THE INTRODUCTION OF China’s universal two-child policy, that permits all couples to have two children, has led to an extra 5.4 million births, according to new research.

The policy, which was announced in October 2015, was enacted to reverse the nation’s stagnant population growth and shrinking workforce in a bid to prevent an economic downturn. 

In the previous 35 years, the country had operated a strict one-child policy, with some exceptions, in a bid to control its growing population. The long-term impacts of this policy are still being felt and likely will be for decades to come.

The old policy, when combined with a cultural preference for boys and sex-selective abortions, also impacted the gender ratio of the population. 

There are about 1.4 billion people living in China – making it the largest country in the world – about 718 million males and 675 million females. By 2050, it’s expected that 330 million Chinese people will be over the age of 65. 

A new study, published in the British Medical Journal, is the first research to use national data to estimate the impacts of the two-child policy change. Births have increased in the last four years, but not as much as some government officials had hoped.

The policy targeted some 90 million women of reproductive age who already had a child, and now would be allowed to have a second child.

There has been much speculation about the impact of the policy, with projections ranging from slightly over one million births to more than 20 million births each year.

However, research to date has been limited. In the new study, a team of researchers based in China and the US set out to measure changes in births since the policy was introduced. 

They compared the number of births in two phases: up to and including June 2016, nine months after the announcement, and from July 2016 to December 2017.

Their findings are based on 67.8 million births in 28 of the 31 provinces of mainland China, an average of 1.41 million births per month.

The researchers estimate that an additional 5.4 million births happened as a result of the new policy during the first 18 months that it was in effect. And for the first time, the number of births to those who had given birth previously exceeded births to first-time mothers.

The policy was also associated with a 59% average increase in births to ‘older mothers’ (35 years or older), but there was no accompanying increase in premature births.

The researchers also found there was a slight decrease in caesarean-section deliveries among first-time mothers.

However, they point out that many of the changes associated with the policy, including the increase in births, appeared to diminish at the end of the study period, raising questions about whether the policy’s effects will be sustained.

Rule progressively relaxed 

The study is observational, so can’t establish cause, but the researchers said their findings clearly show that births increased in response to the policy, albeit not as much as some policymakers had wanted. 

Although they found no significant increase in premature births, the researchers stated that “more work is needed to document and ensure the health of an increasingly older maternal population of second-time mothers in a nation where caesarean delivery rates are high”.

They added that further is needed “to develop a more nuanced understanding of the sustained impact of this historic change on the world’s largest nation”.

The strict one-child rule had been progressively relaxed, particularly in rural areas, before being abolished. In 2013, Beijing announced that couples could have two children if either of them was an only child. 

When the two-child policy was introduced in 2015, experts said it could take around 15 years before any economic benefits would be seen. 

The one-child policy was widely criticised by human rights organisations.

When it was abolished in 2015, William Nee of Amnesty International said: “The move to change China’s one-child policy is not enough. Couples that have two children could still be subjected to coercive and intrusive forms of contraception, and even forced abortions – which amount to torture.

“The state has no business regulating how many children people have. If China is serious about respecting human rights, the government should immediately end such invasive and punitive controls over people’s decisions to plan families and have children.”

Contains reporting from © AFP 2019