Shanghai, China - Dr Shen, an obstetrician gynaecologist at a private hospital in downtown Shanghai, is tired. She has not been home in almost three days, she says. This past month has proven to be the busiest she has ever had at the hospital, which opened in 2013.
"Most of these women are having their second babies, and they all seem to be coming in January," Shen says.
A boom in second children was exactly what the central government was hoping for when it announced the lifting of the world's most controversial family planning scheme, commonly known as the "one-child policy" in October 2015.
Coming into effect from January 2016, China's new universal two-child policy was the culmination of years of loosening its family planning laws, which, since 2014, permitted ethnic minorities, rural couples with a first-born girl, as well as any couple in which at least one party is an only child, to have two children.
But all these exceptions were no help to Shanghai-based Zengdong Yang, 35, and her 36-year-old husband Ruwei Hong. They have a five-year-old daughter, Chen Chen, and were eager to have a second child.
But, with each having a sibling of their own, they did not qualify under the previous regulations, until a universal two-child policy was introduced.
Demographic implications of one child
"We had been waiting and hoping for a change in the policy," says Yang, who is now pregnant with their second child.
"Even if the policy hadn't changed, I definitely would have had another child," she explains, adding that she would have left Shanghai to avoid the city's particularly high fines for violating family planning policies. "Or I would divorce my husband, then we would remarry after a second child was born," she says, explaining that she was contemplating registering as part of a legal, but sham, marriage with a distant relative to accomplish this.
"But this is more convenient," Yang says with relief.
As of 2015, after 35 years of severe restrictions, the demographic implications for the 150 million families in China of having only one child were becoming increasingly apparent and the government was forced to act in an attempt to, at least in part, correct an upcoming demographic disaster for the rapidly ageing country.
It is projected that by 2050, almost a quarter of China's population will be over 65 years of age, according to the Asian Development Bank. That is up from 8.2 percent of the population in 2010.
There are still doubts about whether encouraging couples to have two children will put much of a dent in this long-term demographic trend, but there was a significant rise in births in Chinese hospitals in 2016, with 17.86 million recorded, an increase of 7.9 percent and the highest annual number since 2000, according to China's National Health and Family Planning Commission (NHFPC).
The number of newborns increased by 1.31 million compared with 2015, and the number of second children born rose to 45 percent, up from around 30 percent prior to 2013.
READ MORE: China's 'leftover' women
By the year 2050, commission projections expect the universal two-child policy to result in an extra 30 million working-age people - but even this increase will not be enough, according to experts.
Recent research from Australian National University shows that even if these predictions turn out to be accurate, the effect of a two-child policy on China's growth slowdown or its ageing population would be small - less than 0.5 percent a year of GDP growth and a reduction in aged dependency of 0.03 percentage points.
"Demographically speaking, the two-child policy is too little too late to reverse the declining trend of fertility in China," explains Yong Cai, an expert in Chinese demography working at the Carolina Population Center at the University of North Carolina, Chapel Hill.
"China is only a newcomer in facing the challenges of low fertility and population ageing. While there are a lot of policy proposals, most of them are likely to have a very limited impact. My advice is: Respect people's rights and leave individuals with room for choices."
Mei Fong, author of the book One Child: The Past and Future of China's Most Radical Experiment, agrees. "Having more choices is always better than less, but it's not enough," she says.
"Of course, there's been a slight increase in births because now people have the choice of having a second child. But I think, so far, all the projections suggest what demographers have been saying all along: Yes, there will be a slight uptick, but it won't be enough to meet the issue of worker shortages or the broader birth rate trend," Fong explains.
"Though the birth rate may be higher than it was a year ago, China has been below replacement rates for the past 20 years. With China, numbers are always a bit fudgy, but whatever [the actual fertility rate is], it's very far below 2.1, which is the replacement rate."
|There was a significant rise in births seen in Chinese hospitals in 2016, with 17.86 million recorded [Athit Perawongmetha/Reuters]
One child is enough
A survey of 10,000 respondents from the government-run All-China Women's Federation, conducted in 10 provinces around China, over the last six months of 2016, found that 53.3 percent of couples with one child did not want another.
This ratio rose above 60 percent in wealthy areas, such as Beijing and eastern coastal cities.
According to this study, key factors for parents weighing whether or not to have a second child were the quality of the public services, especially educational and medical services, they would be able to afford for two children, as well as access to childcare.
The length of the mother's maternity leave was noted by 60.7 percent of respondents and 45.8 percent cited "mother's current work conditions" as factors in the decision not to have more children.
Although there is no data available on the rates of employment discrimination against women due to the implementation of the two-child policy as yet, discussion on social networking sites, such as Sina Weibo, overwhelmingly point to already rampant discriminatory employment practices worsening as employers baulk at the prospect of having to pay maternity benefits twice when they hire young women, according to Keegan Elmer, a labour researcher at the Hong Kong-based China Labour Bulletin (CLB).
READ MORE: The problem of too many baby boys in China
"There are plenty of reasons for people to be worried about the effects on equality for women. We already know from the tendencies that already exist that employment discrimination in China is a really serious issue that most women recognise," Elmer says. The lack of good anti-discrimination laws in China makes it difficult for women discriminated against for reproductive reasons to get recourse through the legal system, he adds.
CLB research has shown that it is not uncommon for companies to ask prospective female employees about their plans for future children, or even require female employees to take routine pregnancy tests. Pregnant workers can then be coerced into resigning - for example, by being asked to work unreasonable hours by employers who aim to avoid paying maternity benefits.
"There's a lot of relevant law and employment promotion law and things that could be applied to this situation, but there is no anti-discrimination law that could cover women as a social group. The cases we have seen, the fines are minimal and they're really not enough to encourage anyone to take these things to court," Elmer says.
In Zengdong Yang's case, the fact that her parents and in-laws stay with her family, and take responsibility for much of the child care while she and her husband work, was a major consideration in being able to have a second child - more so than financial considerations.
"Actually, I think, the difference between having one or two children isn't that much of an economic difference, having one child compared to no children is a big difference, but one compared to two children isn't that big a deal," she says.
"I think a very important reason is that our parents live with us so can help us with childcare. I know a lot of women who either are alone in taking care of the children or their parents or parents-in-law are sick and can't help them."
Mei Fong believes there is a role for the government in encouraging couples to have more children through offering support for education or housing, for example, or by completely lifting restrictions on the number of children couples can have.
She also points out that societal attitudes need to change in order to make it easier for women - who often work, as well as take on the bulk of responsibility for raising children and caring for elderly family members.
"There have been some sociologists who argue that you can't have more children or more growth without true equality between the sexes. A lot of women aren't going to have more children because they have to do everything," Fong says.
"A lesser known concern I have seen raised in a few studies is the fact that countries that have Confucian ties have a really low birth rate, all linked to women's position in society and the expectations," she says.
"To be fair, the movement for women's equality in Western democracies also took a lot of time to happen, but there's no doubt that a lot of women in China are looking at the proposition of more than one child and it doesn't look very appetising for them."
Source: Al Jazeera