Chinese people are having fewer kids — so much so that many hospitals in China have stopped delivery services altogether, as a state-owned newspaper noted on March 18. In 2023, some hospitals in China shut down their obstetrics departments.
The closures appear to be accelerating this year. Hospitals that have closed obstetrics departments this year include the Fifth People’s Hospital of Ganzhou City in southeastern China and the Jiangshan Hospital of Traditional Medicine in the eastern province of Zhejiang.
Fewer closures have occurred in inland Chinese provinces, where the average number of children per women is still higher, although low compared to most of the world. There are coastal provinces like Shanghai, Tianjin (near Beijing), Heilongjiang (in Manchuria) where the average woman has less than 0.7 children and the annual birth rate is less than 5 per 1,000 people. By contrast, sparsely-populated inland provinces have higher birth rates. In Tibet, the average woman has closer to 2 kids. More prosperous coastal areas tend to have slightly higher birthrates than coastal areas with aging smokestack industries, but all densely populated coastal areas now have very low birthrates.
The Jiangxi hospital announced that the closure was because of the institute’s “development plan,” while the Zhejiang facility declared that the decision was made based on business considerations.
The number of maternity hospitals in China fell from 807 in 2020 to 793 in 2021, according to the most recent available official data. In 2024, the number is probably below 700.
The closures came as China’s population — the world’s second-largest after India — fell for a second straight year in 2023, a trend that is destined to have big consequences for the world’s biggest manufacturing economy.
China, which once limited couples in urban areas to just one child, has changed policies to the exact opposite, instituting policies to incentivize marriage, parenthood, and childbearing. Such incentives include money, subsidized access to various things, and free public transport.
But it isn’t having much effect: China’s birth rate fell from 6.77 births per 1,000 people in 2022 to a record low of 6.39 births per 1,000 people last year.
Chinese women say they are hesitant to have kids because of the cost and commitment it entails.
