China has announced a new policy requiring all tertiary hospitals across the country to offer epidural anesthesia services to women in labor by the end of 2025.
The decision is part of a broader initiative aimed at creating a more supportive and comfortable environment for childbirth as the country faces declining birth rates and growing concerns about maternal health.
The mandate was issued by China’s National Health Commission, which emphasized the need to improve the overall experience of childbirth for women. The policy highlights epidural anesthesia as a critical component of pain management during labor and childbirth, and it will now be compulsory for all top-tier public hospitals to provide access to this service.
Tertiary hospitals in China represent the highest level of medical care in the country. These facilities are usually located in urban centers and serve as major hubs for complex medical procedures and advanced treatments. With the new requirement, they will need to ensure both the infrastructure and staffing capabilities necessary to deliver epidural services around the clock.
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The move comes amid growing concerns over the country’s low birth rate and the pressures facing women who are considering starting families. Pain during childbirth has often been cited by women as one of several deterrents to having children, along with economic concerns and a lack of work-life balance. By improving access to pain relief, Chinese officials hope to address at least one of the concerns associated with childbirth.
Epidural anesthesia involves injecting medication near the spinal cord to block pain signals during labor. While it is widely used in many developed countries, its availability has been inconsistent in China, especially in smaller cities and rural areas. Even in some major hospitals, limited staffing or training shortages have made access difficult for many women.
The National Health Commission said the new mandate aims to standardize maternity care practices and reduce the disparities in service quality across different regions. Hospitals will be required to train more anesthesiologists and provide the equipment necessary to ensure epidural services can be safely and effectively administered.
Over the past several years, Chinese authorities have launched multiple efforts to encourage childbirth. These include extending parental leave policies, offering financial incentives for families, and expanding child care services. However, the country’s fertility rate has continued to decline, prompting officials to take additional steps to address the underlying causes.
In 2023, China’s population declined for a second consecutive year, sparking alarm over the long-term implications for economic growth and demographic balance. Experts have warned that unless more is done to support families and reduce the physical, emotional, and financial burdens of childbearing, the trend is likely to continue.
Women’s health advocates in China have welcomed the epidural mandate as a significant step forward. Many have long argued that pain relief during labor should be treated as a basic right rather than a luxury. Surveys have shown that a growing number of women in China support epidural use during childbirth, but access has lagged behind demand.
Still, challenges remain. Experts note that a shortage of trained anesthesiologists could hinder full implementation of the policy in some areas, particularly in under-resourced regions. Authorities have pledged to address this by accelerating training programs and increasing investment in maternal health infrastructure.
The policy also marks a shift in how Chinese society views childbirth, with increasing attention being paid to women’s comfort, autonomy, and overall experience during labor. For decades, natural birth without pain relief was often promoted as the ideal, and some hospitals did not prioritize epidural services.
As the year-end deadline approaches, hospitals are expected to ramp up preparations to comply with the mandate. The National Health Commission has indicated it will monitor progress closely and provide support where needed to ensure full nationwide implementation.
If successfully rolled out, the policy could significantly improve childbirth conditions for millions of women across China and serve as a model for similar reforms in other parts of the country’s healthcare system.
