Free college and IVF help: China hunts for ways to raise its birthrate

At China’s annual parliamentary meeting this week, proposals to boost China’s falling birthrate have come thick and fast. On Wednesday, the All China Women’s Federation, a state-backed organisation, called for a national publicity campaign to “advocate a positive concept of marriage and childbearing”, through film and television. Other delegates to China’s parliament have called for tax breaks for companies that employ more mothers, opening up maternity insurance to college students, free college education for families who have a third child born after 2024 and allowing unmarried women to access fertility services.

Last year China’s birthrate fell to 6.77 per 1,000 people, the lowest on record. In 2022 the population shrank by 850,000, the first decline since 1961, a year of famine.

Some areas have already started rolling out pro-fertility policies. In February, Sichuan, a province of more than 80 million people, removed all restrictions on birth registrations, abandoning rules that had previously meant that only married couples could register newborns. Some provinces offer newlyweds paid leave in a bid to encourage marriage and boost the birthrate. In Hangzhou, the capital of Zhejiang province on the east coast, one health insurance scheme is offering couples 3,000 yuan (£364) reimbursements for IVF treatments.

Between 2016 and 2021, the number of medical institutions approved to offer assisted reproductive technology increased from 451 to 539, according to data from the National Health and Medical Commission.

But for the millions of young women in China who are delaying having children, or deciding against it altogether, these policies barely scratch the surface on a profound generational and economic shift that has made small families the norm.

‘One child’ legacy

In 1979 China introduced a one-child policy which limited births via a brutal regime of forced abortions, sterilisations and fines. The government claims that the policy prevented 400 million births, although many demographers think that this is an overestimate. In an influential paper published in 2015, sociologists Martin King Whyte, Wang Feng and Yong Cai noted: “Despite the coercive ferocity of the campaign, China’s rapid economic development since 1980 deserves the lion’s share of the credit” for China’s declining birthrate.

And so it is perhaps unsurprising that although the policy was lifted in 2016, economic factors have continued to limit family sizes.

For Yu Ke, a 29-year-old manager in Hangzhou, there are “three big problems” preventing her having a baby.

“Firstly, the housing price is too high. Secondly, medical costs are too high. Thirdly, educational costs are too high,” she says.

Both her and her partner would need to work full-time to be able to afford an apartment big enough to raise a child in, which she estimates would cost 3m yuan (£364,000) for a 60 square metre unit in Hangzhou. But that would leave no one at home to care for the newborn. “And if our parents came to help us take care of the child, the house would be too small for everyone,” she says.

Last year China’s population shrank for the first time since 1961. Photograph: AFP/Getty Images

Maternity benefits vary depending on the province. From this year Zhejiang will offer 5,000 yuan subsidies to two-child families, and 20,000 yuan grants to third-borns. In Shanghai mothers are offered 4,200 yuan towards their childbirth-related medical expenses. But that is a drop in the ocean when faced with a lifetime of soaring costs.

Benefits ‘unlikely to work’

In 2022, the cost of raising a child in an urban area was estimated to be 630,000 yuan each year from birth to 17. In 2019, a study from the Shanghai Academy of Social Sciences estimated that low-income families, defined as households with an annual income of less than 50,000 yuan, spend over 70% of their earnings on one child.

Government subsidies are “a joke”, says Huang Liqi*, a 29-year-old lawyer in Hangzhou who is also putting off motherhood. “They have absolutely no idea how much it costs to have a child.”

Without changing workplace norms and promoting gender equality at home, benefits will have little impact, says Yun Zhou, a sociologist at the University of Michigan. “These financial incentives have not worked elsewhere and are unlikely to work in China,” she told the Guardian.

Apart from benefits, policies aimed at easing the bureaucratic restrictions around childbirth are also limited in scope, despite grand ambitions. Sichuan’s decision to remove restrictions on birth registrations was “purely administrative”, notes Zhou. It means that the health bureau will be able to collect better data on the number of births in Sichuan, but it is not a sign that the local government will make it easier for all families, particularly single mothers, to raise children. “Unmarried mothers still face a lot of hurdles in trying to access maternal benefits,” Zhou said.

Single women are still banned from freezing their eggs, for example, despite legal challenges. And accessing maternal insurance and maternity leave often requires a marriage certificate. Even in places where the local authorities have tried to ease such restrictions, in practice local officials often demand to see marriage certificates.

When it comes to single mothers, some “discriminatory policies such as the inability to register births, the expulsion of civil servants and even the need to pay fines are changing”, says a lawyer who helps single mothers access their legal rights. But “regulations and practices are still not uniform”.

Many women, married or otherwise, fear the impact that childbearing would have on their career. Employers in China still sometimes ask women about their family planning in job interviews, despite the practice being banned in 2019. In some cases women are asked to sign contracts promising not to get pregnant within a certain timeframe.

Yu Ke worries that her status as an unmarried, childless young woman will make it hard for her to join a new company. “So having a child or not having a child, both will impact women in the workplace. Even if I tell a job that I won’t have a child, they may still suspect me.”

There is still a “pervasive sense of discrimination and inequality in the labour market,” says Zhou.

China’s fertility policies emphasise a “conservative cultural ideology”, says Hongwei Bao a professor at the University of Nottingham. In particular, pro-natalist policies are “hostile to young women and LGBTQ+ people”.

If the government truly wants to increase the fertility rate, it needs to protect women’s reproductive rights and interests, says the lawyer who helps single mothers. “Not only for married childbirths, but also for single parents and gay families”. “The limitations are still greater than the support,” for childrearing, she added.

Those limitations worry a generation of urban young women who are increasingly independent, outspoken and unwilling to settle into the domestic sphere. “When I talk to my girlfriends,” says Huang, the lawyer in Hangzhou, “I see an awakening of female consciousness … these women are not like the Chinese women in the past”.

*Names have been changed