China’s commercial metropolis Shanghai, grappling with one of China’s highest rates of ageing and lowest rates of fertility, has made maternal care completely free in its latest move to encourage childbirth.The city government rolled out a policy on Tuesday that waives all out-of-pocket expenses for maternal care, from pregnancy screenings through childbirth to postnatal follow-ups.The policy builds on — and goes beyond — a central government commitment to make basic services for hospital delivery free to all patients across the country by the end of this year, part of a push to raise birth rates amid a looming demographic crisis that threatens the country’s long-term economic prosperity, the Hong Kong based South China Morning Post reported on Wednesday.From October, all female participants in the city’s medical insurance scheme will be entitled to a maternal care allowance of 4,500 yuan (USD 671), the municipal healthcare bureau announced, adding that if their bills exceed that amount, maternity insurance would cover the rest.Costs for prenatal check-ups, hospital delivery and postpartum recovery within 42 days after delivery would also be reimbursed in full, the bureau said.Last year, the central government pledged the nationwide roll-out of a policy of zero out-of-pocket costs for giving birth, but it has yet to materialise in all corners of the country.“Shanghai’s move is a step forward towards zero-cost childbirth,” said Yuan Xin, a professor of demography at Nankai University in Tianjin.“But like traditional Chinese medicine, these policies are a slow burn — they take time to take effect and will never deliver quick fixes.”Declining birth rates, a shrinking working-age population, coupled with increased life expectancy, are intensifying China’s demographic pressures.The serious demographic crisis is blamed on the decades-old one-child policy followed by the ruling Communist Party.Amid warnings that the demographic crisis will seriously impact the economy, China scrapped the one-child policy in 2016 and permitted all couples to have two children.As it failed to make an impact, China revised the population policy in 2021, allowing people to have three children in an attempt to address the reluctance of couples to have more kids due to mounting costs.China’s demographic crisis included a rapidly ageing population.China’s population aged 60 and above reached 323.38 million by the end of 2025, accounting for 23 per cent of the country’s population.The population aged 65 and above in Shanghai was 4.67 million, accounting for 30 per cent of the total.In a bid to create an environment that is friendly to new parents, governments at the central and local levels have implemented a series of measures to encourage childbirth in recent years, ranging from childcare subsidies to longer maternity leave.But Yuan said such incentives may be less effective in affluent regions like Shanghai than in less-developed areas, where financial burdens played a bigger part in people’s decision to have children.Tianmen in the northern province of Hubei has become a closely watched case study, bucking national trends after offering strong financial support — worth up to 220,000 yuan per child (around USD 30,000) for childbirth and childcare.The city saw its number of new-borns surge by 17 per cent year on year after the policy was introduced in 2024, according to the Post report.