A caesarean section (剖腹产 pōu fù chǎn) can effectively prevent maternal and newborn mortality. But several studies have shown that high cesarean section rates could be linked to serious conditions for both maternal and child health. Since 1985, the World Health Organization has considered the ideal rate for caesarean sections to be between 10-15%, and warns against higher rates than the recommended upper limit of 15%.

China cesarean section rates are high. Indeed, they are among the highest in the world, according to the World Health Organization report (报告 bào gào). Almost half the babies in China during the years 2007-8 were delivered by cesarean section. The latest report published by the Chinese National Health Care Committee notes that the percentage of deliveries by cesarean was 36.7% in 2018.

• 2018年全国剖宫产率为7%。

2018 nián quán guó pōu gōng chǎn lǜ wèi 36.7%.

In 2018, the national cesarean section rate was 36.7%.

The main reason, other than medical necessities, that might explain the high rate of caesarean section in China is women’s concerns over a long and painful delivery (接生 jiē shēng). While epidural injections (无痛分娩针 wú tòng fēn miǎn zhēn) to eliminate pain in a vaginal birth are widely available in developed countries, this service is not always offered in Chinese hospitals. Almost 80% of women in the United States who had a vaginal birth received epidural or spinal anesthesia. In China the rate is under 10%, due to a shortage of anesthesiologists.

According to a map published by The World Federation of Societies of Anesthesiologists, China has only 5.12 anesthesiologists (麻醉学者 má zuì xué zhě) per 100,000 population. The United State, Sweden, Russia, and Czech Republic, for comparison, have more than 20 per 100,000 population. This shortage of anesthesiologists poses a major obstacle to promoting pain-free natural labor in China. Understaffed anesthesia departments are kept busy with surgeries and don’t have time for natural births (顺产 shùn chǎn).

• 国内之剖腹产率很高。

Guó nèi zhī pōu fù chǎn lǜ hěn gāo.

China cesarean section rate is very high.

Many Chinese women end up opting for cesarean sections just to avoid labor pain. Some mothers-to-be (准妈妈 zhŭn mā mā) schedule an elective caesarean section (选择性剖腹产 xuǎn zé xìng pōu fù chǎn) beforehand. Other ask for cesarean sections when arriving at the hospital with contractions. Ma Rongrong, was only 26, when she arrived in labor to the hospital in August of 2017. She was kneeling on the floor, doubled over in pain, begging her family for a cesarean section. In China, cesarean sections require the permission of family members, and Ma’s family refused the operation (手术 shǒu shù). As her labor pains intensified, Ma jumped to her death out of a window in the labor room.

• 很多妈妈都选择剖腹产分娩。

Hěn duō mā mā dōu xuǎn zé pōu fù chǎn fēn miǎn.

Many mothers choose to give birth by cesarean section.

One of the possible reasons of Ma’s family to refuse the operation is the fear that doctors preferred surgery because they could charge a higher price for it. The fact that caesarean section is financially profitable for the hospital is another reason that might explain the high rate (率 lǜ) of caesarean sections in China. Childbirth costs vary according to the mode of delivery. Pricing standards vary widely among hospitals and regions, but usually the cost of cesarean section is higher than the cost of a vaginal delivery. Cesarean sections can double and even triple the cost of birth. When the hospital (医院 yī yuàn) has a financial interest in performing cesarean sections, its doctors encourage and recommend patients to undergo the operation.

In recent years, reducing Chinese cesarean section rate became a priority. China aims to reduce (减少 jiǎn shǎo) its rate, by promoting painless vaginal labor (无痛分娩 wú tòng fēn miǎn). There is a focus on educating women on the benefits of natural birth in brochures and through childbirth preparation courses. China is providing enhanced training of anesthesiologists, obstetricians and midwives, regarding the use of anesthesia during natural births . They are also promoting water birth, hypnosis, TENS device and other ways to relieve the pain. But, mostly, the government is fining and subsidizing hospitals according to their cesarean rates. Nowadays, hospitals are simply turning down requests for elective operations. A woman from Hangzhou city, for example, was due to deliver her first newborn in the Hangzhou maternity hospital. She asked for an elective cesarean section in advance, but was declined.

• 减少非必需剖宫产手术，让更多孕妇自然分娩。

Jiǎn shǎo fēi bì xū pōu gōng chǎn shǒu shù, ràng gèng duō yùn fù zì rán fēn miǎn.

To reduce unnecessary cesarean section surgeries, and let more pregnant women to give birth naturally.

 

Text vocabulary

准妈妈 zhŭn mā mā = expectant mother

孕妇 yùn fù = pregnant woman

分娩 fēn miǎn = to give birth

接生 jiē shēng = to deliver

顺产 shùn chǎn = natural birth

无痛分娩 wú tòng fēn miǎn = painless labor, painless childbirth

剖宫产 pōu gōng chǎn = cesarean section

剖腹产 pōu fù chǎn = cesarean section

选择性剖腹产 xuǎn zé xìng pōu fù chǎn = elective cesarean

手术 shǒu shù = operation

无痛分娩针 wú tòng fēn miǎn zhēn = epidural

麻醉学者 má zuì xué zhě = anesthesiologist

医院 yī yuàn = hospital

报告 bào gào = report

率 lǜ = rate

减少 jiǎn shǎo = to reduce

 

好好学习，天天向上！

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