<P> For parents who had "unauthorized" births or who wanted a son but had a daughter, giving up the child for adoption was a kind of strategy to avoid penalties under one - child restrictions . In fact, "out adoption" was not uncommon in China even before birth planning . In the 1980s, adoptions of daughters accounted for slightly above half of the so - called "missing girls," as out - adopted daughters often went unreported in censuses and survey and adoptive parents were not penalized for violating birth quotas However, in 1991, a central decree attempted to close off this loophole by raising penalties and levying those penalties on any household that had an "unauthorized" child, including those that had adopted children . This closing of the adoption loophole resulted in the abandonment of some two million Chinese children (mostly daughters), many of who ended up in orphanages, some 120,000 of whom would be adopted by international parents . </P> <P> The peak wave of abandonment occurred in the 1990s, with a smaller wave after 2000 . Around the same time, poor care and high mortality rates in some state orphanages generated intense international pressure for reform . </P> <P> After 2005, the number of international adoptions declined, due both to falling birth rates and the related increase in demand for adoptions by Chinese parents themselves . In an interview with National Public Radio on 30 October 2015, Adam Pertman, president and CEO of the National Center on Adoption and Permanency, indicated that "the infant girls of yesteryear have not been available, if you will, for five, seven years . China has been...trying to keep the girls within the country...And the consequence is that, today, rather than those young girls who used to be available--primarily girls--today, it's older children, children with special needs, children in sibling groups . It's very, very different ." </P> <P> Since there are no penalties for multiple births, it is believed that an increasing number of couples are turning to fertility medicines to induce the conception of twins . According to a 2006 China Daily report, the number of twins born per year was estimated to have doubled . </P>

China one child policy how does it work