China's hospitals are stopping newborn deliveries as population shrinks
Semafor Signals
Supported by
Insights from Health Circle, Physician’s Journal, and Korea JoongAng Daily
The News
Hospitals across China are shutting down their newborn delivery services, faced with a declining population that has led to a sharp decrease in demand.
While the exact number of hospitals that no longer deliver newborns remains unclear, Semafor found at least four hospitals across three provinces who announced the closure of their obstetrics departments on the social media platform WeChat in the last month alone.
China’s population fell for a second consecutive year in 2023 due to a record-low birth rate and high deaths due to COVID-19, Reuters reported. The decline has put Beijing on alert as it rushes to boost the recovery of its post-pandemic economy.
The country’s declining population is forcing hospitals to choose to sacrifice once-vital services in order to prioritize its aging population. Fertility-boosting measures are failing as increasing numbers of young people refuse to have children, owing to factors such as high unemployment, falling wages and a patriarchal society that puts much of the burden of caregiving on women.
SIGNALS
Rural hospitals are underfunded and obstetrics strains their budgets
China’s hospitals — particularly rural ones — are facing the strain of the country’s aging population: fewer taxpayers are paying for the more expensive healthcare needed to treat elderly patients, according to Health Circle, a Chinese healthcare blog. Faced with dwindling resources, hospital managers are cutting programs and units that bring in less revenue, including obstetrics, which costs more money to operate than it makes, China’s Physician’s Journal reported. While acknowledging it would be unpopular, the paper suggests increasing fees for obstetrics services, otherwise safe access to maternal healthcare “cannot be guaranteed.”
Beijing can’t convince women to have more children
Since ending three decades of the one-child policy in 2016, the Chinese Communist Party has blamed women for the country’s persistent low birth rate, and is pushing them to have more babies — but many remain unconvinced. Chinese President Xi Jinping in October urged the state-backed All-China Women’s Federation to “prevent and resolve risks in the women’s field,” The Wall Street Journal reported, which one propaganda expert told the Journal is a sign Xi and other top leaders consider women’s increasing refusal to have children a “major threat to social stability.” Balancing work with taking care of aging parents, Chinese women interviewed by the Journal said they simply do not have the energy and resources to have more children, especially given that the government has not yet proposed considerable child benefit plans for families that do choose to conceive.
Korea also faces ‘extinction’ of OBGYNs as doctors strike
South Korea — the country with the world’s lowest fertility rate, at 0.78% — faces an “extinction” of obstetrics and gynecology doctors as fewer and fewer medical students choose to specialize in women’s health, according to the Korean JoongAng Daily. Just 102 new OBGYNs joined the profession last year, and many of those specialize in gynecology, not deliveries. As in China, hospitals across the country — particularly in rural areas — have shut down delivery rooms, in their case owing to staffing issues, forcing pregnant women to travel to give birth, the paper reported.
The Korean government is attempting to fix these “deserts” of newborn care by increasing the annual medical school enrollment quota, but current physicians and medical students oppose the plan and are instead are striking for better pay and hours, which they claim would encourage more candidates to stay in the profession. Sadly, the public health consequences of the strike are already noticeable: mothers are reporting miscarriages and post-delivery complications because their caregivers are on strike, Korea’s Chosun Ilbo newspaper reported.
