The officials also collected large fines from couples who broke the rules. One senior researcher at the Central Party School estimated in 2015 that the fees amounted to between $3 billion and $5 billion annually.

In recent years, the government has been reassigning family-planning employees to roles including in population research and tackling Covid-19. But local governments retain the power to enforce birth limits as they see fit, which has led to inconsistencies.

The central government said in May last year that civil servants did not have to lose their jobs for violating birth limits, yet months later, a village committee in the eastern city of Hangzhou fired a woman after she had a third child — prompting a public outcry.

Ultimately, the fate of China’s family-planning policies may change little. A generation of highly educated women are putting off marriage and childbirth for other reasons, including a rejection of traditional attitudes that dictate women should bear most of the responsibility of raising children and doing housework.

Liu Qing, a 38-year-old editor of children’s books in Beijing, said getting married and having children were never in her future because they would come at too great a personal cost.

“All the things that you want — your ideals and your ambitions — have to be sacrificed,” Ms. Liu said.

Ms. Liu said Chinese society imposed a motherhood penalty on women, pointing to the discrimination that mothers often faced in hiring.

“I’m furious about this environment,” she said. “I’m not the kind of person who would accept this reality and compromise. I just won’t.”

For other Chinese, having fewer children is a matter of necessity when holes in the country’s social safety net mean that a major illness can lead to financial ruin.

Ms. Fan, the woman in Hubei who was spared a fine, said that she and her husband, a laborer, were getting increasingly desperate. Public health insurance had covered half the cost of her daughter’s treatment for leukemia, but they were on the hook for $76,000.

She had a third child only because she heard that a sibling’s cord blood could help in the treatment of leukemia. But she later learned that such treatment would cost more than $100,000.

“I don’t dare think about the future,” Ms. Fan said. She added that if her daughter’s condition deteriorated or they went broke, they would have to give up treatment.

“We can only leave it up to her fate,” she said.

Research was contributed by Claire Fu, Liu Yi, Albee Zhang and Elsie Chen.

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