Of Children, China, and Covid-19

IN THE summer of 2013, I was six months pregnant and completing a five-week research attachment at the Chinese Institute of Pathogen Biology outside of Beijing.

Weekdays were a blur of experiments, but weekends afforded us some time to enjoy the sights, food and culture.

It is hard to top the memory of climbing up the majestic Mutianyu portion of the Great Wall in summer, especially while carrying a small incubator in my midsection.

But one of my most vivid memories was a relaxed Saturday spent visiting a beautiful local mosque in the outer Beijing suburbs, and trying delicious halal Peking duck with a PhD student from the laboratory.

We sat on an hour-long bus ride talking about our families and she mentioned having a sister.

I recall asking, "I thought there was only one child allowed per family?"

She said that this was true, but there were special rules for her ethnic group, allowing them to have two whereas the majority Han population were only allowed one. Three years later, all Chinese families were allowed two children.

Since 2021, three children were allowed, and incentives provided. But these policies have done little to increase the total fertility rate (TFR) in the country.

In fact, the data shows a plunge in the TFR in 2021—likely due to pandemic factors and China’s especially stringent zero-Covid policy.

Early this year, China reported a higher number of deaths than births for the first time in 60 years — a trend experts say will be difficult to reverse.

Many interpret this as the beginning of a demographic decline in China. But if we were to compare the TFR of China to Malaysia from 1995 to 2020, China’s TFR has been steadily at 1.6 – 1.7 children born per woman of reproductive age (15-49 years) while Malaysia’s TFR has dropped from 3.31 – 1.97 children.

A TFR of less than 2.1 means a woman is not having enough children to replace herself and her partner in the next generation, thus being below 'replacement level fertility'. Without any migration, the population will decline.

These declining rates have affected all ethnic groups in the last decade, and the TFR for all ethnic groups except Malays (2.2 children) have reached below replacement level.

The Malaysian Department of Statistics reported last year that Malaysia’s TFR in 2021 had dropped further to a TFR of 1.7, following the 'baby bust' trend seen worldwide due to the Covid-19 pandemic.

There are several economic, health and societal reasons to delay having children during a pandemic.

People who have lost income and/or have survived a year of home-schooling are unlikely to plan for another mouth to feed or another child to teach.

Although the virus is known to cause milder disease in babies and children, the virus is particularly harmful to pregnant women, especially if unvaccinated.

Attending healthcare facilities regularly, as pregnant women often have to do, comes with a host of risks of exposure.

This is especially true at the height of the pandemic and prior to the widespread availability of vaccines.

Recent studies confirm unvaccinated pregnant women have a higher risk of requiring intensive care and ventilators, and worse they have a 70% increased risk of death.

In addition, general anxiety about pandemic risk and uncertainties and restrictions on travel keeping partners apart would indubitably contribute to reduced baby-making.

Today, with vaccines available and things returning to normalcy, some reports are suggesting that birth rates are returning to pre-pandemic levels.

Despite better control of new waves of outbreak thanks to higher population immunity, the economic effects of Covid-19 are still only unfolding.

Living has become less affordable for a large proportion of people, even with government assistance in the form of economic stimulus packages throughout the pandemic.

While some of this financial pressure reflects general inflation and a sluggish economy, it is further fuelled by our desire for materials and a lifestyle that requires more money to support.

Having children has become a lifestyle decision. Spend tens of thousands on a hospital delivery, baby gear, clothes, nursing paraphernalia or pay for vacations and nicer handbags?

The cost of having a baby is only a small fraction of the costs of feeding children and giving them an education.

These are only the monetary costs, as any parent will tell you, the day you become a parent is the day you never stop working (and worrying) for your child.

This is why no individual should be pressured into having children, and everyone’s own perfectly valid reason to defer or delay having children should be respected.

But supporting the commitment to raising children through appropriate financial, societal, and educational support may empower couples who are delaying having children due to competing life and financial priorities. And there is urgency in this need for empowerment.

Humans are the only resource that cannot be grown from the ground, harvested from the sea, or manufactured in a factory.

It takes two people of different sex to produce viable offspring, and at least one person (though more often, a proverbial village) to make a lifelong commitment to raise the offspring until they are of age to bear their own children.

As the situation in China suggests, policies to prevent people from having fewer children can be quickly successful, but policies to encourage more children are less straightforward.

Failure for us to explicitly recognise that growing a healthy population is a national priority may find us in an irreversible situation.

Few things rival the joy of welcoming a new family member. If you asked me, huffing and puffing while carrying my little incubator up the Great Wall of China roughly 10 years ago, if I wanted another child, I would have given a negative answer.

But then I welcomed my second child, and it hurts to imagine an alternate reality. Children bring endless demands, anxiety, exhaustion, and exponential costs. They also bring infinite beauty, hope, wonder and potential.

But the greatest benefit of having children to me is a selfish one.

As complicated as life can get with children in the equation, there is no formula that brings as much meaning and happiness to me as giving my children a hug after we talk through an argument.

No bigger thrill than watching my children enjoy food, books, or music that I loved since I was a child.

There is no purer love than what I feel when entertaining complex philosophical questions small children tend to pose right before drifting off to sleep.