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China will begin charging a 13% value-added tax on contraceptives starting Jan. 1 and will exempt child care services from the same tax, a move officials say is part of a broader effort to boost births as the country faces a sustained population decline, according to the BBC and The Associated Press.
The tax reform, announced late last year, eliminates exemptions that had been in place since 1994, when China was still implementing its decades-old one-child policy.
In addition to the new tax on contraceptives such as condoms and birth control pills, the Chinese government is exempting childcare, marriage-related services and elder care from value-added tax (VAT), the BBC reported.
Beijing has been pressuring young people to marry and have children as it grapples with an aging population and a sluggish economy. Official figures show that China's population has shrunk for three consecutive years and around 9.54 million babies will be born in 2024.
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A caregiver carries a baby in a woven basket in China as the government implements new fiscal and social policies aimed at encouraging families to have more children amid a population decline. (Cheng Xin/Getty Images)
That figure is about half the number of births recorded a decade earlier, when China began easing limits on family size, according to national statistics cited by the BBC and the AP.
China's demographic pressures have been mounting for years. Births fell from about 14.7 million in 2019 to about 9.5 million in 2024. In 2023, India officially surpassed China as the world's most populous country.
The new tax on contraceptives has sparked ridicule and concern within China. On social media, some users joked about stocking up on condoms before prices rise, while others argued that the cost of contraception pales in comparison to the expense of raising a child, the BBC reported.
“I have one child and I don't want to have any more,” Daniel Luo, a 36-year-old resident of Henan province, told the BBC. He said the price increase would not change his family plans, comparing it to small increases in subway fares that do not alter daily behavior.
Others worry that the policy could have unintended consequences. Rosy Zhao, who lives in the central city of Xi'an, told the BBC that making contraceptives more expensive could lead students or people with financial difficulties to take risks. He called that the most dangerous potential outcome of the policy.
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China reversed its controversial one-child policy in 2015. (Adek Berry)
Health experts echoed those concerns in interviews with the AP, warning that higher prices could reduce access to contraception and contribute to more unwanted pregnancies and sexually transmitted infections. China recorded more than 670,000 cases of syphilis and more than 100,000 cases of gonorrhea in 2024, according to data from the National Administration for Disease Prevention and Control.
China has also reported some of the highest abortion numbers in the world. Between 2014 and 2021, authorities recorded between 9 and 10 million abortions a year, according to the National Health Commission. China stopped publishing data on abortions in 2022.
Demographers and policy analysts remain skeptical that taxing contraceptives will significantly increase birth rates. Yi Fuxian, a scientist at the University of Wisconsin-Madison, told the BBC that the idea that higher condom prices would influence fertility decisions amounts to thinking too much about politics.
Revenue from value-added taxes, which amounted to nearly $1 trillion last year, accounts for around 40% of China's tax revenue, according to figures cited by the BBC.
Henrietta Levin of the Center for Strategic and International Studies (CSIS) described the move as symbolic, reflecting Beijing's attempt to raise what she called strikingly low fertility numbers. He also warned that many incentives and subsidies rely on provincial governments that are already heavily indebted, raising questions about whether they can adequately fund the measures.
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A family of three takes a selfie in a Beijing shopping mall as the Chinese government weighs options to increase the birth rate. (Yang Yuran/China News Service/VCG via Getty Images)
Public health experts interviewed by the AP said the policy could disproportionately affect women, who bear most responsibility for birth control in China. Research published by the Bill and Melinda Gates Foundation in 2022 found that approximately 9% of couples use condoms, while 44.2% rely on intrauterine devices and 30.5% on female sterilization. Male sterilization represents 4.7%.
Some women say the tax reignites resentment toward the long history of government involvement in reproductive decisions. The Communist Party enforced the one-child policy from about 1980 to 2015 through fines, sanctions and, in some cases, forced abortions, according to the AP. Children born outside the polity were sometimes denied family registration, effectively making them non-citizens.
“It's a disciplinary tactic, a management of women's bodies and my sexual desire,” Zou Xuan, a 32-year-old teacher in Jiangxi province, told the AP.
Concerns about further state intrusion have also been raised in recent months. The BBC reported that women in some provinces have received calls from local officials asking them about menstrual cycles and pregnancy plans. A health office in Yunnan province said the information was needed to identify pregnant women, a move that critics say risks alienating the very families Beijing hopes to encourage.
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Levin warned that such approaches could damage public trust. She told the BBC: “The [Communist] The party cannot help but get involved in every decision that matters to it. So he ends up being his own worst enemy in some ways.”
While the government is adjusting policies once used to limit population growth, experts warn that reversing decades-long demographic trends will be much more difficult than raising prices at the cash register, especially after years of policies that determined whether families could have children.
