For decades, abortion was freely available to women in China. In fact, as a tool of the one-child policy, it was traumatically forced on women to make them conform to the state’s need to reduce the population.

But now that China is far more worried about its shrinking population, it seems to be reversing course and moving towards more carefully controlling how woman access abortion. In other words, abortion will continue to be a tool of state policy in China—it’s just that the policy has changed.

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Buried in a State Council document outlining a slew of health, education, and employment measures the government said are aimed at improving equality for women over the next decade, China noted that it would strive to “reduce non-medical abortion,” without providing further details.

While it’s unclear immediately how this might change the process of having an abortion, access in some provinces has tightened in recent years. In 2018, Jiangxi province moved to require women more than 14 weeks pregnant to have multiple medical professionals sign off that their abortion was medically required.

China abandoned the one-child policy in 2015, amid evidence that the strict birth controls had gone too far. The one-child policy not only meant that over time younger generations became smaller in size than older ones, but also led to a skewed sex ratio in favor of men that is also limiting the number of births taking place now. But the relaxation appears to have made little difference. In 2020, an estimated 12 million babies were born in China, while the population over 65 is expected to cross 300 million by 2025.

This year China announced a three-child policy, a decision that was met with a wave of criticism pointing out child care costs and workplace discrimination that women face, contributing to their desire to have fewer children.

The State Council document also pledges to address these factors, vowing to end workplace discrimination and improve opportunities for women, consider more favorable tax policies that allow deductions for childcare, and promote socialist families where housework is equally shared between men and women. While all of that sounds great, for many women, already the focus of state propaganda to start a family, the brief phrase about abortion is likely to produce concern that their ability to make decisions about ending an unwanted pregnancy could be curtailed.

“This is Texas marching into China,” said a Weibo user about the news, referring to the US state’s recent decision early this month to ban all abortions as soon as a fetal heartbeat is detected. “My female friends have already started discussing getting sterilization,” said another.

But Xiong Jing, a prominent Chinese feminist activist, noted that much would depend on the actual implementation of the phrase, pointing to the document’s overall focus on improving equity, including improving sexual education in school and promoting the sharing of the burden for contraception between men and women more equally.

“As there is only one line about the reduction in abortions in the outline, and given it is only a guidance document, we need to observe how the execution will look like in real life, such as whether public hospitals will have any restrictions or standardization on abortions,” said Xiong.

Meanwhile, it’s worth asking whether China’s concerns about the population will ever temper the state’s tendency to strongly promote having children within marriage. Chinese law currently prohibits unmarried women from accessing fertility services such as egg freezing, a policy that one Chinese woman, Teresa Xu, has brought a legal challenge over. The policy document also says it plans to make changes in the provision of fertility services, but whether that will include helping women to start families without a patriarch remains to be seen.

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