China’s low birth rate has been a top concern for the government since it introduced a universal two-child policy in 2016. After decades of a rigidly enforced restriction on couples to have only one child, the number of newborns has not risen as expected.

Births across the country have continued to fall over the past three years, from 17.86 million in 2016, to 17.23 million in 2017, and 15.23 million last year, according to data from the National Bureau of Statistics.

Social demography professor Yang Juhua, from the Centre for Population and Development Studies at Renmin University of China in Beijing, said there were several factors influencing Chinese women’s decision to stick to one child, despite the policy relaxation.

“People are reluctant to give birth because of two reasons: no money to raise kids and no people to look after them, especially when the babies are too young to be admitted to kindergartens,” she said.

The economic stress of raising a child was not about basic living costs, but the expense of extracurricular courses and tuition fees at elite private schools, she said.

“Parents have to send their kids to learn various subjects in order to keep up with their peers amid fierce competition. So the kids are called cash-smashers.”

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Doris Ding, a mother of an eight-year-old boy in Shanghai, said she decided years ago not to have another child.

The senior manager at an audit firm and her husband, an IT engineer at a technology company, pay more than 200,000 yuan (US$30,000) a year for their son to attend an international primary school. His after-school classes, which include piano and public speaking, cost another 50,000 yuan a year.

“So it’s out of our reach to raise a second kid,” Ding said.

Yang said that for many families the second major challenge was an inability to find relatives or other trustworthy people to take care of their children while they were at work.

“Grandparents are too old or not strong enough to do that. We often hear complaints from old people that they are tired of raising the first kid and don’t want to help raise the second one. Otherwise, they don’t have a personal life at all for many years,” she said.

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Nurseries providing places for children under the age of three was far from sufficient to resolve the problem, Yang said.

On Thursday, China’s executive State Council proposed a raft of policies aimed at easing the childcare burden for new parents, including encouraging companies to set up day care services for children aged three and under, as well as extended childcare and maternity leave.

According to research by Zhu Qin, a professor from the Centre for Population and Development Policy Studies at Shanghai’s Fudan University, China’s total fertility rate is just 1.54 per woman, putting the country among the lowest birth rates in the world.

As well as the economic factors, Zhu said women were not willing to give birth because of the lack of support from society.

The latest survey from Zhaopin.com showed only 8 per cent of companies had designated rooms for mothers and infants, while 40 per cent of working mothers said they did not take their legally entitled maternity or breastfeeding leave.

“In big cities, white-collar women face the challenge that their career progress will be affected by having babies,” Zhu said.