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Elderly island

With fewer young marriages and abortion numbers sky high, Taiwan faces a severe birth dearth

Elderly island

A man looks at the artwork The Moment We Meet displayed at the Taipei 101 Station in Taipei, Taiwan. The display shows old people’s faces to convey the message “An elderly person is the future of my body, a child is the future of my bloodline.” (David Chang/EPA/Newscom)

Photo by Angela Lu

Jocelyn Zhou at the Ray of Hope clinic.

Associated Press/Photo by Wally Santana

A foreign caregiver pushes an elderly woman in Taipei.

In the tree-lined Sanmin Park in Kaohsiung, Taiwan, Indonesian caretakers push wheelchairs bearing the elderly—some hooked to oxygen tanks—who gather at the park for their daily breath of fresh air.

Signs of graying in Taiwan are evident everywhere: Whited-haired ah-mas (or grandmothers) haggling at street markets or dancing at the park far outnumber mothers pushing baby strollers. Taiwan has the third-lowest birthrate in the world, a dismal 1.11 children per couple, as fewer young people marry and abortion rates skyrocket. The estimated number of abortions per year eclipses the number of births: In 2013, about 195,000 babies were born on the island of 23 million, yet one doctor said the number of abortions a year could be as high as 500,000.

Government policy isn’t to blame for the low birth numbers: The semiautonomous island doesn’t fall under mainland China’s one-child policy. In fact, President Ma Ying-jeou calls the low birthrate an “issue of national security,” and the Taiwanese government gives economic incentives to encourage childbearing. In Taipei, parents receive a $667 baby bonus, a $5,000 child care allowance, and free tests to find fertility problems. But amid rapid industrialization and changing culture, those efforts have so far been unable to reverse the trend. Meanwhile, Christians—who make up fewer than 5 percent of the population—have started opening crisis pregnancy centers and teaching churches about the sanctity of life.

Families have historically played an important role in Taiwan, but that began to change when the country experienced a period of explosive economic growth, known as the “Taiwan Miracle,” from the 1960s through the ’80s. Millions of young men and women moved from the countryside to work in urban areas. Cut off from their communities and facing endless opportunities to increase their wealth, they abandoned traditional views of marriage and childbearing and pursued careers. They said raising kids in the city cost too much and took too much time.

Compounding the problem was a change in Taiwan’s abortion law. In 1984, the government passed the Eugenic Protection Law. It legalized abortion up to six months into pregnancy in any case where the mother’s mental health or family life would be affected. It requires a woman to get the consent of her husband if married or parents if a minor. And with unwed mothers ostracized in society and parents eager to save face, consent isn’t difficult to secure. 

Taiwan has not released official abortion statistics, but in 2011 National Taiwan University College of Medicine professor and pediatrician Lue Hung-chi estimated the number to be between 300,000 and 500,000. Other doctors have agreed with the figure, while the Bureau of Health Promotion stated that doctors in Taiwan perform at least 240,000 abortions a year. If the 500,000 number is accurate, Taiwan would have one of the highest per-capita abortion rates in the world.

Located on the cluttered Zhongyi Road, a three-story vertical sign juts out from a storefront. Racks of used T-shirts and jeans spill out the front door, which opens into a thrift store filled with more clothes, Christian knickknacks, and household appliances. This is Ray of Hope, a crisis pregnancy center in the southern city of Tainan.

Up a narrow flight of stairs is a cozy counseling room with blue couches and images of developing preborn babies on the walls. Down the hall are offices for the center’s “Worth Waiting For” abstinence program, which teaches at local schools and churches. Jocelyn Zhou, a cheerful young woman from a Christian family, is the main counselor and social worker at the clinic. She chats with young women facing unplanned pregnancies and works with a nearby orphanage providing international adoptions. (Adoption is not popular in Taiwan, where many people reject the idea of raising someone else’s child. Recent changes in the adoption law make international adoptions more difficult, as well.)

Most of Zhou’s clients say they face strong pressure from boyfriends or parents to abort. So Ray of Hope also provides a safe house for women who decide to continue their pregnancies and need to escape from upset boyfriends or can’t afford housing. With an undisclosed location and tight security on every floor, the safe house provides lodging, Bible studies, job classes, and live-in counselors. 

Like many Taiwanese, Zhou said she never really thought about the sanctity of life. But then she heard about Ray of Hope through her church. As she better understood what an abortion entailed, she was horrified by it, a view that puts her outside the mainstream of her peers: “I think young people talk about it as something very normal. Teachers think [abortion] is a way to solve the problem.”

Individuals make the decisions not to have children, but the cumulative effects of all those individual decisions will have profound consequences for Taiwan. An aging society means fewer workers and more people needing government services. Yang Wen-shan, a demographer at Academia Sinica in Taipei, told The Guardian that “right now, seven working people are supporting one older person. By 2045, 1.45 people will be supporting one.” By 2060, Taiwan’s population will drop from 23 million to 19 million, according to projections from Taiwan’s Council for Economic Planning and Development.

Low birth numbers also affect education. After the birth rate hit its lowest point—0.91 in 2011—a survey by the King Car Education Foundation found that nearly 80 percent of teachers worried the low birth rate would lead to layoffs and affect their teaching career. Minister of Education Wu Ching-ji predicted in 2009 that more than 30 percent of universities would have to close in the next decade if the birth rate worsens. The government even worries it won’t have enough soldiers in case of military attack, a real concern as Taiwan maintains its tense relationship with mainland China.

And the trend in Taiwan isn’t an anomaly in the area. A look at the other countries with the lowest birth rates reveals a high concentration among well-to-do East Asian countries—Singapore, Macau (a Chinese territory), Hong Kong, and South Korea.

That’s why Mark Li (name changed for his protection) of China Life Alliance doesn’t think politics can fix the bigger problem in mainland China: “We are praying that the one-child policy would end but not just that, we are praying for God to be on the move to heal the nation and for churches to be a light.”

‘Curious about the source of our love’

Who will take care of elderly parents? That’s a question facing countries with declining birthrates. In Taiwan, the eldest son takes care of his parents, but with fewer kids, including some who have moved to America, many children have outsourced their duty to Indonesian caretakers. Almost half a million foreign workers live in Taiwan, with more than 210,000 working as domestic helpers or caregivers. 

Brokers sign young Indonesian women to three-year contracts with families that agree to provide room, board, and a salary in exchange for 24/7 care of elderly parents. Brokers take a large portion of the salary to cover the cost of bringing the girls to Taiwan, plus interest. 

Migrant workers earn much more money in Taiwan than they could at home, so they send remittances back to husbands and children they’ve left behind. It’s taxing work, living in a foreign country, learning a new language, and taking care of elderly patients suffering from such conditions as strokes or Alzheimer’s disease. Some families treat caretakers poorly, requiring them to work around the clock, leaving the house only to take out the trash or buy something at the store.

The Taiwan Industrial Evangelical Fellowship (TIEF) in Taipei sees this as an opportunity to reach out to the foreigners. Indonesia has been difficult to reach with the gospel, but now Muslim workers are coming to Taiwan, learning Chinese, and sometimes working in Christian homes. TIEF encourages churches to start language classes for caretakers who are already bringing the elderly to church. Others open “Gospel Centers” that hold classes on different subjects such as Taiwanese cooking, and create a gathering place for caretakers to relax and talk with friends.

In Kaohsiung’s Sanmin Park, Susan Yu and Wei-shin Tsay of Holy Light Theological Seminary show up every Saturday to talk with the elderly and their caretakers. They also tried reaching out to caretakers at train stations and Indonesian grocery stores, but found it difficult because the foreign workers don’t get much time off. But at the park, they realized they could befriend not only the caretakers, but the lonely elderly people who often aren’t visited by their own children.

The Indonesians are a tight-knit community, so once Yu befriended a few women, they introduced her to their friends, and they’ve been able to put together makeup tutorials, celebrate birthday parties, and hold games nights. Says Yu, “We show them that we love them, then they can be curious about the source of our love.” —A.L.

Angela Lu Fulton

Angela Lu Fulton

Angela is a senior reporter for WORLD Magazine and a part-time editor for WORLD Digital. She is a graduate of the World Journalism Institute and Northwestern University's Medill School of Journalism. Angela resides in Taipei, Taiwan. Follow her on Twitter @angela818.



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  • Joe Saur
    Posted: Mon, 04/11/2016 01:11 pm

    It is interesting to see all of the countries being reported as having less than replacement birth rates: Japan, Taiwan, all of Europe, Russia, the U.S., and on and on.  I guess when one stops reading the Bible, the bit about "Be fruitful and multiply" seems to get lost...       Joe     (Father of 12; Granddad of 15 (and counting))

  • Minivan Man's picture
    Minivan Man
    Posted: Mon, 04/11/2016 01:11 pm

    God bless the Ray of Hope clinic!So sad that people don't want children.  It's one thing to oppose abortion, but another to actually be open to children in a marriage.  So many Christians oppose abortion, but never give a second thought to their own attitude towards children.  Apparently, the Taiwanese are a little more honest.  You'll notice this quote from the 4th paragraph: "They said raising kids in the city cost too much and took too much time."  In other words, they'd prefer free time and money.  In the US, we've crafted a more altruistic defense: "We're better equipped to minister to others, and better stewards when we try to limit our offpsring."   It is an insult to God to tell him that the fruit of the womb, a handmade blessing from the Almighty is not wanted.  We treat children like some sort of extravagant toy.  We feign humility and meekness by turning them away, pretending the life that might come is purely for us.  God bless you women who have counted the cost of pregnancy and child-rearing, and remain open to the children God may bring.  I want to tell you plainly, that if you welcome a child into your life, it is as if you are welcoming Jesus Christ.  Matthew 25:40, Matthew 19:14As the article goes on, we see that not only are the Taiwanese anti-children, they are also anti-adult.  Elderly parents are sent off to be cared for by others.  And I'll bet some of those people brag about their sacrifice, paying for expensive elder care.  Is the US any different than Taiwan on this?  Who personally, literally cares for their elderly parents?  I suppose we are at least consistent though.  Our children are shipped off to daycare and abundant other programs to be raised by professionals, why would we treat our elderly any different?  The truth is, God has given us people to love in our lives, and we try to pawn them off on others.  May God have mercy on us, and continue to remove our blinders!