As China struggles with a shrinking birthrate, business is going on as usual at the bustling department of obstetrics and gynecology at Anqing Municipal Hospital, a leading medical facility in the southwest of Anhui province.

Xu Xiaofan, a 31-year-old woman who has been pregnant for 34 weeks, regularly visits the hospital for consultations and routine checks. Her first child is scheduled to be born next month.

Hailing from neighboring Chizhou city, Xu, who is using a pseudonym to protect her privacy, is a quality control worker at an automobile manufacturer. She married her husband, an Anqing native, in May last year.

"It is quite natural for both of us to have this baby. We did not make any special preparations," she said. "Yet these days, many young people are not willing to have children, and they have many concerns such as housing problems. Some do not even consider getting married."

According to the National Bureau of Statistics, the fertility rate nationwide was 6.77 births per 1,000 people in 2022 and 6.39 per 1,000 last year.

Xu said that the willingness to have babies varies depending on the size of the cities people live in and their social surroundings.

Taking stock of her peers and close female friends who are also in their 30s and living in Anhui, Xu said most already have at least one child.

"The financial burden for young residents is much heavier in metropolises such as Shanghai compared to Anqing," she said."One of my cousins lives there, and he is already 36 years old. He and his wife are not planning to have a baby."

Data provided by local statistics authorities echoed her observations. The fertility rate in Anqing registered 6.07 births per 1,000 in 2022, while the rate in Shanghai that year was only 4.35 per 1,000.

Tong Chen, a physician in the hospital's obstetrics department who treated Xu on the eve of the Spring Festival holiday, is also a voluntary member of the hospital's concierge services.

She is a witness to the increasingly improving pregnancy checks being conducted in the country, which is part of nationwide efforts to boost fertility.

"These days, most women coming to deliver here were born between 1990 to 1995. For those born between 1985 to 1990, more of them are here to give birth to their second child," she said.

Tong, 34, joined the medical staff in 2010. She and her husband have two children.

"We had our second child by accident," she said, laughing."The first child was born out of true love."

She also saw an uptick in the country's birthrate after restrictions on having a second child were lifted in 2015, though statistics have pointed to the cooling of the second-child boom in recent years.

"Recently, we have seen more pregnancies and deliveries of a first child than a second child," she said.

Jiang Xihuan, the head nurse of the department, is a certified fertility instructor with the International Childbirth Education Association.

Jiang, 55, specializes in the use of music therapy and meditations to help relieve the pain of pregnancy and childbirth. She is also a local pioneer in applying these techniques and taught them in free training courses and workshops she offered to pregnant women in local communities last year.

In her eyes, the ongoing low fertility rate needs to be addressed with a holistic approach, as financial incentives are not enough to relieve the pressure and anxiety today's young women feel when it comes to childbearing and parenting.

"Decades ago, the country was way poorer, but people were more willing to have children. These days, negative narratives about childbirth shown in mass media are gaining more attention," she said.

"More should be done to help women address their physical and psychological pains during pregnancy and delivery, effectively value their sentiments and address their great emotional needs," she added.

While some Chinese have superstitions that babies born during the Year of Dragon may receive more blessings, Xu, the pregnant woman, said she did not intentionally plan to have a baby this year.

"The entire community should gain a panoramic perspective on the education backgrounds, household situations and living environments of young women," she said as she discussed the country's low fertility rates.

"If they have a greater financial burden, strive for higher education or have an ambitious career path, they may be more unwilling to have a child," she said.

Zhang Bing and He Jiang contributed to this story.