In China, there have been reports of the closure of obstetrics and pediatric wards in hospitals in various cities, raising concerns about the dual trends of the marketization of public healthcare and a continued low birth rate. Despite the National Health Commission of the Chinese Communist Party explicitly stating in March that “obstetrics should not be closed at will,” local medical institutions continue to shut down obstetrics departments under operational pressures to reduce losses.
Since April, counties like Danzhai in Guizhou, Chongzhou City in Sichuan, and Xinqian in Jiangxi have successively announced the consolidation of obstetrics and neonatal services that used to be scattered across multiple hospitals into one location. Some maternal and child health hospitals have stopped admitting inpatient deliveries and no longer have labor rooms.
A resident of Qingdao City, Shandong Province, Mrs. Zhang, expressed her frustration in an interview with Epoch Times on July 10th when she found out that the familiar obstetrics department in the hospital had been dismantled when her family members went to the hospital for prenatal check-ups. “The hospital said it was a merger for optimization, but we still have to go to other hospitals. Nowadays, hospitals are managed by profit-making units, so they would rather keep beds idle for internal medicine to make money. Obstetrics and pediatrics are originally public services, why should they focus on revenue generation?”
Guangdong Xinyi City Hospital of Traditional Chinese Medicine announced on April 10th that it would completely stop inpatient deliveries in the obstetrics department starting from May 1st, only providing outpatient services such as prenatal check-ups, antenatal care, and postpartum recovery. The hospital advised pregnant women who had already made appointments for delivery to quickly contact other institutions for rearrangements. The hospital stated that this move aimed to “optimize the allocation of medical resources.”
Reviewing publicly available information, it is found that this year, public hospitals in Suzhou, Nanchong, Meishan, Ganzhou, Jiangshan, Huizhou, and other places have successively announced the closure of obstetrics services, with some even being tertiary hospitals. For instance, Suzhou Municipal Hospital’s Baita District stopped obstetric consultations as early as August of last year and merged relevant services into the newly established Suzhou Maternal and Child Health Hospital.
According to official data, China’s birth population has drastically decreased from 17.86 million in 2016 to 9.02 million in 2023, nearly halved. Scholars generally believe that the continuously declining birth rate is the main reason for the operational pressure on obstetrics departments.
Regarding the arrival of a new wave of obstetrics department closures, medical professionals in Zhengzhou expressed to Epoch Times that “since 2024, the trend of obstetrics department closures has gradually become apparent. In the future, not only obstetrics departments, but also the number of pediatric departments and children’s hospitals will significantly decrease, and the entire medical industry chain focusing on children will shrink.”
The pediatric field in Chinese hospitals is similarly facing contraction. Recently, a netizen from Inner Mongolia disclosed on social media that a hospital entrusted with the heavy responsibility of the pediatric department for the autonomous region received a notice in early July, requesting the removal of half of the pediatric ward within 3 days, reducing the number of beds to less than 50. Although the hospital did not publicly respond, public opinion generally believes that this action is related to the financial situation of “revenue not meeting expenses.”
A medical student commented in the online community, saying, “When I was interning, half of the pediatric department was cut. After the chief physician retired, the hospital decided to shut down the department because it wasn’t profitable. At this rate of development, doctors will sooner or later be laid off.”
Many healthcare workers in various regions have pointed out that apart from the decrease in patients, there is a severe shortage of obstetric and pediatric doctors. China Central Television (CCTV) has reported that some obstetrics departments in hospitals have been unable to successfully recruit new staff for four consecutive years. Even with the educational threshold lowered to a master’s degree, it remains difficult to fill the positions. A doctor in Changzhou lamented on social media, saying, “Young people are unwilling to work, it’s too tiring and dirty, everyone is fleeing.”
According to mainland media reports, with the continuous decline in childbirth volume, many obstetric doctors cannot maintain sufficient clinical proficiency, which poses medical safety risks and prompts young doctors to choose to change specialties or fields.
The National Health Commission of the Chinese Communist Party issued a notice in March of this year entitled “Notice on Strengthening the Management of Assisted Delivery Services,” explicitly requiring public medical institutions to “principally ensure the continuity of obstetric services” and banning the setting of profit indicators for obstetric care providers. However, the document also allows localities to “coordinate the adjustment of medical resources,” leaving room for policy flexibility for local merger or business closures.
Regarding the current situation of hospitals, several interviewees expressed to reporters that under the system of “inadequate subsidies from the Chinese authorities and the practice of treating diseases to earn revenue,” hospitals find it challenging to sustain obstetric services that have low income, high risks, and low patient flow over the long term, forcing them to be merged or even shut down. Tsinghua University sociologist Liang Tao (pseudonym) told Epoch Times that the trend of declining population and aging in China is irreversible.