In a Slate article called “Cesarean Nation: Why do nearly half of Chinese women deliver babies via C-section?”, author and journalist Mara Hvistendahl looks at the reasons behind China’s skyrocketing cesarean rates. Between 2007 and 2008, a whopping 46 percent of Chinese babies were born via C-section – the highest documented rate in the world. This number is three times higher than the World Health Organization’s recommended 15 percent threshold.
Comparatively, Canada has a C-section rate of around 26 percent (as of 2006) while the US hovers around 32 percent (as of 2007).
Why is China’s C-section rate so high? “China is the leader of the pack by a long shot, due in part to its distinctive history,” argues Hvidenstahl. Here’s what she means:
- Superstition: Pregnant Chinese women often hire fortune tellers to predict an auspicious date and time for the operation. For example, the sixth and eighth days of the lunar month are popular, but people avoid Tomb Sweeping Day (清明节, April 4-6) like the plague.
- The shift to a market-based health care model: In the 1990s, China made the move from a nationalized health care system to a market-based model. Prior to that, C-sections were relatively rare and expensive. But from 1993 to 2002, the country’s cesarean rate quadrupled.
- Convenience: Midwives are rare in China; most of the time, childbirth falls instead to “overworked obstetricians.” C-sections are easy to schedule and present fairly low risks, so doctors are generally happy to accommodate patients.
- Economic incentives: Some say C-sections are a handy way for hospitals to increase revenue. In big cities, a cesarean can cost over RMB 6,300 – more than double the cost of a vaginal birth. According to a WHO study, 62 percent of surveyed Asian hospitals “have a financial interest in performing C-sections.”
But perhaps the most significant factor in the rise of C-sections is China’s one-child policy. The latter contributed to a climate in which women (and their husbands, parents, and in-laws) seek to minimize the risks associated with pregnancy:
Not only are pregnant women in China expected to take supplements, eat bitter medicinal soups, and avoid strenuous physical activity, they are pressured to wear antiradiation vests to protect their bellies from cellular phone signals and thick, unbecoming overalls adorned with teddy bears believed to soothe baby.
What’s more, the biggest risks associated with C-sections – such as a ruptured uterus or hemorrhaging caused by abnormalities in the placenta – tend to happen during later births. Of course, much of that apprehension melts away if you’re only allowed to have one child.
The article doesn’t touch on VBACs (vaginal birth after cesarean), doulas, or water births. To find out more about these natural birth options in Beijing, visit the following resources:
- Beijing Antai Maternity Hospital: A private Chinese hospital that offers unimpeded water births and VBACs (Chinese proficiency required).
- Beijing Doula: The website of Liora Pearlman, doula-in-training and founder of Beijing Mamas
- Robyn Wexler: Robyn Wexler is a trained doula and the co-founder of Yoga Yard.
- Beijing United Family Hospital: The Obstetrics and Gynecology department at BJU has midwives on staff and can provide VBACs.
Do you have an experience to share about C-sections in China? Let us know in the comments.
