Amazon Studios

Early on in Nanfu Wang and Jialing Zhang’s new documentary, One Child Nation, an 84-year-old midwife is asked how many babies she has delivered throughout her career. She brushes the question aside and instead spills out a startling admission. “I really don’t know how many I delivered. What I do know is that I’ve done a total of between 50,000 to 60,000 sterilizations and abortions,” she says.

The scene that follows is astonishing, not only for plainly illustrating the horror and scale of the film’s subject—the far-reaching consequences of China’s one-child policy—but also for the exceptional nature of the confession. “I counted this out of guilt, because I aborted and killed babies,” the midwife, Huaru Yuan, continues. “Many I induced alive and killed. My hands trembled doing it.” Since retiring, Yuan has dedicated her life to treating families struggling with infertility, as a kind of spiritual penance. But retribution will one day come for her, she says, her voice bereft of self-pity.

Yuan’s words set the tone for the rest of the film, which investigates a huge network of human-rights violations in empathetic and intimate terms. The movie, which took home the U.S. Grand Jury Prize: Documentary at the Sundance Film Festival earlier this year and opened in select theaters on Friday, is framed in part as a personal essay from Wang. Born in China early during its one-child-policy era, the 33-year-old co-director was largely ignorant of its implications until she herself became pregnant and was spurred to examine the law’s history. The realities of the policy are described by various people who were tangled in its web: a former village official tasked with enforcement, an ex–human trafficker who sold infants to orphanages, and members of Wang’s own family who relinquished their newborns.

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.

The film argues that its subjects are victims themselves: Their trauma and pain are just as real as the harm they admit to carrying out, and their actions didn’t occur in a vacuum. “It takes a lot of courage, but also a lot of information, for someone to recognize the right and the wrong when the order is coming from above,” Wang told me. Having grown up in China’s Jiangxi province, she said her own initial perspective on the policy was warped by an immense propaganda machine. Songs, media, and “the background of life” were plastered with messages about the one-child rule’s inherent righteousness.

It’s no surprise, then, that members of the generation before Wang—those who witnessed and endured the early stages of the law—display a kind of cognitive dissonance. “All the people who resisted and suffered, if you ask them today—my mom, my grandpa, and my aunt, my uncle—everyone would still say the policy was necessary and eventually positive,” Wang said. Throughout the film, these older folks return to the same sentiment. When asked if she hates the policy, Wang’s aunt, who also expresses longing for the daughter she gave away, says, “What’s to hate? Policy is policy.” An old village official, who recoils at his memories of the law in action, echoes this answer when Wang asks whether its implementation was cruel. “It might be cruel. But policy is policy,” he says. “What could we do?”

When the state strips a population of its agency, there is little room to consider individual ethical imperatives or personal conscience, One Child Nation suggests. What’s left is a stoic refrain—Policy is policy—that might sound to viewers like a way of coping. At the end of these conversations, Wang and Zhang often leave the audience with lengthy shots of their subjects in silence, as if the quiet is a reminder of what they must live with.

For some, the repression that One Child Nation delves into may feel remote. But the matter of individual agency pulls U.S. audiences into the film’s implications. “I’m struck by the irony that I left a country where the government forced women to abort, and I moved to another country where governments restrict abortions,” Wang, who lives in New Jersey, narrates toward the end of the documentary. “On the surface, this seemed like opposites. But both are about taking away women’s control of their own bodies.” The line is a brief and isolated bit of commentary on American politics, but the comparison is striking after what viewers have witnessed.

The story that One Child Nation tells is about the past. In 2015, the country adopted a two-child policy, a change that prompted renewed reflections on the human- and reproductive-rights violations carried out in the law’s name. Outdated, propagandistic slogans on buildings in China have been scrubbed and replaced by signs celebrating the paradigm of the two-child household. But the film—traces of which have been censored online in mainland China, Wang said—insists that what happened shouldn’t be forgotten, especially as familiar tactics of violence and disinformation are replicated in service of other national measures. The movie seeks to be an essential historical document—and a kind of warning to audiences both in China and elsewhere. History can repeat itself, Wang told me, in eerily similar ways and in places we might not expect.

We want to hear what you think about this article. Submit a letter to the editor or write to letters@theatlantic.com.