Consequences of Birth Policies and Practices in Post-Reform China

Abstract

This paper comments on the provision of birthing services in Sichuan and Shanxi Provinces in China within a policy context. The goal was to understand possible unintended and harmful health outcomes for women in the light of international evidence, to better inform practice and policy development. Data were collected from October 2005 to April 2007 in 25 hospitals across 13 counties and one city. Normal and caesarean birth records were audited, observations made of facilities and interviews conducted with officials, administrators, health workers, women who delivered in hospital facilities and women who delivered at home. We argue that in the context of a neo-liberal health economy with poorly developed government regulatory policies, those with the power to pay for maternity care may be vulnerable to a new range of risks to their health from those positioned to make a profit. While poor communities may lack access to basic services, wealthier socio-economic groups may risk an increase in maternal morbidity and mortality through the overuse of avoidable intervention. We recommend a stronger evidence base for hospital maternity services and changes to the role of the State in countering systemic problems.

Barriers to increasing hospital birth rates in rural Shanxi Province, China

“…Some of these results have been published elsewhere. [27][28][29] The findings reported here drew on the same sampling base with all available women who were residents of the prefectures and had had a home birth within the previous six months and could be contacted through the MCH worker and invited to participate. We managed to interview all the eligible women (n=30) in five of the counties studied.…”

Caught between social and market considerations: a case study of Muhammadiyah charitable health services

“…It is increasingly common in Muhammadiyah and other private services in Indonesia to use ultrasound screening not only for early detection of multiple pregnancy and better gestational age assessment, as recommended by the World Health Organization (WHO), 20 but also to provide a visual record of the growth, formation of sexual identity and movements of the fetus. † Frequent scans have not been shown to have hazardous effects, but they are poorly justified on clinical grounds as they do not enhance perinatal outcomes.…”

“…† Frequent scans have not been shown to have hazardous effects, but they are poorly justified on clinical grounds as they do not enhance perinatal outcomes. 20 Women health's organizations ask whether women are making an informed choice,** a concern raised also in other countries with a high frequency of scans, such as Syria, Viet Nam and China. [20][21][22] In a parallel trend, caesarean section is increasingly recommended in Muhammadiyah facilities as in the rest of the country and the region.…”

“…20 Women health's organizations ask whether women are making an informed choice,** a concern raised also in other countries with a high frequency of scans, such as Syria, Viet Nam and China. [20][21][22] In a parallel trend, caesarean section is increasingly recommended in Muhammadiyah facilities as in the rest of the country and the region. A recent audit of Indonesia and three other Southeast Asian countries found that overall caesarean rates were 27%, whereas complications requiring caesarean section are estimated by WHO at 5-15% of deliveries.…”

Childbirth care practices in public sector facilities in Jeddah, Saudi Arabia: A descriptive study

“…A wide range of well-established online databases was used including Medline, Maternity and Infant Care, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library Database of Systematic Reviews, Pubmed and Google Scholar. Some studies found had examined the routine policies and practices of normal birth worldwide (Maimbolwa et al, 1997;Festin et al, 2003;Turan et al, 2006;Harris et al, 2007;Danichevski et al, 2008;The SEA-ORCHID study group, 2008;Chalmers et al, 2009). In the Arab world, studies of hospital policies and practices for normal childbirth have begun to assess whether they are within EBP (Khayat and Campbell, 2000;Abdulsalam et al, 2004;Khalil et al, 2005;Wick et al, 2005;Hassan-Bitar and Wick, 2007;Sweidan et al, 2008;Khresheh et al, 2009).…”