exponentially increasing population size. The government planned to use education and publicity as their main modes of increasing awareness. Zhou Enlai launched the first program for smaller families under the guidance of Madame Li Teh-chuan, the Minister of Health at the time. During this time, family planning and contraceptive usage were highly publicized and encouraged. The One-child policy, initiated in 1978 and first applied in 1979, mandated that each married couple may bear only one child except in the case of special circumstances. These conditions included, "the birth of a first child who has developed a non-hereditary disability that will make it difficult to perform productive labour later in life, the fact that both husband and wife are themselves single children, a misdiagnosis of barrenness in the wife combined with a passage of more than five years after the adoption of a child, and a remarrying husband and wife who have between them only one child." The law was replaced by a two-child policy in 2015, and then a three-child policy in 2021. On July 26, 2021, all restrictions were lifted, allowing Chinese couples to have any number of children. Sex selective abortion In China, males are thought to be of greater value to a family because they take on greater responsibilities, have the capacity to earn higher wages, continue the family line, receive an inheritance, and are able to care for their elderly parents. The preference for sons coupled with the one-child-policy have led to a high rate of sex selective abortion in China. Therefore, mainland China has a highly masculine sex ratio. Amartya Sen, the Nobel Prize-winning economist, asserted in 1990 that over 100 million women were missing globally, with 50 million women missing from China alone. Sen attributed the deficit in the number of women to sex-selective abortion, female infanticide, and inadequate nutrition for girls, all of which have been encouraged by the One-child policy. The sex ratio between male and female births in mainland China reached 117:100 in the year 2000, substantially more masculine than the natural baseline, which ranges between 103:100 and 107:100. It had risen from 108:100 in 1981—at the boundary of the natural baseline—to 111:100 in 1990. According to a report by the State Population and Family Planning Commission, there will be 30 million more men than women in 2020, potentially leading to social instability. As the One-child policy limits the number of