Historical Review and Future Prospects of Family Planning Policy:

Impact, Challenges and Responses

Xinran Wang

Art and Science, The Ohio State University, Columbus, U.S.A.

Keywords: Total Population, Fertility Rate, Population Growth Rate.

Abstract: This article reviews and analyzes the historical evolution, implementation background, and main challenges

in policy transformation of China's family planning policy, and explores its far-reaching impact on population

structure, economic development, and social culture. With economic and social development, China's

population is facing new challenges: on the one hand, the reduction of the working-age population is

weakening economic vitality; on the other hand, the aging problem has caused increased pressure on social

security and medical systems. In addition, the increase in one-child families has increased the support burden

of the younger generation. In recent years, the country has gradually adjusted its fertility policy and

successively introduced independent two-child, comprehensive two-child and three-child policies. However,

the policy relaxation has not significantly increased the fertility rate, reflecting deep-seated problems such as

high childcare costs, employment discrimination, and shortage of educational resources. Still exists. To deal

with this complex problem, this article combines literature and data analysis to put forward various policy

suggestions, including abolishing birth restrictions, improving childcare and social security systems,

promoting equal employment for women, reducing education and medical costs, etc., to establish a supportive

fertility system. social environment. This article believes that comprehensive reforms will help optimize the

population structure, promote sustainable economic and social development, and provide a reference for other

countries to deal with similar challenges.

1 INTRODUCTION

As a far-reaching national policy from the late 20th

century to the early 21st century, China's family

planning policy was designed to deal with the

resource, environmental, and economic challenges

brought about by excessive population growth. In the

1970s, China's total population exceeded 900 million.

The rapidly growing population puts tremendous

pressure on natural resources such as land, energy,

and water resources. For this reason, the country

officially implemented the one-child policy in 1979

to reduce the fertility rate through coercive means to

control population growth.

In the early stages of implementation, the one-

child policy successfully alleviated resource

constraints and economic development pressure to a

large extent. The demographic dividend provides

labor force support for the take-off of the

manufacturing industry and the acceleration of

urbanization. At the same time, the quality of life and

per capita education level of residents have

significantly improved. However, the negative effects

of this policy gradually emerged over time.

First, the problem of demographic imbalance is

becoming increasingly serious. The decline in the

birth rate and the increase in life expectancy have

caused China to gradually enter an aging society.

Data shows that by 2023, China ’ s elderly

population aged 65 and above will account for more

than 14% of the total population (The State Council

2024). This shift has increased the burden on the

social security and medical systems, while potentially

inhibiting economic growth.

Secondly, the imbalance of gender ratio has

become a prominent problem. Due to the abuse of

traditional patriarchal concepts and technological

means, the proportion of male births in some areas is

much higher than that of females, resulting in an

imbalance between supply and demand in the

marriage market and even giving rise to a series of

social problems, such as the trafficking of women and

an increase in social instability.

Wang, X.

Historical Review and Future Prospects of Family Planning Policy: Impact, Challenges and Responses.

DOI: 10.5220/0013996400004916

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 2nd International Conference on Public Relations and Media Communication (PRMC 2025), pages 587-594

ISBN: 978-989-758-778-8

587

Third, family structures have undergone profound

changes. The shift from the traditional multi-

generational family to the nuclear family model has

caused young people to bear greater family

responsibilities and financial pressure. The one-child

generation not only needs to support their parents but

may even support their grandparents at the same time,

placing a heavy financial and psychological burden

on this generation.

In order to solve these problems, China has

gradually adjusted its family planning policy since

2013 and has successively launched an independent

two-child policy, a comprehensive two-child policy,

and a three-child policy in 2021. However, the actual

effect of these policies is not as good as expected. The

high cost of childcare, the unfair treatment of women

in the workplace, and the shortage of educational

resources make many families unwilling to increase

the number of children.

Therefore, the current policy adjustments not only

need to relax the fertility policy, but also focus on

social and economic reforms. Optimizing medical,

education and housing policies to reduce childcare

costs; strengthening women's employment security to

eliminate the negative impact of childbirth on career

development; improving the pension security system

and reducing the financial burden of the younger

generation are the key paths to solving current

problems. This article aims to analyze the history and

current situation of China's family planning policy,

put forward targeted policy suggestions, and provide

directional thinking for the sustainable development

of society in the future.

2 HISTORICAL REVIEW OF THE

POLICY

2.1 Origin and Implementation of the

Policy

In the late 1970s and early 1980s, China faced severe

challenges brought about by the rapid growth of its

total population. Data from the third national census

in 1982 showed that the national population had

exceeded 1 billion, far exceeding the carrying

capacity of the economy and society at that time.

Public services such as education, medical care, and

housing were seriously undersupplied, and the large

number of new population brought tremendous

pressure to the reform and opening up that was still in

its infancy. (The State Council of the People's

Republic of China, 2005)

Against this background, the Chinese government

began to implement the one-child policy in the early

1980s, strictly controlling most urban families to have

only one child through legislation and administrative

means. Although there was a certain degree of

flexibility in rural and ethnic minority areas, it still

played a positive role in suppressing fertility rates

overall. (Ze, 2023)

Establish family planning offices at the grassroots

level, implement a birth approval system, collect

social maintenance fees from families with more than

one child, provide additional benefits to single-child

families (such as education and medical subsidies

brought by the single-child certificate), etc. (Zeping,

2024). Strengthen publicity and education, policy

mobilization and administrative supervision,

encourage social groups, enterprises, institutions, and

individuals to provide donations for population and

family planning work, and strengthen legal

regulatory, and social moral pressure. The one-child

policy effectively reduced the national birth rate in

the short term. According to data from the National

Bureau of Statistics, the national total fertility rate

(TFR) gradually dropped to around 2.0 in the mid-to-

late 1980s. However, it also led to a certain degree of

simplification of family structure, laying a solid

foundation for the subsequent demographic dividend

and sustainable social development, but also laid the

groundwork for potential problems such as aging and

gender imbalance.

2.2 Policy Adjustment and

Development

With time, the problems of low fertility rate and

imbalanced population structure are becoming

increasingly apparent. The aging trend is

accelerating, and the proportion of the working-age

population will drop from 70.1% in 2010 to 61.3% in

2023. The sex ratio is seriously skewed in some areas.

To address these challenges, the country piloted the

"two-child policy for couples with only one child" in

2013, implemented the universal two-child policy in

2016, and further relaxed it to three children in 2021.

(National Bureau of Statistics, 2001)

The intensified aging population and the declining

fertility rate (the total fertility rate in some areas has

fallen below 1.3) have forced the government to relax

birth restrictions to ensure a moderate birth

population size and labor supply. In 2016, the year

when the "universal two-child policy" was

implemented, the national new birth population

rebounded briefly (17.86 million, an increase of about

1.3 million from the previous year), but then fell year

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by year. The introduction of the three-child policy

further shows that the government hopes to hedge

against future labor shortages and social security

pressures through further relaxation. However,

factors such as high childcare costs, employment

discrimination against women, and a shortage of

educational resources have resulted in low actual

fertility intentions, and the effect of policy

adjustments is limited.

2.3 Society’s Response to Policy

Changes

Facing the current two-child and three-child policies,

social reactions are divided. Some urban middle-class

families have certain economic and child-rearing

resources and welcome the relaxation of birth

restrictions. Echoing this is the response motivation

of some rural families. Although the rural economic

foundation is weaker than that of cities and education

and medical resources are relatively scarce, the

traditional culture of "more children, more blessings"

and the demand for family labor still have a strong

influence in some areas. For such families, policy

relaxation means that while maintaining or expanding

the size of the family, they can expect to share the

burden of elderly care in the future, thereby

alleviating the impact of population loss and aging on

rural development.

Most young couples are affected by economic and

workplace pressures, high housing prices, and rising

child-rearing costs, and their willingness to have

children continues to decline. Many surveys show

that the dual pressure of caring for parents and raising

children in the future, as well as concerns about the

lack of childcare and child-rearing support policies,

are important reasons for suppressing fertility.

Overall, although policy relaxation has made an

attempt to adjust the population structure, it is not

enough to reverse the trend of long-term low fertility

rates. Without more comprehensive social welfare

and public service support, society's substantive

response to policy changes will be very limited.

3 MAIN IMPACT OF FAMILY

PLANNING POLICY

3.1 Positive Impact

The family planning policy reduces the population

growth rate and relieves pressure on resources and the

environment. The one-child policy significantly

reduced the natural growth rate of the population in

the early stages of its implementation. According to

official statistics, from the late 1970s to the early

1990s, China's birth rate and total fertility rate both

declined significantly. The slowdown in population

growth has alleviated the tension between resources

and the environment to a certain extent, providing a

valuable time window for economic structural

transformation and ecological and environmental

governance. The growth rate of per capita

consumption of cultivated land and freshwater

resources has tended to slow down during this period,

urban environmental pressure has been reduced, and

some areas have achieved good ecological restoration

results.

The family planning policy provided a

demographic dividend and promoted rapid economic

development in the early stages of reform and

opening up (National Letters and Calls Bureau,

2001). Under strict birth control, the labor force of

young adults born in the 1980s and 1990s is still large

and their education level is gradually improving,

providing sufficient labor supply for China's reform

and opening up. The surplus rural labor force has

transferred to coastal cities, and high-quality and

relatively low-cost human resources have attracted a

large number of foreign-funded enterprises and

manufacturing industries to settle in China. The rapid

development of import and export trade and

infrastructure construction contributed an important

demographic dividend to the average annual GDP

growth rate which maintained a high level of 8%-10%

during this period (Yingshun, 2019). At the same

time, as the average number of children in a family

decreases, the government and families can invest

more resources in the education and health of each

child, improving the quality of the new generation,

which further promotes industrial upgrading and

technological innovation.

3.2 Negative Impacts

First, the working-age population is decreasing and

the pressure on social security is increasing. In recent

years, China has gradually entered a deeply aging

society. Data from the seventh national census in

2020 show that people aged 65 and above account for

13.5% of the total population, much higher than 7%

in 2000. During the same period, the proportion of the

working-age population dropped from more than

70% to 63.4%. This change means that the burden of

social support has increased significantly, and the

pension and medical security systems are facing

increasing pressure from the huge elderly population.

Historical Review and Future Prospects of Family Planning Policy: Impact, Challenges and Responses

589

Economic development is also facing new challenges

due to shrinking labor supply and limited R&D and

innovation vitality.

Secondly, the gender ratio is imbalanced. Due to

the existence of the traditional concept of "preferring

boys over girls" and the long-term one-child

restriction, some families prefer to have boys through

abnormal means. As a result, the newborn sex ratio

continued to be higher than the warning level of

110:100 from the late 1990s to the early 21st century,

and was once close to 120:100 (National Bureau of

Statistics data, 2000). This imbalance not only affects

supply and demand in the marriage market but may

also lead to problems with social stability and

women's rights. At present, the "sequelae" of

imbalanced gender ratios are gradually becoming

apparent, such as the expansion of the group of

"leftover men" and the intensification of marriage

squeeze and population migration problems.

Third, family structure changes. The one-child

policy has changed China's traditional multi-child

family structure. From the "multi-generational

household" or extended family model where brothers

and sisters help each other, it gradually evolved into

the "family of three" or "4-2-1" model (that is, four

grandparents, two parents, and one child). Although

small families can concentrate resources on raising

children, once parents or grandparents grow old and

need support and care, there is often a lack of sharing

of responsibilities among brothers and sisters,

causing huge financial and mental pressure on the

younger generation. In the context of increasing

aging, the elderly care function of small families

continues to weaken, and the problem of insufficient

supply of social elderly care and childcare services

has become increasingly prominent.

4 CURRENT STATUS AND

CHALLENGES FACED BY THE

THREE-CHILD POLICY

4.1 The Underlying Causes of Low

Fertility Rate

China officially announced the implementation of the

three-child policy in 2021, aiming to reverse the trend

of continued low birth rates, shrinking labor force,

and accelerated aging. However, the loosening of

policies has not brought about a large-scale increase

in newborns, and the deep-seated contradictions

behind the low fertility rate remain prominent.

First, the high cost of childcare prohibits many

families. The cost of living in cities continues to rise,

and competition for education, medical care, and

childcare resources is fierce. Families invest heavily

in raising their children in terms of food, clothing,

housing, transportation, early education, and

extracurricular training. Especially in first- and

second-tier cities, the average monthly education or

training expenses a parent spends on their children

often exceeds 20%-30% of their income. With the

supply of childcare subsidies, kindergartens, and

childcare public services relatively weak, some

couples of working ages have shelved or given up

their childbearing plans due to financial pressure.

Secondly, housing pressure also has a significant

impact on fertility intentions. According to relevant

statistics, most young urban families need to bear

high mortgage loans, and the proportion of house

prices in annual household income continues to rise.

If you want to accommodate two or three children in

a limited living area, you need extra space and

financial support. This puts a heavy burden on young

people who have insufficient financial accumulation

and insufficient job stability.

Finally, barriers to career development and

workplace discrimination are also important concerns

for young parents. Although the law emphasizes labor

protection for women during pregnancy and

childbirth, in actual recruitment and promotion

processes, some companies still have biases or set

implicit thresholds against women who have given

birth to multiple children. Women's choice between

childcare and the workplace often leads to a further

reduction in the desire to have children. In addition,

the frequent overtime culture and insufficient

implementation of the flexible employment system

make it difficult to meet the needs of working parents

for childcare time and energy.

4.2 International Comparison

Japan has gradually improved its childcare welfare

system since the 1990s, including providing childcare

subsidies, extending maternity and childcare leave,

and encouraging companies to provide flexible work

arrangements for women. (The State Council of the

People's Republic of China, 2021) However, Japan’

s fertility rate has still hovered around 1.3 for many

years, indicating that financial subsidies and

maternity leave alone are difficult to significantly

increase the desire to have children. South Korea has

also invested a large amount of budget in the past

decade to expand its public childcare system, but it

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still faces the dilemma of a total fertility rate falling

below 1.0. (National Letters and Calls Bureau, 2001)

Judging from the experience of these countries,

increasing fertility rates requires multi-level and

comprehensive measures. On the one hand, must

promote reforms in the housing, education, and

medical systems at the economic level to reduce

childcare costs. On the other hand, must strengthen

conceptual guidance at the social level and advocate

a more balanced lifestyle between work and family.

For China, blindly relaxing fertility restrictions is not

enough to promote a rebound in low fertility rates.

Only by cooperating with policies such as

comprehensive childcare services, employment

protection, housing security, and tax exemptions can

the burden of childbearing on families be reduced on

a practical level, and can it be possible to truly

stimulate young people's desire to have children. It

can be seen that the implementation of the three-child

policy should be coordinated with broader social and

economic reforms to maintain the sustainability of

population structure and social development in an

increasingly competitive global environment.

5 FUTURE DEVELOPMENT

DIRECTION

Facing the current severe trend of low fertility rate

and aging population in China, it is obviously not

enough to rely solely on policy adjustments to relax

birth restrictions. The optimization of population

structure and sustainable development of social

economy requires comprehensive reform and

institutional innovation at a more macro level. Based

on the analysis in the previous article, the future

development direction can be carried out from two

aspects: policy and comprehensive reform.

5.1 Policy Recommendations

5.1.1 Completely Lift Birth Restrictions

After the implementation of the two-child and three-

child policies, more and more research and social

survey results show that the low willingness to have

children is not simply due to policy restrictions, but

rather due to the comprehensive consideration of

economic, time costs, and the child-rearing

environment by families. Given this, completely

lifting birth restrictions has become a feasible and

necessary option. Handing over birth decisions

completely to families will help eliminate the external

pressure or hidden constraints brought about by

policy control. At the same time, it can also release

the "potential demand" of some groups that already

have the desire to have children, thereby reversing the

downward trend in the birth rate to a certain extent.

However, lifting birth restrictions is only the first

step. Without the corresponding social welfare,

childcare services, and policy support, the freedom of

childbearing itself is difficult to transform into actual

childbearing behavior. Therefore, it is necessary to

work together with a series of economic and social

policies to effectively improve the overall fertility

level.

5.1.2 Family Support Policies

(1) Childcare subsidies and tax incentives

Referring to the response measures of Japan, South

Korea and other countries to the declining birthrate,

promoting childcare subsidies, tax incentives or tax

refund mechanisms in China is the key. On the one

hand, direct or indirect financial support can

significantly reduce the cost of raising children for

families; on the other hand, if a gradient and

differentiated subsidy can be implemented for

families with multiple children, the living and

education burden of families with multiple children

can be effectively reduced (The State Council of the

People's Republic of China., 2018). People should

actively explore the design of subsidy standards that

are tailored to local conditions based on the economic

development level and fertility costs of different

regions so that local governments can implement

them and families can benefit.

(2) Improve childcare services and preschool

education supply

High-quality kindergartens and childcare institutions

are the core links to ensure the scientific cultivation

of infants and young children and relieve the

employment and care pressure on parents. The

government can vigorously develop public and

inclusive childcare institutions through financial

subsidies and policy encouragement, and standardize

the qualifications and quality supervision of private

institutions. Community-based inclusive childcare

centers and flexible and diverse preschool education

models can enable dual-income families to find a

balance between work and childcare, and further

enhance their willingness to have children.

(3) Employment and welfare protection

To truly encourage childbirth, it is necessary to

establish an institutional environment that is more

friendly to women's workplace rights. Extending

maternity leave, expanding the coverage of childcare

leave, and formulating statutory systems for maternal

protection and paternal participation, such as

mandatory paternal childcare leave, are all conducive

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591

to sharing childcare responsibilities and enhancing

family confidence in childbearing. For enterprises

that employ multiple female employees of

childbearing age, tax reductions or social security

subsidies can be provided to reduce the company's

concerns about hiring women and prevent

discriminatory employment (Index Mundi, 2018). In

addition, a flexible work system or home office

mechanism should be established to provide more

diverse working methods for multi-child families.

5.1.3 Optimizing the Elderly Care System

(1) Developing a multi-level elderly care service

industry

The intensification of aging is not only a problem of

fertility policy but also related to the coordination of

the social security system and the elderly care

industry. The government can encourage social

capital to invest in multi-level service systems such

as community elderly care, family elderly care, and

institutional elderly care to enrich market supply and

improve quality. For example, through the public-

private partnership (PPP) model, enterprises can be

attracted to participate in the construction of elderly

care institutions and rehabilitation centers to provide

long-term care services for disabled and semi-

disabled elderly people. At the same time, local

governments can be encouraged to explore a new

elderly care model of "home + community +

institution" in the form of financial support or

subsidies.

(2) Improve social security and medical support

A stable and sound social security system can reduce

the pressure on the younger generation to support

their elderly parents and give them more confidence

to maintain a balance between their children's

education and their elderly care. Pension, medical,

and long-term care insurance must be fully covered

and the level of protection must be continuously

improved. For example, the long-term care insurance

pilot should be promoted and the scope of

beneficiaries should be expanded to reduce the

economic burden on families. The tiered diagnosis

and treatment system and community medical service

network should be improved to provide more timely

and convenient health management and rehabilitation

care for the elderly.

5.2 Comprehensive Reform

The relaxation of the birth policy alone is not enough

to fundamentally reverse the trend of declining

fertility rates and unbalanced population structure.

The key lies in the coordination and coordination

among "population-economy-society".

(1) Education system reform

To break the dilemma of "excessive childcare

expenses", it is necessary to continue to increase

investment in high-quality education resources and

balance their layout. Further, deepen education

reform and narrow the urban-rural and regional

education gaps. From preschool education, and

compulsory education to higher education, all stages

need to optimize investment plans and resource

allocation. Only by reducing the economic and

mental pressure on families to educate their children

can young couples feel more secure and supported

when making decisions about having children.

(2) Upgrading the medical and public health system

For maternal and child health care and prenatal and

postnatal medical services, can increase investment in

county and township primary medical institutions to

ensure the quality and safety of medical care for

pregnant women. Through comprehensive

reproductive health education and free pregnancy test

services, can help women of childbearing age reduce

the risks of pregnancy and childbirth and increase

their confidence in having children. In addition to

maternal and child health care, need to continue to

promote the reform of the medical insurance system

to ensure that the heaviest medical expenses in the

cost of raising children are reasonably shared.

(3) Linking economic and housing reforms

The willingness to have children is highly correlated

with the family's economic situation and housing

conditions. The government can explore diversified

housing security mechanisms through land, financial,

and rental market reforms, such as public rental

housing, low-rent housing, or shared-ownership

housing, to lower the housing threshold for families

with multiple children. In first-tier and megacities,

can moderately adjust the industrial layout and

population relocation measures so that young people

can enjoy high-quality public services and

educational resources in areas with relatively low

living costs, and balance job opportunities and living

conditions.

(4) Household registration and talent mobility

The conditions for settling in cities should be

gradually relaxed or relaxed to encourage the free

flow of talent and reduce the uneven distribution of

public resources caused by the household registration

system. A smoother flow and reasonable distribution

of the population will not only help eliminate the gap

in education, medical care, and employment

opportunities between regions but also allow families

with multiple children to choose their place of

residence and work more flexibly.

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6 CONCLUSION

This article reviews and analyzes the historical

evolution, implementation background, and main

challenges in the policy transformation of China’s

family planning policy, exploring its far-reaching

impacts on population structure, economic

development, and social culture. In the late 1970s,

China implemented the one-child policy to address

the resource constraints, environmental damage, and

economic pressure caused by rapid population

growth. Initially, the policy alleviated these issues,

but with economic and social development, new

demographic challenges have emerged: a shrinking

working-age population weakens economic vitality,

and the aging population increases pressure on social

security and medical systems. Furthermore, the rise

of one-child families has increased the financial and

caregiving burdens on the younger generation. In

recent years, China has gradually relaxed its fertility

policy, introducing the "two-child policy," the

"comprehensive two-child policy," and the "three-

child policy." However, these adjustments have not

significantly increased the fertility rate, reflecting

deeper issues such as high childcare costs,

employment discrimination, and a shortage of

educational resources. To address these complex

problems, the article proposes several policy

suggestions, including abolishing birth restrictions,

improving childcare and social security systems,

promoting gender equality in employment, and

reducing education and medical costs to create a more

supportive social environment for fertility.

Comprehensive reforms would help optimize the

population structure, promote sustainable economic

and social development, and offer valuable insights

for other countries facing similar challenges. China's

family planning policy has played an important role

in different historical stages. From the positive role of

controlling population growth and promoting

economic development in the early stage of policy

implementation to the emergence of population

aging, gender imbalance, and low fertility rate in the

later stage, the complex role of family planning policy

in social economy and population structure is visible.

Although the policy adjustments in recent years have

achieved some results, the deep-seated problems are

still severe, indicating that simply relaxing birth

restrictions is not enough to solve the systemic

challenges of population and economic development.

In the future, the country needs more

comprehensive and multi-field policy measures. On

the one hand, the cost of raising children should be

reduced by improving the social welfare and

childcare support system. On the other hand, the

protection of women's rights and interests should be

strengthened, and the socially supportive

environment for childbirth should be optimized. In

addition, the reform of social security, medical care,

and pension systems should be further promoted to

provide a solid foundation for the optimization of

population structure and the sustainable development

of economy and society. Through comprehensive

reform, China may achieve a dual balance between

population and economy, and provide experience for

the world to deal with similar problems. While This

article mainly focuses on the historical review and

policy suggestions for China’s family planning, but

it does not delve deeply into the specific regional

differences and the varying impacts on different

socioeconomic groups. Additionally, while proposing

policy adjustments, the article does not extensively

explore the practical challenges and feasibility of

implementing these reforms on a large scale.

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