Abstract：Objective To analyze the delivery and hospitalization expenses of two-child puerpera in a hospital. Methods From February 2006 to August 2020, 2 474 puerpera were selected from the first page of inpatient medical records, and 4 948 research samples were formed. The basic situation of puerpera were described, as well as constituent ratios and rank of the major diagnoses. The t-test of two groups of independent samples was used to compare the age of delivery, length of stay and hospitalization expenses of women with vaginal delivery and cesarean section. The influence factors of hospitalization expense were screened with multivariate linear regression analysis. Results The year-on-year growth rate of two-child puerpera was 123.53% in 2014, 109.36% in 2016, and stabilized after 2016. The total number of vaginal delivery women (n1=2780) was higher than that of caesarean delivery women (n2=2168). The average age of delivery, average length of stay and average expenses of hospitalization of the vaginal delivery group were all lower than those of the caesarean delivery group, and the differences were statistically significant. In multivariate regression analysis of hospitalization expenses, age of delivery, delivery mode, policy of "single two-child", policy of "universal two-child", hospitalization days, comorbidities and complications entered into the regression equation (F=2926.669,P<0.001,R2=0.784). Conclusion The two-child policy has promoted the peak period of two-child births, which entered a stable period after 2016. The age of childbirth and the cost of hospitalization gradually increased, the age difference of childbirth increased, and the length of stay gradually decreased. In the vaginal delivery group, the proportion of spontaneous vertex delivery of women giving birth to the second child was lower than that of women giving birth to the first child, but the proportion of gestational diabetes was higher. In the cesarean delivery group, the first major diagnosis of women giving birth to the first child was selective caesarean birth, but the first major diagnosis of women giving birth to a second child was pregnancy with uterine scar. Age of delivery, delivery mode, two-child policy, length of stay ,comorbidities and complications were independent influence factors of hospitalization expenses.