This chapter examines welfare changes in reform era China through the lens of care – that is, the daily and generational work of reproduction essential for the functioning of society and the economy. During the Mao era, care roles and responsibilities were largely socialized, enabling women to enter the labour force in vast numbers while also contributing to rapid improvements in a range of welfare indicators. The reform era has seen the work of care largely returned to the domestic sphere, with households providing care with unpaid (predominantly female) labour, or accessing care services through the market. These changes have significant implications for women’s choices around work, family and fertility, as well as for the welfare of care recipients. Market reforms and the commodification of care services affect the provision and quality of care services, the nature of care work and the status of its providers. The chapter sheds light on the gendered nature of welfare systems, and the wide-ranging implications of how care is delivered and financed: on the welfare and opportunities of women as carers; and on the wellbeing of those in need of care, as well as on broader economic, social and demographic outcomes.