneficence, which promotes “doing good” whenever possible; while “not doing harm” and “doing good” are often seen as the same thing, there are important distinctions to make between the two (Verve College). Most notably, non-maleficence often encourages non-action, as the most surefire way to not commit harm is to do nothing at all in most scenarios. Beneficence encourages a more active model of the world, pushing people to evaluate their actions on the basis of if they continue to do good in the world.

However, this is not always the case, as non-maleficence can in fact encourage action taken to protect an individual or a society. In comparison, beneficence can provide more perspectives and empathy to a situation, aiming to do the best thing for everyone rather than simply preventing the cause of further harm. Going back to Bognar and his statement that “the worst thing you can do to the climate is to have children”, the flaws in non-maleficence are that it encourages the avoidance of harm no matter the cost at times. If Bognar’s statement is true, then theoretically, the best way to prevent harm would be to not only not have children, but to exterminate existing ones to reduce emissions. The value of beneficence instead looks to perform “good” actions, which would entail neither committing murder nor having lots of kids, in order to value both the environment and the lives of children. Looking at the situation from a societal perspective, “to do good” would be implementing whatever measures are necessary to improve population health given the wide reaching negative consequences that would come about if it was not improved. However, it is also important to acknowledge that doing good would also entail causing the least amount of harm to individual citizens, many of which would be harmed under a blanket enforcement of either required abortions or childbirths. At the very least, upholding the principle of beneficence would require maintaining autonomy for all parties involved, given the harms that can come about due to a lack of autonomy that were discussed earlier.

Because of how subjective “doing good” and “not doing harm” is, it is extremely difficult to create an ethical model that judges one as more beneficial over the other. Because of this, it is best in most cases to allow the individual to decide their own reproductive decisions, as different people may be subject to different harms and benefits based on their decisions, leaving them vulnerable to the possibility of an overarching governmental policy. However, there is still room for regulation throughout this framework. While we can argue over the comparative harms of losing one’s career freedom, there are certain actions that are universally considered harmful, such as the act of abusing children. In order to prevent the least harm possible and do good in society, the government does have the ability to regulate these actions in a way that protects children and parents, regardless of the ethical or moral beliefs of the parents involved. This can be seen through governmental programs like Child Protective Services, which work to protect and help kids by holding their parents to an objective standard of treatment (OCFS). These kinds of regulations maintain autonomy for parents, while also working to improve safety and security for all involved, an important balance to strike if population regulation is implemented in our societies. 

In contrast with non-maleficence, which encourages the complete avoidance of harm, the principle of beneficence represents the idea of doing good on a broader scale. While population regulation holds great potential to do harm, it also holds great potential to do good by improving population health and preventing widespread disaster across the nation.

Because of this, beneficence supports both limitation and growth as they both hold that same potential to do good. However, it is important to note that doing good also takes into consideration the unintended consequences of regulation, meaning that under the principle of beneficence, policies that will do the most good for women, such as child subsidies or tax credit, would be seen as more ethical than policies such as China’s One Child Policy. It is especially important to consider the impacts of these policies on women given that they are the primary target of reproductive legislation, something that can isolate them from men and leave them more vulnerable to governmental intervention than their counterparts. 

The Uneven Burdens of Reproduction

Another important value to consider is equality: specifically, how reproductive policies place more of a burden on women than on men.  If standards of excellence are to be applied to parenting, they must be applied universally across all groups in order to uphold the values of justice, fairness, and accountability. In order to uphold the value of fairness and the principle of justice, population regulation policies should avoid placing an undue burden on women and emphasize equal responsibility in parenting through balanced paternal and maternal leave, as well as avoiding stereotypes based on gender. 

It cannot be denied that in the creation of a child, the woman holds the most influence over the development of that life. Men will never be burdened by pregnancy in the same ways that a woman would be, especially during the pre-partum months. Pregnancy impacts women in many ways, some of which we still do not understand, and can continue to affect them after the birth itself. It is well documented that it can permanently alter aspects of a woman’s body, such as her weight and proportions.  It carries a mental and emotional toll, partly due to shifting hormone levels, and an increased risk for various problematic medical conditions. It is not uncommon for women to discover that their bodies have changed forever postpartum (Salamon et al). There is even primary research showing that a woman’s brain can shrink after giving birth and never recover afterwards (Doctrow). In addition, postpartum depression affects many and takes a huge toll on an already strained mental state (Mayo Clinic). Overall, pregnancy has much more significant physical, mental, and emotional effects on women, leaving them much more at risk to reproductive policies than their male counterparts. Women are often expected to hold the primary responsibility for childcare in a relationship in comparison to their male counterparts. While many would say that society has improved for women since the 1950s, it is still much more common for the wife to stay home and raise the kids while the man provides income for the family (Haines). Even in homes with two working parents, it is often the mother who sacrifices her career in order to take care of the children. Maternity leave is more widely offered in the US than paternity leave, with an average of 10 weeks of maternity leave being offered in comparison to just one week of paternity leave (Hastwell). While some of this difference can be chalked up to extra leave needed from pregnancy, it is hard to deny that there is a larger societal expectation that women take care of their children than there is for men. Because women take on a larger role in their kid’s lives, they are more impacted by reproductive policies than their husbands would be. Having more children would place more of a burden on them than their husbands, further increasing gender gaps in society. 

Some may argue that because women hold more control and ownership over having a child, they should have more responsibility in raising that child. In addition, they could argue that it is impossible to create laws that affect both genders equally in many cases, given the vast morphological differences between the two (Katz-Wise et al).. For a man, the main option for birth control are condoms, which do not have a 100% success rate. In contrast, women have the ability to use IUDs or birth control pills to help protect themselves against pregnancy; while also not 100% successful, these options have less chance for user error, while also reducing dependency on a partner’s actions to prevent their own possible pregnancy. Abortion is also an option present if a woman becomes pregnant unwillingly.

Since women have all these options to prevent pregnancy, they hold a duty towards their child if they decide to have one. Not only does this duty involve protecting the baby during pregnancy, but also taking on the role of main caregiver for the child once born. Under this view, men hold less responsibility, if any, for supporting their biological children, as they were not the ones who chose to carry the baby to term and therefore do not hold moral responsibility towards that child. 

However, this argument overlooks the realities that women face when trying to manage their reproductive health. First, women often do not have complete control over their birth control and abortion options. Intrauterine devices (IUDs) and birth control pills, while effective, are either extremely painful to implement or come with numerous side effects. Both also often have stigma associated with their use, along with the use of abortions. Abortions are regulated by many state and federal laws, making it extremely difficult for some women to receive them. Despite these options, women are often still vulnerable to the choices of their male partner; in terms of condom use, they simply have to trust that they used it correctly without any guarantee. Additionally, while they do not give birth to the baby, the male partner contributes just as much genetic material as the mother, making him responsible as a biological parent equal to that of his female partner. Men should be taking more responsibility for their children because their choices, as well as the women’s, lead to pregnancy. In order to create a truly fair and equal society, equal reproductive responsibilities must be given to both men and women. In addition, the act of having a child often places more societal pressure and stereotypes on the female partner than the male one, as they are expected to give up parts of their life in order to provide for this new one.

Throughout human history, the identity of women has often been reduced to that of a wife or mother, disregarding the personality, interests, and values of the individual behind the perfect parent(Katz-Wise et al). For example, there is often this expectation or belief that women inherently know how to parent their children better than men due to their “maternal connection” to the child. As demonstrated by Maria Kuhn, these stereotypes often fail to account for the troubles and turmoils behind parenting in reality. In expecting perfection, society forces all women to forever strive towards an ideal that they will never reach, giving up their time and labor to do so. Stereotypes around parenting like this also further enforce the idea that parenthood must take precedence over everything else in life, replacing every one of the parent’s former interests, job opportunities, and social events. While this belief certainly exists for individuals across the gender spectrum, it is more impactful for women as they are the ones relegated to the home under a traditional split of labor. 

Some may argue that it is necessary to sacrifice in life as well as parenthood, and that it would be impossible to raise a child well without giving up something of your own in return. Raising a child inherently requires more time, more money, and more effort; all of these resources have to come from somewhere that already exists. If the goal of parenthood is to rear a well-adjusted, happy, and healthy kid, then it must be required that the parent prioritizes the kid’s health over their own. If a parent still has more effort they can give, they still hold the ability to give their child more attention, more resources, more love. Being a parent should mean wanting the best for your child and their future, not settling when it is easiest for them. While we can all agree in theory that a child should receive the best life possible, this theory runs into numerous roadblocks when being applied to real-life scenarios. Should there truly be no line in the sand where the needs of the parent take precedence over that of the child? I would think not, given that parents are people too and need the same basic things as you or I to live a happy and successful life. It is also similarly impossible to draw a clear boundary at what can be done to provide the best life possible, as there can almost always be more sacrificed. Quality of life and access to it can vary greatly between different socio-economic classes as well, yet we do not see it prudent that the majority of kids should be raised by the ultra-rich, who by most definitions would be the only ones capable of truly providing the best life possible to a child. At the end of the day, aside from child abuse, it is impossible to create universal standards for how one should parent and how much they should give to the life of their offspring. Even if standards for parenthood were established, stereotypes of maternal superpowers would still remain unethical as they would place an undue burden on only the female population, completely ignoring the role of the male partner as a parent.

In order to create fair and just laws surrounding population regulation, it is necessary to invoke gender equality and place equal parenting responsibility on both male and female parents. At the end of the day, both people contribute equally to the creation of a child, and thus should both hold a duty towards supporting and raising that child. Measures, such as parental leave for both genders, should be undertaken to avoid the objectification of women and the reduction of their lives to that of a housewife, instead still providing them the opportunity to hold careers and pursue their passions on top of being a mother. While basic standards of parenthood should be established and applied to both genders, it is very difficult to judge the ability of a parent to give to their children after that due to subjectivity. The government should enforce these basic protections for children in order to minimize harms done through regulation while respecting the parenting decisions of the majority of their population. 

The Role of Duty in Reproduction

I chose to analyze the issue of governmental intervention in population through the lens of deontology, which judges actions based on their adherence to a set list of principles or duties held by individuals. Governments are made to be representatives of the people, imposing the laws and regulations that are best for the majority of society. Following this, governments would have a deontological duty to act in the best interest of their citizens in terms of maintaining population health and minimizing the subsequent negative consequences that could follow. Thus, they would have a duty to regulate the population, whether that be through limitation or encouraging growth. However, it is important to recognize that the government also holds a duty to respect the rights of its citizens, especially when it comes to their autonomy. Ideally, governments are meant to walk the line between paternalism and autonomy: they regulate enough in order to provide all citizens with a safe and prosperous life, while allowing enough autonomy for individuals to make their own decisions using their own values. Many governments, such as our own, explicitly protect these rights of freedom through their Constitutions (Reshanov). By taking away the autonomy of all women, even in the case of a population crisis, governments are violating the duty to respect the choice of their citizens and sacrificing individual suffering for the greater good. This has the potential to create a slippery slope, where governments are justified in removing autonomy from their citizens as long as the majority benefits somewhat; this line of thinking often leads to concentrated state power and totalitarian ambitions, which often become corrupt and overbearing. While the government has a duty to regulate its population to prevent economic and social collapse, it also must consider the impacts on its citizens, especially women, and take steps to prevent overreaches of autonomy. 

In addition, I found that women do not hold a duty towards maintaining population health individually, as it holds too great a potential to conflict with their own values. While duties are straightforward for a government to follow, it is impossible to insist that all women have the same responsibilities in preventing societal collapse, as it places an undue burden on an already burdened population. As mentioned earlier, the choice to have kids is a weighty one, and involves many different factors that parents must consider, each of which varies from family to family. If women were bound by duty to have kids or not have kids no matter what, great harm would be inflicted on many families. By forcing women to accept a larger duty to population health, the government threatens their individual duties by creating a societal one that supersedes all others at all costs. Creating limitations on reproductive choice not only infringes on autonomy, but on the individual’s ability to fulfill their responsibilities. For example, it is commonly accepted that parents have the duty to give their child a good life, and that they should only intend to have one if they know that they have the means to raise one. Imagine a couple, who want to have a child one day, but hold off due to their financial situation and ability to provide around-the-clock care for that future child. If the government required childbirth in this situation, the parental duties of this couple would be compromised, forcing them into having a kid that they don’t feel like they can support to the best of their ability. This compromise of personal values for large-scale gain is inevitable when forcing citizens to take on the burdens of a larger government. Individuals should certainly have an awareness of the impact of their actions on a larger scale, but they should not be forced to sacrifice the things in their life in order to uphold societal values. 

In conclusion, it is nearly impossible to say that all women must consider society’s needs over their own, as this approach invalidates their individual duties to their partners, families, and future children. While women, and all citizens, certainly hold some level of duty through the framework of deontology to their government and the wellbeing of their society, they also hold other, more pressing duties as well, such as their responsibilities as a mother, brother, student, and worker. If women took full responsibility for promoting population health, that would mean potential neglect of their duties to their existing children, family, friends, and workplace, upending their lives for a single life that serves as only a drop in the bucket of the national population. This role in regulating population is exclusive to the government, as it is their responsibility to provide for citizens and shape a prosperous society, especially when it comes to matters that may occur in the future. However, it must also be acknowledged that another part of the government’s duties is to uphold the rights of citizens, such as those found in the constitution of that country. Thus, the government should regulate, but it must be in respect to the autonomy of citizens and not infringe on their civil liberties. 

Conclusion

 In an ideal world, government and reproductive health would be completely separate, and up to the individual.However, we can not overlook the signs of collapse right in front of us; nor can we assume that the problem will sort itself out.South Korea is not an exception in the world; while it boasts one of the lowest birth rates, it is by no means alone, with countries like Italy, Sweden, Thailand, and yes, even the United States, experiencing similar drops in new births. Despite common belief, population regulation is not a thing of the past; instead, it is a tool that we may be forced to use in the very near future. For example, within the first 100 days in office, the Trump Administration has been exploring various policy options for lifting birth rates, such as a $5,000 “baby bonus” after delivery, an increase in education on menstrual cycles to increase fertility, and a reservation of 30% of Fulbright scholarships for married applicants or those with children (Kitchener). Trump has even dubbed himself “the fertilization president,” suggesting that these topics are incredibly important to our country and will continue to be relevant for many years to come (Goldberg).

Population regulation, like all other governmental policies, is a tool that can be used for the greater good of society. Like any tool, there must be limits on how it can be used. In order for population regulation to be ethical, citizens must continue to have autonomy over their own reproductive choices. There must be no required standards that citizens have to meet, whether that be a ban on having children or an order to have children. This ensures that the autonomy of citizens is protected and that they can provide the best life for however many children they want to have.The government should have the ability to use positive reinforcements to encourage population policy, however, as these measures help provide support towards women without forcing them into a corner. Rather, these potential benefits simply become considerations to think about when discussing reproductive choices. As long as the incentives stray away from punishing tactics such as fines, they provide benefits towards those who wish to pursue that path while not negatively impacting those uninterested.

 There are many ways the government can pursue a healthier population without infringing on autonomy. Many countries today use methods like child benefits, increased childcare and parental leave, access to birth control and family planning, and access to abortion in order to give citizens the resources to make their own choices. As long as the policy does not force women to choose, it can be used to some benefit. Avoiding punishment tactics throughout regulation also helps to support the value of non-maleficence further, as this helps to mitigate potential harms that can occur under population regulation such as those experienced under China’s One Child policy or Romania’s Decree 770. This also allows the government to pursue a population policy that is best for the majority of society. By working to actively reduce harm done through policies by using more autonomous methods of regulation,  the government can do good by maintaining or improving population health while avoiding diminishing the good experienced by individuals under the policy, upholding the value of beneficence. Beneficence can also be upheld by population regulation by making sure that policies address the gender gap in impact, and aim to preserve and create equality in parenthood in order to alleviate the excess burden on women. 

Under both non-maleficence and beneficence, population limitation and population growth encouragement are equally ethical, as both bring potential good and harm into society. Because both kinds of regulation hold the potential to do good, the principle of beneficence can be applied to both of them to justify their creation. While population growth encouragement leads to more physical and financial harms, as the creation of more children places more stress on society and individuals, it cannot be ignored that population limitation policies can violate women’s bodies through abortions and sterilizations and similarly remove their bodily autonomy in pursuit of a greater goal. Thus, both kinds of regulation can be ethical if they are undertaken with the goal of reducing harm done in order to do good for the nation. 

The government should also aim to close the equality gap in reproduction to avoid placing an undue burden on women alone in these policies. Access to abortion in the case of rape or health threats to the mother is critical for this, as it helps to prevent the reduction of women to an incubator for a greater life. In addition, steps should be taken to level the childcare burden between both genders. Maternal and paternal leave should increasingly be implemented into the American workforce to allow both the mother and the father to take care of their newborn without sacrificing their job in the process. In general, policy should be remade to recognize the father and mother as equal parents with equal responsibility.

Regulation not only can be pursued under these guidelines, but it should be pursued if necessary, as the duty of the government states that it must pursue the best future for citizens and work to protect them from potential disaster, such as a population crisis. The government should take these steps to regulate the population, while also respecting the rights of citizens as a secondary part of their duty. While individual women do not hold a responsibility towards population health, the government does, and should move within these guidelines in order to secure the best consequences for everyone possible. It is unreasonable for each family to weigh population health in their decisions, but it is not for the government, which was created in order to pursue a greater good for everyone. 

If done through a noninvasive approach with the goal to strengthen population health for the greater good, population regulation is ethical for the government to pursue. However, the duty to do so falls on the shoulders of our elected officials, not those of individual women simply trying to live their lives. 

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