For every pregnancy leading to a Taiwanese woman giving birth, a remarkable three are estimated by a Taiwan pediatrician to have been aborted, a figure that others believe isn’t too far from reality.

When on July 17 the veteran National Taiwan University College of Medicine professor and pediatrician Lue Hung-chi told a forum that 300,000 to 500,000 abortions are carried out in Taiwan each year, he was seeking to send alarm bells ringing. If his estimate is true, it has to be one of the highest per-capita abortion rates in the world.

Statistics show that the country has one of the lowest total fertility rates in Asia, apparently driven at least partly by the ready availability of the abortion drug RU-486. The government announced earlier this year that the average number of children a Taiwanese woman would have in her lifetime was the lowest in the island’s history, at 0.91 per woman.

In fact Taiwan’s total fertility rate appears to be the lowest rate any country has recorded anywhere, according to the Population Reference Bureau, although 2010 was an abnormal year, since families were putting off having children because babies born in the Year of the Tiger are thought to be quick-tempered and willful. For whatever reason, the low birthrate was recently declared a national security issue by President Ma Ying-Jeou.

With only 166,000 babies born on the island in 2010, Lue said, the government should act urgently to tighten the island liberal abortion law, which stipulates that a woman can undergo an induced abortion “if the pregnancy adversely affects the psychological or physical health of the woman or her family life.”

Measures should be implemented to encourage people to have children, counseling should be provided and an environment created that facilitates adoption, Lue told Asia Sentinel.

“Children's health care in Taiwan is terribly underfunded. The national health system is not in favor of pediatrics,” Leu said, which he blamed as part of the reason for the low birth rate. “In over 30 percent of Taiwan's towns no pediatrician can be found.”

Lue made it clear that his estimate is just that.

“In Taiwan, there is no solid data available,” he said. “Of course, the figures I mentioned include pregnancies that are ended with the abortion drug RU-486.”

The most recent official data on abortion numbers is over a decade old. In 1999, 42,282 legal abortions were performed compared to 283,661 births. In the absence of authoritative statistics, what's left is anecdotal evidence and assumptions of those who work or do research in the field.

Some believe the figures are lower. Lee Mao-sheng, a professor at Chung Shan Medical University's College of Medicine, believes the figure could be 80,000-100,000 with the number possibly being as high as 150,000 if illegal abortions were counted.

Chao Kun-yu, deputy director-general of the Bureau of Health Promotion, said that including RU486, roughly 240,000 abortions are carried out legally per year. Pan Hun-shan, a physician with the Obstetrics and Gynecology Department at Shin Kong Wu Ho-su Memorial Hospital, believes the 300,000 to 500,000 figure to be realistic, saying that one to two mothers out of every ten who visited his hospital were there seeking abortions. Pan suspects that the percentage is significantly higher in private clinics.

Taiwan's demographers agree that it's obvious that the birth-abortion ratio is dangerously skewed.

“Demographers in Taiwan can only do their best by conjecture,” Yang Wen-Shan, a professor at Academia Sinica's Research Center for Humanities and Social Sciences, told said in an interview. “The health authority may have some estimated number of aborted fetuses, but it is never reported in the public domain.”

Every year, Yang aid, “there are around 13,000 births given by teenagers. If 90 percent of the total number of teenage girls who become pregnant would not want to give birth before they enter into marriages, we estimate that there are around 130,000 aborted fetuses by teenagers alone.”

Social demographers commonly conclude that there are around 200,000 abortions in Taiwan annually, and suggested that the 500,000 figure mentioned by pediatrician Lue came about through the estimate that each of the RU486 pills sold is counted as an abortion.

Yang agreed, however, that the high abortion rate for a good part is to blame on the lack of an adequate adoption system.

“Many of my colleagues argue that if the government would change the child adoption system in Taiwan, every year we can save enough babies to make up the deficits of the lowest-low fertility situation,” he said.

“The abortion rates are higher for unmarried women,” he continued.”According to the statistics, approximately 90 percent of them will make a decision to abort the fetus. Also women with higher parity [the number of times a woman has given birth] have higher rate of abortion, women whose husbands have higher socioeconomic status, as well as those of older age that had already given birth to a baby boy.”

Gender-selective abortions -- aborting girls before their would-be mothers had their first boy – has also led to an alarming gender imbalance. The practice, found in much of Asia, is mainly due to the belief that males will carry on the family name. By regional comparison, only South Korea and China account for male-to-female infant ratios roughly as unnatural as that of Taiwan.

In 2010, in Taiwan 1.09 males were born for every one female, while in South Korea and China the figure was 1.07 and 1.133, respectively. Taiwanese health authorities estimate that last year alone more than 3,000 female fetuses were selectively aborted on the island but prosecutors have a hard time fighting the practice because doctors often have blood samples screened by outside laboratories, meaning there is no evidence.

Unlike in the West, abortion has never been a polarizing issue in Taiwan. Neither NGOs nor public advocacy groups vociferously discourage abortion, and even the churches are remarkably quiet. Abortion was legalized in 1985 and has been generally accepted, mainly because of the stigma associated with unwed motherhood. In recent years, however, the prohibiting cost of education is overwhelmingly cited as reasons for couples not wanting children. Some 75 percent of Taiwan's children visit cram schools where tuition fees for one child alone can easily account for 25 percent of a worker's monthly income.

“Taiwan's abortion rate is high mainly because the economic growth rate is low,” said Tim Wang, deputy director of the ruling Kuomintang’s (KMT) Youth Department. “As government debts account for NT$5 trillion [US$173 billion], we can say once the child is born, it owes the country NT$200,000. Under these circumstances, young couples don't want to raise children.”

In the past, to the Taiwanese, as for societies elsewhere, it was the more children, the better. This was because filial support formed the by far most important financial pillar of retirement. But also this rationale to bear offspring has all but ceased to exist.

“Few people regard children as a means of support after retirement. Most Taiwanese who want to have children do so because they love kids,” said Joseph Tien, an assistant professor at Tamkang University's Department of Insurance. Investment-linked insurance has replaced the traditional filial support as the main means to prepare for retirement, he added.

In the eyes of pediatrician Lue, Taiwan's suspected shockingly high abortion rate has to be taken on top-down by Taiwan's policymakers.

“We cannot demand young pregnant women to think of the nation; it's the government that must think of the nation,” Lue said.