A number of hospital obstetrics units in China have closed, prompting discussion about the effects of China’s dramatically falling birthrate.
Several hospitals in Zhejiang province have reportedly closed or downsized their obstetrics units, along with hospitals in Jiangsu and Guangdong.
China’s birthrate fell to a record low in 2022, with just 9.56m births, a drop of nearly 10% compared with 2021. That meant the population shrank for the first time since 1961, a year of mass famine in China. The slump is fuelling a demographic crisis in China, with an ageing and shrinking population that threatens to derail the country’s GDP growth. This year India officially overtook China to become the world’s most populous country.
China’s leaders are keenly aware of the problems caused by a greying population, and officials have introduced a range of measures to try to boost the birthrate. The one-child policy was scrapped in 2016, with families now allowed to have up to three children. With young people increasingly putting off or deciding against childrearing altogether, the three-child policy is more of an ambition than a limit. Sichuan province has abandoned limits on birth registration altogether. Some local authorities offer cash subsidies for second and third children.
These policies have had little impact on the birthrate, which is in stubborn decline. The number of new births a year has nearly halved since 2016. Young women in particular often feel that the costs of raising a child are too high and that their own economic prospects are gloomy, not to mention that of the next generation. Urban, educated women are also increasingly resistant to accept the patriarchal family norms that come with having a child.
The recent hospital closures have not been officially linked to falling birthrates. In April, a health centre in Guangxi province said that it would stop offering deliveries in the obstetrics and gynaecology unit because of the increasing number of high-risk pregnancies in the district. Last month, the Second hospital of Yinzhou, a district in the eastern city of Ningbo, announced that it would no longer be offering maternal diagnosis and treatment services. The local health bureau later clarified that the obstetrics unit was being integrated with a newly-built women’s and children’s health centre at the Affiliated People’s hospital of Ningbo University, about 6 miles away. The bureau said that the number of obstetrics beds in Yinzhou had increased to 237 between 2022 and 2023.
In some cases, hospitals blamed a lack of staff rather than a lack of babies for the winding down of obstetrics services, which cover pregnancy, childbirth and the postpartum period. Two clinics in Huizhou, and one in Guangzhou, have suspended overnight services in their maternal health wards because of a lack of obstetricians and gynaecologists, according to the Paper.
But several online commentaries have linked the news to China’s population struggles. In an article published on NetEase, a Chinese content provider, a blogger with the username “Say it quickly” wrote: “The deserted obstetrics departments means that fewer women are getting pregnant … [China’s] newborn population has been declining in recent years, and the situation is not optimistic”.
One obstetrician from the Harbin maternal and child care hospital told Chinese media: “In the past, the number of births might have been seven or eight, or 10 in a day, now it can be one every few days. If there is one a day, that’s great.”
Additional research by Chi Hui Lin
