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China mandates epidurals in tertiary hospitals to encourage childbirth

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China has announced that all tertiary-level hospitals across the country must provide epidural anaesthesia during childbirth by the end of 2025, in a bid to promote a “friendly childbearing environment” and combat falling birth rates.

The directive, issued by the National Health Commission (NHC), requires tertiary hospitals — facilities with over 500 beds — to offer the pain relief procedure by 2025, while secondary hospitals with more than 100 beds are expected to follow suit by 2027.

China is grappling with a sharp demographic shift after its population declined for the third straight year in 2024. 

Experts have warned that the downward trend is likely to continue, threatening the long-term stability of the world’s second-largest economy.

Only about 30% of pregnant women in China currently receive anaesthesia to ease childbirth pain, compared to over 70% in some developed nations, according to state-run China Daily. 

The World Health Organization (WHO) endorses epidural use for healthy expectant mothers who request it, and the practice is common in countries like France, where 82% of pregnant women choose it, and in the United States and Canada, where uptake exceeds 67%.

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The NHC said the move 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 parallel with the new medical requirements, several provinces have started including epidural costs in their medical insurance coverage in an effort to lower financial barriers and encourage childbirth.

Authorities are also introducing additional incentives. In June, health officials in Sichuan province proposed extended marriage leave of up to 25 days and maternity leave of up to 150 days, aiming to build what they described as a “fertility-friendly society.”

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