During the 35 years when it was in effect, from 1980 to 2015, the one-child policy was often framed by the international media as a notable example of a strict government known for emphasizing the country over the individual. Despite moments of scrutiny, coverage of the rule in recent years—in both a heavily censored China and abroad—has mostly consisted of narratives quantifying the policy’s economic and demographic effects, rather than exploring the details of how it was carried out. Many commentators have characterized the law as an austere but reasonable sanction: At the time of the policy’s adoption, China’s government forecast widespread famine as the country’s population neared 1 billion people. As a result of the estimated 400 million births prevented, the standard of living in China has consistently climbed.

But the logic of pragmatism seems absurd, almost irrelevant, in light of the human costs laid out in One Child Nation. “In those days, women were abducted by government officials, tied up and dragged to us like pigs,” Yuan, the midwife, recalls in the documentary. She describes traveling the country performing sterilizations and abortions, most of which were coerced by family-planning officials. Parents who resisted were detained, their homes demolished, Yuan says. The most haunting scene of the film is wordless—a nearly unbearable sequence of images revealing what appear to be full-term fetuses discarded in garbage heaps.

As One Child Nation continues, the trail of horrors it depicts becomes long and winding. When China opened its doors to international adoption in 1992, many state-run orphanages became sites for human trafficking. Through her interviews, Wang learns about how newborns from families who violated the policy were kidnapped by family-planning officials and sold to orphanages, a detail that was repressed by the government (in the film, Wang speaks with a journalist who was eventually forced to flee to Hong Kong because of his reporting). To this day, many adoptees—and their families—find learning the truth about their origins nearly impossible.

A significant number of the babies sold were abandoned by their families or given to “matchmakers” for adoption. Many of the infants were girls given up by parents who hoped instead for a male child to carry on the family name. In one scene, Wang’s uncle recalls the loss of his newborn daughter, who was left on a meat counter in a market and died two days later when no one took her. Another of Wang’s relatives talks about how she gave away her own daughter to a human trafficker, fearing the child would die if abandoned.

Throughout One Child Nation, Wang never indicts her subjects, nor is her interview technique one of coaxing out truths. “These individuals did not have a choice. [Zhang and I] didn’t want [audiences] to look at them and think they are just evil or backwards or stereotypical,” Wang told me. Indeed, the stories in the film are complicated. Wang’s uncle says his mother demanded that he give his daughter away, threatening to commit suicide or to kill the baby herself before taking her own life. “I thought I could save her life by giving her away. But she ended up dead,” Wang’s uncle says, a sadness welling in his eyes. The moral calculus behind these situations—nurses performing forced abortions, families abandoning newborns, and traffickers (many of whom were saving babies from certain death) selling them—may seem muddied, but One Child Nation seeks to cast the state as the sole and true perpetrator.