HONG KONG: In a bid to tackle its declining birth rate, China will soon require all major hospitals to offer epidural anesthesia during childbirth, aiming to ease pain for mothers and encourage more women to have children.

The National Health Commission (NHC) announced that all tertiary-level hospitals—those with over 500 beds—must provide epidural anesthesia services by the end of 2025. Secondary-level hospitals with more than 100 beds are required to follow by 2027. However, tertiary hospitals must already begin offering these services by the end of this year.

The move is part of broader efforts to foster a "friendly childbearing environment" as China faces an unprecedented demographic challenge. The country's population declined for the third consecutive year in 2024, and experts warn the slide is likely to continue in the coming years.

Currently, only about 30 percent of pregnant women in China receive epidurals during childbirth, compared to over 70 percent in developed countries, according to China Daily. In France, for instance, around 82 percent of women opt for epidurals, while in the U.S. and Canada, usage exceeds 67 percent.

The World Health Organization recommends offering epidurals to any healthy woman who requests pain relief during childbirth. Despite the international norm, access to epidural anesthesia has long been limited across many parts of China due to staff shortages, resource constraints, and a lack of trained anesthesiologists in maternity care.

The NHC said the policy would "improve the comfort level and security of medical services" and "further enhance people's sense of happiness and promote a friendly childbearing environment."

In addition to increasing availability, a number of provinces have begun including epidural costs under their medical insurance schemes, a move intended to reduce the financial burden of childbirth.

China has rolled out several other incentives in recent years to encourage family formation, but the response has been tepid. High childcare costs, job uncertainty, and a slowing economy have all contributed to the reluctance of many young Chinese to marry or start families.

In June, health authorities in Sichuan province proposed expanding marriage leave to 25 days and maternity leave to 150 days to promote what they called a "fertility-friendly society."

Despite deploying a wide range of policy tools—from cash subsidies to housing benefits—analysts say a major cultural shift is needed to reverse the trend, as personal preferences, economic stress, and lifestyle priorities continue to weigh heavily on younger generations.