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Family size, fertility preferences, and sex ratio in China in the era of the one child family policy: results from national family planning and reproductive health survey

BMJ 2006; 333 doi: (Published 17 August 2006) Cite this as: BMJ 2006;333:371
  1. Qu Jian Ding, associate professor1,
  2. Therese Hesketh, senior lecturer (t.hesketh{at}
  1. 1 Institute of Population Studies, Zhejiang University, Hangzhou 310012, PR China
  2. 2 Centre for International Child Health, Institute of Child Health, London WC1N 1EH
  1. Correspondence to: T Hesketh
  • Accepted 8 November 2005


Objectives To examine the impact of the one child family policy in China on fertility, preferred family size, and sex ratio.

Design Secondary analysis of data from the Chinese cross sectional national family planning and reproductive health survey, 2001. Interviews of representative sample of women aged 15-49.

Results Data were obtained from 39 585 women, with a total of 73 202 pregnancies and 56 830 live births. The average fertility rate in women over 35 (n = 17 078) was 1.94 (2.1 in rural areas and 1.4 in urban areas) and for women under 35 (n = 11 543) 1.73 (1.25 and 1.79). Smaller families were associated with younger age, higher level of education, and living in an urban area. The male to female ratio was 1.15 and rose from 1.11 in 1980-9 to 1.23 for 1996-2001. Most women wanted small families: 35% preferred one child and 57% preferred two.

Conclusion Since the one child family policy began, the total birth rate and preferred family size have decreased, and a gross imbalance in the sex ratio has emerged.


  • Embedded Image Additional tables A and B are on

  • This article was posted on on 11 May 2006:

  • Contributors QJD was part of the team that designed the study and assisted in data collection in Zhejiang Province. QJD and TH analysed the data and TH wrote the paper. QJD and TH are guarantors.

  • Funding None.

  • Competing interests None declared.

  • Ethical approval National Family Planning Commission standards committee.

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