A child looks at his reflection in a window in Beijing, Nov 17, 2013. [Photo/Agencies]

When Gu Xuan fell ill one night with only her 8-year-old daughter by her side, she felt lucky she could call her sister who was a 30-minute drive away.

Gu was taken to hospital for surgery and was told she could have died from a hemorrhage if she had been a few hours late.

"We must have another child," she yelled into the phone last year. Her husband was working in Tokyo. "I don't want my daughter to grow up in solitude, with no one around to give her help."

She insisted her husband return to Beijing. He did earlier this year. But at 41, Gu suffers from anemia and severe backache. She doubts she can live through the pain of childbirth and have a healthy baby.

"The policy change has come too late for me. If I was 30-something, I'd not hesitate at all," she said.

The news of the policy change has been praised by many people in their 20s and 30s. Women of Gu's age, however, have mixed feelings. In addition to age and health considerations, some fear they may have to give up their jobs to bring up another baby. Less income plus higher expenses makes them feel insecure. In cities like Beijing, many worry a bigger family means a bigger home, but house prices are beyond the affordability of average wage-earners.

Other worries include poor air quality, food safety and academic pressure in a society where schoolchildren spend most of their spare time attending cram classes hoping to stand out among their peers.

As a result, the opportunity to have a second child may not become a reality.

Demographers are not anticipating an influx of newborn babies at a time when young couples prefer smaller families.

"More babies may be born in the first four to five years, but the birth rate is likely to drop again soon after that," said Zhai Zhenwu, a demographer with Beijing-based Renmin University of China.