China’s strict enforcement of a controversial family planning policy has led to extreme birth control measures, including more than 330 million abortions, official data from the health ministry has revealed.

There have been 336 abortions since the Chinese government first introduced the one-child policy to curb the country’s ballooning population in 1971. Almost 200 million men and women have undergone sterilization while 403 million intra-uterine devices have inserted in women, reportedly sometimes by force.

According to government data, China records 13 million abortions annually, or 1,500 every hour, reports The Daily Telegraph.

The Chinese government has previously estimated that without the restrictions, the country’s 1.3 billion-population would be 30% larger.

But the policy has now been blamed for the country’s aging population. Last year, China’s dependency ratio – which compares the potential workforce with the number of children and retirees – rose last year for the first time in almost a half-century.

“This makes China’s population look more like a developed country than a developing one, which is a key disadvantage in labour-intensive industries,” Ken Peng, an economist with BNP Paribas, told the Financial Times.

The birth restrictions have also led to a severe gender imbalance because of a traditional preference for male children and the selective abortion of female foetuses, reports the FT.

China’s newly appointed leader Xi Jinping has vowed to fold the family planning commission into the Health Ministry.

“We need to find a new family-planning policy to fit with the times,” said Huang Jiefu, former vice minister at the Health Ministry.