Although China’s one-child policy ended years ago, the consequences of forced abortions, sterilizations, abandoned newborns, and government abductions are just being realized.

“One Child Nation,” a documentary by Amazon Studios, hits theaters Friday, detailing the devastation felt by parents forced to abandon their children, in many cases knowing they would die, and women forced to have abortions or sterilizations “tied like pigs” to satisfy the Communist Party from 1979 until 2015 — similar to human rights abuses reported in North Korea.

“Every woman has almost gone through a forced abortion or forced sterilization,” Nanfu Wang, co-director and producer of the documentary, told PBS. “Sometimes the babies … they were born alive, and because of the policy and her job, she had to kill them after they were born alive, and she is really traumatized because of that.”

Wang spoke to the midwife who delivered her, who admitted performing 50,000 to 60,000 abortions over her time to enact a policy that the government claims prevented 400 million births.

“I was the one who killed. I was the executioner,” the midwife said. “The state gave the orders, but I carried it out.”

The film’s preview says it “will challenge the way you think.” But Wang said her family, after decades of propaganda, still believes the policy was a good thing for China overall.

Wang’s uncle describes abandoning his own newborn daughter, hoping someone would adopt her, but he found her the next day dead, covered with bugs.

“My mom threatened to kill herself and said, ‘If you keep this baby girl, I will either kill myself or I will strangle her to death first before killing myself,'” he shared. “I thought I could save her life by giving her away but she ended up dead.”

Almost every person they spoke to said they didn’t have a choice, from family planning officials to midwives to ordinary Chinese citizens.

Wang asks in the film: “What made these good people do evil things?”

While the Chinese government has said it is in the process of ending all population control policies, the crackdown on religion has intensified.