Objective To analyze the incidence and trend of birth defects in Yingquan District before and after the implementation of the universal two-child policy,so as to provide scientific basis for the government to make decisions on maternal and child health. Methods Retrospective analysis method was used to analyze the occurrence and change trend of birth defects in the provincial birth defect monitoring project sites in Yingquan District from 2011 to 2020,and the incidence,main types and sequence changes of birth defects in the 5 years before and after the implementation of the universal two-child policy were compared. Results The incidence of birth defects at the provincial birth defect monitoring project sites in Yingquan District was 73.52/10 000 in the past 10 years.The incidence of birth defects in 5 years after the implementation of the universal two-child policy was higher than that in the previous 5 years (χ²=6.606,P=0.010).Congenital heart disease gradually rose to the first place,with an incidence of 34.24/10 000.Congenital malformations and deformations of the musculoskeletal system with multiple and syndactyly(toes) had become the second largest type of birth defects,with an incidence rate of 19.82 per 10 000. Conclusion After the implementation of the universal two-child policy,the incidence of birth defects has increased and the order of birth defects has changed.