Many young couples are unwilling to have a second child because of factors such as the high cost of raising a larger family and a lack of child care, professional or familial, according to Yang Wenzhuang, head of population and family affairs at the National Health Commission, citing surveys conducted by the organization.

Yang added that some women are concerned that a second child would interfere with their careers, noting that a 2017 survey of female employees who had given birth within the previous 12 months showed that one-third had seen their salaries fall.

In some companies with large numbers of female employees, women had to stagger their pregnancies to suit staffing conditions, and the number who chose to resign due to pregnancy had risen, he said.

In recent years, governments at various levels have strengthened policies to support the universal second-child policy.

With the exception of the Tibet autonomous region, all provinces, municipalities and autonomous regions on the Chinese mainland have adopted revised family planning regulations, extending pregnancy leave by between 30 and 90 days. New fathers can also take between seven and 30 days of leave, depending on where they live.

The commission will intensify population monitoring and analysis, and improve basic medical services to cover every aspect of pregnancy and birth.

Moreover, the commission will work with other departments to solve difficulties couples face, including child care, education, housing and employment, to establish a favorable environment and reduce their burden while raising a family, Yang said.

"Population is a major issue that concerns the comprehensive, coordinated and sustainable development of China," the commission said in reply to China Daily's questions regarding the possibility of further adjustments to the family planning policy.

"We will closely watch population fluctuations ... and promote the improvement of supporting policies to promote balanced population development."