China has unveiled a plan to make childbirth essentially free under its national medical insurance system by 2026, as authorities intensify efforts to reduce family financial burdens and build a more birth-friendly society amid declining fertility rates.
The policy was announced at a recent national healthcare security conference and aims to ensure that the basic medical costs of childbirth are fully covered nationwide. Under the plan, families will no longer bear out-of-pocket expenses for standard delivery services within approved insurance policy limits.
Several regions have already taken the lead. Seven provincial-level areas, including Shandong, one of China’s most populous provinces, currently provide full coverage for in-hospital childbirth medical expenses within policy scope.
Zhao Chunmei, vice president of a women and children’s hospital in Jinan, Shandong, said the reforms have significantly eased the cost burden on families. According to Zhao, women covered by employee maternity insurance at her hospital typically pay less than 1,000 yuan (about 141.53 U.S. dollars) out of pocket for a standard delivery, a sharp reduction from previous years.
“The costs have dropped sharply, significantly easing the financial burden on families,” she said.
Authorities clarified that the free-childbirth policy will apply only to standard medical services. Expenses incurred at premium-priced hospitals or for drugs and materials outside the basic insurance catalog will not be reimbursed.
The National Healthcare Security Administration also announced plans to expand maternity insurance coverage to include flexible workers, migrant workers and individuals engaged in new forms of employment. Officials added that coverage for prenatal checkups will be gradually expanded, subject to the sustainability of the national medical insurance fund.
China’s fertility rate has remained low for several years, and the country has experienced population decline since 2022. With a population of about 1.4 billion, demographic pressures linked to aging and low birth rates have become a key policy concern. This year’s Central Economic Work Conference included fertility policy on its agenda, emphasizing efforts to “stabilize the number of newborns.”
In recent years, the government has rolled out a series of measures aimed at supporting families and reducing the cost of child-rearing. In July, China introduced its first nationwide childcare subsidy program, which will provide families with an annual subsidy of 3,600 yuan for each child under the age of three starting January 1, 2025. The program is expected to benefit more than 20 million families each year.
“This marks China’s first direct cash subsidies for all families with children, sending a clear message that raising children is a shared responsibility of the country, society and families,” said Du Min, a researcher at the China Population and Development Research Center.
The government has also begun phasing in free preschool education, waiving care and education fees for children in their final year of kindergarten starting from the autumn semester this year. Officials estimate the policy will reduce household spending by about 20 billion yuan in the current autumn semester alone.
In addition, assisted reproductive services are now covered by medical insurance across all 31 provincial-level regions and the Xinjiang Production and Construction Corps. Painless delivery services are also included in insurance coverage in certain areas.
The expanding policy package has drawn widespread public attention, particularly on social media. While many netizens welcomed the financial relief, others raised concerns about broader issues such as childcare availability, parenting pressures and work-life balance.
One Weibo user expressed hope that more comprehensive policies would follow to address the full range of challenges associated with having and raising children.
Economist Luo Zhiheng noted that Chinese policymakers are increasingly prioritizing investment in human capital, focusing on initiatives that enhance people’s capabilities throughout their lives, including childcare, healthcare, education and skills training.
“Investment should be linked to population mobility, demographic structure and measures to raise the fertility rate,” Luo said. “The government should increase funding to further lower the costs of childbirth, education and child-rearing, thereby boosting people’s willingness to have children.”
China currently has about 126,000 childcare service institutions offering a total of 6.657 million childcare spots, with publicly accessible spots rising to 4.73 per 1,000 people.
In Meishan, Sichuan Province, for example, a local childcare center provides health checkups and developmental screenings alongside childcare services. The center, which accommodates 140 children, offers full-day, half-day and hourly care for children aged zero to three.
Looking ahead, these policies are expected to continue and expand. According to recommendations for China’s 15th Five-Year Plan (2026–2030), the country aims to promote positive views on marriage and childbearing, refine incentives to boost birth rates, and further reduce the costs of childbirth, parenting and education through subsidies and personal income tax credits.
