The worry for some couples is that authorities could turn to more forceful or restrictive measures akin to those used to enforce the one-child policy. Guidelines released by the State Council in September said local governments should try to reduce the number of abortions for “nonmedical reasons.”

Twelve public hospitals contacted by The Washington Post, including facilities in Shanghai, Beijing and Guangzhou, said they no longer offered the procedure. Six hospitals said they still perform the surgery, but one said it was no longer available to unmarried men.

Couples and single men who sought the procedure said doctors and hospital staff refused, telling them they would regret the decision later. Some asked for documentary proof of marriage and evidence that couples had already had children before going ahead with the surgery.