One-child policy brings mothers prosperity - and pain

China has made great strides toward improving the quality of life for mothers and children in the last 15 years. Infant mortality has steadily dropped. At the end of last year, 56.4 in every 100,000 women died during pregnancy or childbirth, a drop of 25.8 per cent from the 2001 figure, according to the Ministry of Health.

Maternal Child Health (MCH) care has also improved due to government regulations as well as and international aid from WHO and UNICEF. Virtually all urban women and over 60 per cent of rural women now give birth in hospitals.

Lu Hao, Zhang Qingying (right) and their only child. © Don Hinrichsen

Working women

In 1978, under Deng Xiao Ping, China initiated a set of economic reforms that led to the opening up of China and the development of a market economy. The Chinese economy has steadily expanded in both state owned and private sectors but the majority of work units have continued to give priority to male graduates.

According to a 1993 article in Wenhuibao, a Chinese newspaper, women are still not considered to have business acumen, although they traditionally control the household finances. Additionally, many employers feel that females can't perform physical work, even though women have always done the bulk of farm labour in the countryside. Finally, managers fear that female graduates will marry and have children shortly after becoming employed, thus costing the company more money than a male employee.

Women workers in state and private enterprises are the first to be laid off for the above reasons. Employing female workers costs more because when a female worker takes maternity leave the factory has to pay the basic wage and some additional benefits. In this way economic reforms have also led to the discrimination against women in the work environment.

A working mother may choose the amount of maternity leave she wishes; it usually ranges from one month to one year. In a study done by Zhang Li Xin, a Foreign Languages Department Beijing Normal University Librarian in Beijing, she found that, out of twenty female librarians, "Seven women had a 6-month maternity leave, 5 women had a three-month, and 7 women had a 56-day maternity leave and during the maternity leave women receive their full salary except bonuses."

Thus, the traditional Chinese idea of more children for more blessings and bringing up children for the old age is losing appeal among harassed working mothers. In a survey of 20 female librarians, with 19 married, and one single, Ms Zhang found that two of the married women had 2 children, while all others had one child. When she asked them how many children they would like to have; 9 women said one, 4 women said 2, 2 women said 2-3 but all agreed that more than one child would be a great burden on themselves and their families.

Furthermore, according to the People's Daily, March 31, 2004: "City women are undergoing some changes in their conception of having babies. Now it seems pretty normal for women to have no kid. An example is that in a medium-sized foreign company in Beijing, the 21 women at thirty or above, five have babies, one is expecting and the other 15 all have no kid. And only 2 of the 15 intend to have children in the future."

Giving Birth

Certainly, more and more Chinese women are working full time, marrying later, and many feel that a child takes too much time and commitment. Public education and affluence may have more influence than the doctrine of the One Child Policy on middle class women. Finances and work opportunities now sway Chinese families to feel content with just one, or even no child.

Sexuality education is now a regular feature of the curricula in many secondary schools throughout China. © Don Hinrichsen

"The idea that kids are great because they will care for their elderly parents is disappearing," said Dr. Wang, a 55 year old female doctor in Hohut specializing in obstetrics. "Work pressure, women staying in school longer, and a desire for more consumer goods, as well as a wish to have a solid economic base before having kids - all of these factors influence women."

Even more interesting is the rising number of C-section births combined with a growing disinclination to desire more than one child, or a child at all. In a 2001 research article sponsored by Better Birthing Initiatives (BBI), co-authored by Xu Qian, Helen Smith, Li Zhou, Ji Liang, and Paul Garner the researchers cataloged several important birthing preferences among contemporary Chinese mothers in south China within a hundred miles of Shanghai. Overall, only 50 per cent of the women gave birth vaginally.

Pain relief

Physiological and cultural reasons determine the increasing amount of C-section births. First, women are afraid of the pain incurred during natural childbirth. Nationwide pain relief was rarely administered, both to save the mother money as well as from mothers' fear that it might damage the infant.

Miss Wang, a hotel clerk of thirty six in Hohut, Inner Mongolia, explained, "I refused pain medicine because it cost 80 RMB, almost half again of my hospital fees for my one week stay (200 RMB, inclusive) sixteen years ago. Even today medicine costs more than hospital care."

According to the BBI study only 22 per cent of women out of the total Caesarean section cases were diagnosed with fetal distress. Other reasons for CS delivery mentioned frequently by providers were under term and over weight babies. A few Chinese doctors felt more confident in using CS because it had a lower risk of complications than vaginal birth.

A third reason for non-vaginal birth is cultural: choosing an auspicious date for birth, marriage, and other important ceremonies remains popular throughout China. "Caesarean delivery allowed me to choose a lucky day of childbirth according to the Chinese calendar," said Mrs Na. "This was very important to my entire family." Conversely, many Chinese women feel that a C-section will damage their 'yuan qi' (vigour), and cause them to lose energy. C-section deliveries are also more expensive than vaginal deliveries by about 1000RMB; such births require a longer hospital stay, IV antibiotic procedures, and more checkups by staff members. In fact, many Chinese doctors are reluctant to do the operation for fear of infection.

Chinese Way

Additionally, many doctors reluctantly perform episiotomies for the same reasons. This may result in increased incidence of tearing, increased foetal distress and more frequent postpartum vaginal bulging and stretching. Since the 1990s both the WHO and UNICEF have promoted baby friendly hospitals and begun education campaigns to change such provider behaviour.

Traditionally during delivery a woman has her family around her, even in the labour room. Chinese women as a rule give birth en masse; there are no private birthing rooms, except in a few very new foreign owned and operated hospitals, mainly in Beijing and Shanghai. In the past, labour wards became very crowded. But in the last fifteen years medical personnel have come to feel that family members may cause cross infection, or disrupt the medical procedures, so nowadays a nurse or midwife stays with the woman in labour and the family waits outside.

The Chinese Way has always treated children and mothers with great affection. Working mothers can rest under the doting care of their families. They now receive very good maternity benefits from their employers. But having entered the professional work force, seeking economic prosperity and job fulfillment Chinese mothers must struggle, like Western mums, to find the time and money to create and raise their children. Development has brought Chinese women both pain and prosperity.

Valerie Sartor is an American freelance writer. She has worked in Northern China since December 2004 and teaches English to graduates at the Inner Mongolia Agriculture University.

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