Dexen, 47, an ethnic Tibetan farmer, is mother to 13 children. But she did not originally intend to have so many children.
Dexen, who lives in the rural part of Nedong County in the Shannan Prefecture of Tibet Autonomous Region, southwest China, decided some years ago to take birth control measures after she had three children. But doctors found she was already pregnant with her fourth child.
After giving birth she went for a routine medical examination, and was found to be pregnant again. In the following years, Dexen became pregnant again and again until eventually - and reluctantly- she had become a "super mother".
"Too many children means a heavy burden on my family," said the worried Dexen.
"Due to limited manpower and financial resources, we cannot provide sufficient services to meet the stringent needs of people for family planning," said Purbu Zhoi'ma, director of the Family Planning Committee of Tibet Autonomous Region.
Covering more than 1.2 million sq km, Tibet has a population of 2.61 million, of whom 92.2 percent are Tibetans. On average, fewer than three people live within one sq km.
Each year, the regional family planning committee sends family planning workers to the remote countryside providing farmers and herdsmen with free medical consultations, contraceptives and medicines for such common ailments as diarrhea.
"Whenever and wherever they go, the workers are surrounded by people who urgently need help and medicines," said Purbu Zhoi'ma. Contraceptives worth nearly 2 million yuan are sent to farmers and herdsmen in remote areas annually.
In view of the region's population growth, in 1985 Tibet adopted a regulation which encouraged family planning among Tibetan cadres and workers and urged them to have two children over a period of time.
The regulation stresses prenatal and postnatal care and improved health of mothers and children among farming and herdsmen's families. It also calls for methodical measures to spread birth control information.
Han people who work and live in Tibet, are allowed to have just one child according to regulations that apply in interior areas of China.
"As far as how many children farmers and herdsmen can have, there has been no restriction," Purbu Zhoi'ma said.
Currently, each family in Tibet has three or four children on average and in grazing areas, the number is five or more. There are also families with as many children as Dexen has.
However, the new Tibetan generation living in urban areas has a different attitude from their elders: they prefer to have fewer children and a better quality of life.
Cering Zhoigar had a daughter last year and doesn't want any more children. "Both my husband and I are very busy with our job sand we want to devote time to bringing up my child," said Cering Zhoigar, who works for a
Lhasa real estate firm.
Cering Norbu, 31, a civil servant in the Qamdo Prefecture in eastern Tibet, is allowed to have two children. But he and his wife chose to have only one. "We want our child to be well educated in the future," he said.
Sometimes Purbu Zhoi'ma suggests some couples have one more child in view of their financial situation. But statistics show that more than 60 percent of urban couples choose to have one child.
"The population size does influence the economic development and social progress of a region," said Purbu Zhoi'ma. But she noted, "Emphasis should be put on improving the health of and guaranteeing education for the people."
At present, the natural population increase rate is 14 per thousand in Tibet, compared with 9.7 per thousand in interior areas of China, she said.
Thanks to improved medical services and living standards, Tibet's population has increased rapidly while the mortality rate for infants, pregnant women and women in childbirth has drastically dropped in successive years.
Purbu Zhoi'ma said Tibet had drafted a local population and family planning regulation. Drafted according to Tibet's special situation, it has been submitted to the regional people's congress for examination and discussion.
The regulation made specific suggestions for Tibet's existing family planning policies and stressed women's health care, she said.
