The countries with anti-natalist policies most often cited are China, India, Singapore, Iran, Peru, Vietnam, and Uzbekistan. Each government tried, at some point over the last half-century, to push birth rates down. The methods ranged from voluntary contraception programs and tax penalties to hard birth quotas backed by forced sterilization and forced abortion. Most of the harshest programs have been abandoned or reversed, but their demographic effects continue to shape these countries today.
What Counts as an Anti-Natalist Policy
Anti-natalist policies sit on a wide spectrum. On the softer end, governments expand contraception access, fund reproductive health education, and run campaigns encouraging smaller families. In the middle sit economic disincentives: fines for extra children, reduced access to public housing, loss of tax benefits, or shorter paid maternity leave. At the far end, governments have set hard birth caps enforced through forced sterilization and forced abortion. The line between family planning and population control usually turns on whether the state respects individual choice or overrides it.
China
China’s one-child policy is the most widely known anti-natalist program in history. The Chinese Communist Party formally launched it on September 25, 1980, when a public letter from the Central Committee called on all party members to limit themselves to one child.1Encyclopedia Britannica. One-Child Policy At the time, the country was approaching a billion people and facing severe shortages of capital and consumer goods.
Enforcement combined incentives for compliance with penalties for violation. The government made contraception widely available and offered preferential jobs and financial rewards to families that stayed within the limit. Violators paid a “social maintenance fee” that varied by income and location; collections across 24 provinces totaled roughly 20 billion yuan in a single year. In 1983, a year with about 21 million births, the government carried out 14.4 million abortions, 20.7 million sterilizations, and 17.8 million IUD insertions, a large share of them involuntary.
China relaxed the policy in 2016 to allow two children, then passed a law in August 2021 permitting three.2National Health Commission of the People’s Republic of China. Third-Child Policy Introduced Neither change reversed the trend. China’s population has been shrinking since 2022. In 2025, births fell to 7.92 million while deaths rose to 11.31 million, a net loss of 3.39 million people in one year.
India
India’s mass sterilization drive from 1975 to 1977 is one of the most coercive population-control episodes outside China. During “the Emergency,” Prime Minister Indira Gandhi suspended constitutional rights and the government launched an aggressive campaign focused on men. In 1976 alone, 6.2 million men underwent vasectomies. Targeted groups included the poor, illiterate men, prisoners, and homeless men; unmarried and childless men were not spared. In some states, people had to show proof of sterilization to collect a salary or receive medical treatment. Vasectomy camps in Uttar Pradesh processed over 5,600 procedures a day, and men were sometimes rounded up and taken to hospitals by bus.
The backlash helped defeat Gandhi at the polls in 1977 and left a lasting stigma on family planning. Since then, government sterilization efforts in India have shifted almost entirely toward women, with roughly 4.5 million female sterilizations performed annually.
Singapore
Singapore’s “Stop at Two” campaign took a bureaucratic route rather than a coercive one. It came into effect on August 1, 1973. Families with more than two children faced lower priority for public housing through the Housing and Development Board, reduced income tax relief capped at three children, higher childbirth fees at government hospitals that rose with birth order, and paid maternity leave cut from three confinements to two.3National Library Board. Two-Child Policy – Singapore Infopedia
The policy worked, and then some. By the mid-1980s, Singapore’s fertility rate had dropped below replacement level. The government scrapped the disincentives in 1987 and has spent nearly four decades since offering cash bonuses, tax breaks, and subsidized childcare to encourage larger families.
Iran
Iran’s family planning program, officially launched in December 1989, is often described as the most effective voluntary anti-natalist effort on record. It set three goals: delay first pregnancies, discourage childbearing for women under 18 or over 35, and limit family size to three children. The Ministry of Health distributed free modern contraception through a nationwide network of primary health care clinics.
Several features distinguished the program. In 1990, Iran’s High Judicial Council declared sterilization for both men and women compatible with Islamic law. A 1993 law limited certain social benefits to a couple’s first three children. Couples had to attend family planning classes before receiving a marriage license, and universities added a mandatory two-credit course on population and family planning.
Iran’s total fertility rate fell from 6.58 children per woman in 1980 to 1.9 by 2006, one of the fastest fertility transitions ever recorded.4World Bank. Fertility Decline in the Islamic Republic of Iran 1980-2006 Urban fertility hit 1.8 by 2006, well below replacement. Iran now actively encourages larger families, though the cultural shift toward smaller ones has proven hard to undo.
Peru
Between 1996 and 2001, the government of President Alberto Fujimori ran a mass sterilization program that targeted impoverished and indigenous communities. Under the National Reproductive Health and Family Planning Program, over 300,000 women and roughly 25,000 men were sterilized. The overwhelming majority of the women were rural, indigenous, and poor, and did not give meaningful consent.5Office of the High Commissioner for Human Rights (OHCHR). Peru: Fujimori Governments Forced Sterilisation Policy Violated Womens Rights
In 2024, the UN Committee on the Elimination of Discrimination Against Women found that the program amounted to sex-based violence and intersectional discrimination. The Committee noted that widespread or systematic forced sterilization could constitute a crime against humanity under the Rome Statute, and expressed concern about a Peruvian law that blocks prosecution of crimes against humanity committed before 2002.
Vietnam
Vietnam kept a two-child limit for decades. It began informally in the north in the 1960s, expanded nationally after reunification, and was formalized in the early 1990s. Enforcement was relatively loose for ordinary citizens but strict for government officials and members of the ruling Communist Party, some of whom resigned rather than face consequences for having a third child.
The National Assembly abolished the two-child limit in 2024, driven by the same pressures felt in China and Singapore: falling birth rates and an aging population weighing on economic growth. Alongside the repeal, Vietnam proposed heavier fines for prenatal sex selection, reflecting continuing concern about gender imbalance.
Uzbekistan
Human rights organizations have documented state-directed forced sterilization in Uzbekistan going back to at least 2000. A 2013 investigation described a systematic program affecting tens of thousands of women, in which all women of reproductive age who had delivered two or more children were treated as potential targets. Medical staff faced quotas set by health administrators and were held responsible for meeting them.
The U.S. State Department’s 2020 human rights report on Uzbekistan noted that, unlike in previous years, there were no reports of government doctors pressuring women to accept sterilization that year, and the law was described as permitting only voluntary sterilization with informed consent.6United States Department of State. 2020 Country Reports on Human Rights Practices: Uzbekistan Whether the practice has ended or simply become harder to document remains contested.
Countries With Softer Programs
Not every anti-natalist effort involved force or hard caps. Egypt has run an active family planning program aimed at bringing fertility down to replacement level, focused on expanding contraceptive access and reproductive health education rather than imposing penalties. Bangladesh launched an extensive door-to-door outreach program in the mid-1970s that relied on female community health workers to bring information and contraceptives directly to households. Bangladesh’s fertility rate fell from over six children per woman in 1975 to just over three, largely without coercion. Voluntary approaches like these tend to work more slowly than forced ones, but they produce real declines.
What These Policies Left Behind
The most visible legacy of strict birth limits has been skewed sex ratios. In countries with strong cultural preferences for sons, capping family size intensified sex-selective practices. China’s sex ratio at birth rose from 107 boys per 100 girls in 1982 to 120 by 2005, well above the biological norm of about 105.7World Health Organization. Preventing Gender-Biased Sex Selection: An Interagency Statement China now has an estimated 30 million more men than women.
Aging populations are the other lasting consequence. Countries that suppressed birth rates for a generation now face shrinking workforces and rising dependency ratios. China’s population has fallen for four consecutive years, with annual births below 8 million and deaths above 11 million. Singapore ran into the same math in the late 1980s. The pattern holds across the group: pushing fertility down is far easier than pulling it back up once small-family norms take root.
How International Law Treats Coercive Population Control
The international framework has moved firmly against coercion. The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), ratified in 1979, guarantees women equal rights with men to decide the number and spacing of their children.8Legal Information Institute (LII) / Cornell Law School. CEDAW Committee The 1994 International Conference on Population and Development in Cairo went further, stating in its Programme of Action that “any form of coercion has no part to play” in family planning and calling on governments to remove barriers to reproductive health services while respecting individual choice.9United Nations. Programme of Action – International Conference on Population and Development, Cairo 1994 The Cairo consensus did not end coercive practices, but it established that population targets do not justify overriding reproductive autonomy.
Why Most Countries Have Reversed Course
The global trend now runs the opposite direction. China moved from one child to three in five years. Vietnam scrapped its two-child limit in 2024. Singapore has spent decades trying to raise fertility. Iran, once celebrated for how fast its birth rate fell, now promotes larger families. The reversals share a common lesson: the economic weight of an aging, shrinking population can arrive faster than policymakers expect, and cultural norms around small families outlast the policies that created them. Countries still working with high population growth, concentrated in sub-Saharan Africa and parts of South Asia, have generally pursued education and contraceptive access rather than the coercive methods that defined the 20th century.