THE GENDERED COST OF CHINA'S PRONATALIST TURN

The Communist Party of China (CPC) increasingly frames fertility promotion as a pillar of nation-building and long-term economic strategy. Recent measures, such as the removal of the value-added tax (VAT) exemption on contraceptives, suggest that market forces are being employed by the CPC to shape reproductive behavior and place the burden of demographic recovery on women. This approach reflects a long-standing reality in China, where reproduction has never been politically neutral and has always fallen within the purview of state governance. This pattern reveals the core contradiction in China’s approach because while the state promotes a progressive image of gender equality on the international stage, it continues to constrain women’s reproductive autonomy to fulfill its population goals.

Responding to this demographic challenge, the 2025 Government Work Report (政府工作报告) emphasized the need to formulate fertility-promoting policies, expand childcare subsidies and develop integrated childcare services, signaling that boosting population growth is now a national priority. In December 2025, the Standing Committee of the National People’s Congress began reviewing the draft Childcare Services Law (托育服务法草案), an eight-chapter statute designed to regulate and expand childcare services for children under three, strengthen service standards, reduce the financial burden on families, and improve population quality and health outcomes. The White Paper on Women’s Development (中国妇女发展纲要) also placed great emphasis on fertility and women’s role as child-bearers. Within this broader trajectory of demographic governance, the recent decision to impose value-added tax on contraceptives can be seen as an extension of the state’s effort to influence reproductive behavior.

Who Pays for Demographic Recovery?

China’s decision to lift the value-added tax (VAT) exemption for contraceptives, including condoms, signifies a pivotal juncture in its ever-evolving demographic policy. As public health goods that support national population goals, contraceptives were free from VAT for more than thirty years. Their removal from the exemption list under the new Value-Added Tax Law is therefore not a neutral administrative decision. A worsening fertility crisis is the backdrop for this policy change. Despite the shift from a one-child to a three-child policy framework, birth rates have remained low, and local governments are dealing with dwindling labor pools and rising welfare costs.

Contraceptive taxation is not a decision taken in a vacuum. Rather, the CPC aims to use market pressure to attain its goals in the arena of family-building. In this case, the state aims to accomplish this not by directly mandating reproductive conduct, but by raising the cost of avoiding pregnancy. However, the covert nature of this policy does not lessen its political ramifications. The taxation of contraceptives highlights a deeper contradiction in China’s pronatalist strategy, where the state promotes both supportive subsidies and economic penalties. On one hand, the state has expanded family support through measures such as a universal childcare subsidy of 3,600 yuan per year for children under three. On the other hand, increasing the cost of contraception shows that the state is willing to apply financial pressure to manipulate reproductive choice. Before its abolition in 2021, the social maintenance fee (社会抚养费) was another key instrument through which the state used financial pressure to regulate reproduction. Families who exceeded birth quotas faced regular fines from their local governments. Although the fee was abolished alongside the shift to the three-child policy, it portrays a deeper continuity in how the state governs reproduction. For decades, fertility has been manipulated through a combination of financial rewards and punishments. From this perspective, the latest taxation on contraceptives is not a policy departure but a revival of market-based controls over fertility.

This market-based control will lead to visible financial implications for women, with the burden of contraceptive taxation falling unevenly across Chinese society. More than 75% of Chinese women between the reproductive ages of 15 and 49 rely on some form of contraception, making them the primary consumers affected by the 13% price increase. Among younger adults, condoms are the most widely used form of contraception, which means that the taxation will disproportionately impact students and early-career workers who have limited income security.

Demographic Challenge and Fertility as Geoeconomic Strategy

China’s pronatalist turn is not simply a social policy adjustment but a geoeconomic strategy tied to labor supply in an increasingly competitive global economy. Recent data by China’s National Bureau of Statistics shows that China’s population declined for a fourth straight year in 2025, with births at record lows and a marked increase in the over-60 age group. Persistently low fertility threatens long-term productivity and China’s position within global manufacturing chains. As birth rates fall, the working-age population shrinks, weakening the labor base that supported decades of rapid economic growth in China. Shifts in population structure also affect family and societal support systems. A rising dependency ratio increases household burdens, while government resources get redirected toward elderly care, thereby limiting investment in younger populations and industries.

Interestingly, economist Lin Yifu argued that China’s large pool of educated scientists and engineers and its massive domestic market and technologically superior industries could offset the disadvantages of an aging population. However, this confidence paradoxically exists with the numerous demographic interventions that the CPC has initiated in 2025. The continued pronatalist policies on the part of the CPC reflect that, despite this outward confidence, it does not seek to disregard any concerns it has with low fertility rates.

Gender, Work and the Repercussions of Pronatalism

At the core of China’s fertility challenge lies a persistent gender imbalance in the division of labor and care. Childbearing remains a high-risk decision for women, and they face “motherhood penalties” like a stalled career progression and employment discrimination. Despite official discourse around “shared parenting,” caregiving responsibilities continue to fall on mothers. Some recent measures, like expanded childcare subsidies and public nursery services, may ease short-term pressures, especially for rural women and low-income families for whom modest transfers matter. In lower-wage regions, these initiatives could also help some women stay in the workforce after childbirth. Unfortunately, these measures stop short of addressing the patriarchal structures that reinforce the double burden of work.

Additionally, household labor remains unpaid and dominated by women, while companies both directly and indirectly penalize childbirth. Programs like “mom jobs” (妈妈岗) are pushed by the CPC as practical solutions, but they institutionalize in policy the very inequalities they claim to address. By targeting mothers rather than parents, these schemes double down on the gendered politics of home by applying it to the public sphere. In this manner, the decision to tax contraceptives seems to represent a skewed policy that legitimizes gendered expectations placed on women. While the state offers conditional welfare once women become mothers, it disregards women as active political actors beyond their reproductive capacity.

The gendered implications of contraception also extend beyond their use as a family-planning tool. Birth control pills are routinely prescribed for conditions such as polycystic ovary syndrome (PCOS) and hormonal regulation. For 58% of women on oral contraceptives, the pills are not about birth control but a vital treatment for polycystic ovary syndrome (PCOS). For these women, higher costs are not just about reproductive choice but also access to medical tools. By relegating these pills to demographic policy, the state completely absorbs women’s health into the realm of fertility objectives. This kind of demographic anxiety displayed by the CPC ultimately sidelines any form of health that is not associated with the social act of reproduction.

The Double Standard in China's Demographic Strategy

The repeated constraints that women’s health is facing in China exists parallelly alongside China’s international commitments to gender equality. In 2015, President Xi Jinping announced China’s support for UN Women and donated 10 million dollars for international programs. These programs were initiated with the aim of advancing women’s development and health while framing gender equality as a global public good and a marker of responsible governance. This international posture is a sharp contrast to domestic demographic policy, where women’s bodies are hemmed into their reproductive roles.

Through outward engagements and conferences like the Global Leaders’ Meeting on Women (全球妇女峰会), China portrays itself as a guardian of women’s development. However, domestic policies such as the taxation of contraceptives show how women’s health concerns unrelated to reproduction are subordinated to population objectives. What emerges is a double standard in China’s treatment of women: “new milestones” in women’s empowerment are championed on the global stage, while their reproductive autonomy is constrained in domestic policies to further demographic goals.

In sum, China’s contemporary pronatalist turn illustrates a reconfiguration rather than a retreat of state involvement in intimate life. The instruments have shifted from overt birth quotas to subtler fiscal and welfare mechanisms, yet the governing logic remains continuous: fertility is treated as a matter of national strategy, not individual autonomy. Within this framework, women’s bodies function as the primary site through which demographic anxieties are managed. Far from resolving the fertility crisis, such measures risk deepening labor market discrimination, reinforcing unpaid care burdens, and medicalizing women’s health needs through a pronatalist lens. The long-term consequence is a narrowing of women’s citizenship to their reproductive capacity, revealing that China’s demographic strategy is not only an economic project but also a profound renegotiation of gender, labor, and state power in the twenty-first century.

Image Credits: Xinhua