We recently had our second child – a baby boy we named Evan (and Li Li, 力力, in Chinese). This being our second time to go through pregnancy and birth in Beijing, there was much to compare, and contrast, between our first experience giving birth in Beijing four years ago and this time around. Here are some of the biggest differences we’ve noticed and some of the most important things we’ve learned:
1. Healthcare costs have gone up considerably: The grand total for having our daughter at Peking Medical Union Hospital four years ago was around RMB 26,000 – this included all prenatal visits, medicine, the c-section procedure and the hospital stay. For our second child we purchased an online “group buy” package from Amcare that cost around RMB 28,000 and ended up paying around RMB 60,000 for everything (prenatal, c-section, medicine, hospital stay etc.) in the end. Apparently prices at PKMU are in a similar range these days due to high demand for doctors at this prestigious public hospital. If you are looking for higher quality service and more attentive care offered at Beijing’s better-known private healthcare facilities but are on a budget, you’d be well advised to get prenatal insurance at least a year in advance.
2. Demand for nannies (in Chinese, yue sao, 月嫂) has also dramatically increased, as has the price: The first nanny we hired (one of 13 we eventually cycled through) back in 2008 had an asking price of around RMB 1,700 a month (granted, she was considered “less experience,” hence the lower rate). We are now paying the nanny we just hired RMB 6,800 a month, which is considered a relatively low rate considering others are asking for as much as RMB 12-15,000 a month – more than what most white collar office workers make in Beijing.
3. Chinese public hospitals don’t actively encourage breastfeeding: We discovered this the night after our first child was born when the late-shift nurse stuck a bottle of formula in our crying baby’s mouth and left for the night. We fought a losing battle to breastfeed her from then on and eventually gave up entirely for the bottle. Fortunately breastfeeding is working out much better this time as both the nurses at AmCare and our nanny are experienced in teaching mothers how to breastfeed – a concept that has yet to be fully adapted by most public hospitals in China.
4. Do your homework when it comes to selecting an ob-gyn: The right doctor can mean the difference between life and death, as we found out first-hand. Due to her extremely thin and sensitive uterus (exacerbated by the previous c-section), my wife was in a dangerously critical condition in the weeks running up to the delivery and during the procedure itself, when she started bleeding profusely. We were lucky to have Dr Gai Mingying, who has over 30 years of experience, overseeing the delivery – not only was she was able to successfully complete the c-section, but also instructed the less-experienced nurses about how to tend to my wife’s bleeding during the critical hours after the surgery when she was very much in danger of succumbing to her bleeding. We asked for Dr Gai by name based on what we knew of her reputation from word-of-mouth and online resources like haodaifu (haodf.com), an online medical professional database with patient rankings and comments. There are several similar sites in Chinese, including 51daifu.com, daifumd.com and haoyisheng.com – if you’re looking into hospitals with Chinese doctors (many more well-known doctors split their time between several institutions, both public and private) ask a Chinese friend to help you search if necessary.
5. Decide carefully between having a c-section vs natural birth if it’s your first delivery: As I mentioned above, my wife opted to have a c-section for her first delivery due to a heart condition that the doctors feared would flare up during labor. We came to regret this in hindsight – the procedure turned out to be quite risky due for my wife due to her extremely thin uterus that very nearly stretched the incision to the breaking point – we were extremely lucky that things turned out fine in the end.
6. On a related note, AmCare allows dads-to-be to see their babies in the delivery room upon birth, which is great (as public hospitals in China invariably do not), but what they don’t tell you is you might also see your wife completely cut open on the operating table if she is undergoing a c-section. I was definitely not prepared for the sight of my wife being operated upon (or her digestive organs splayed out on a tray to be more precise) when I was led into the OR to see my baby. The experience was unsettling, to say the least – I was overjoyed to see my son, but completely and utterly freaked out to see my wife in such a state. I assumed there would at least be a sheet to obscure the view, which there was, only it was obscuring my view of her head and face. For the doctors this is an everyday sight, of course, but if you’re squeamish like me you might want to ask about the setup first.
7. Chinese vs English names on the birth certificate: If you’re a mixed-nationality couple like us (I’m American, my wife is Chinese), recording your child’s name on the birth certificate can be a bit tricky if you’d like your child to have both a Chinese and English name. In the case of our daughter we had to use a pinyin transliteration of her Chinese name “Jing-Yu” (as recorded on the hospital issued birth certificate) to apply for her American passport and social security card despite the fact that I have given her an English name. For our son we opted to just use his English name on the birth certificate – which means that his Chinese name has no legal bearing for now. This is a grey area not only for my kids but also myself as a notary recently informed me that the only legally recognized Chinese name I can use on official documents in China is the awkward transliteration of my English name (“Jie Rui Jia Zhan”) that is printed in my Beijing-issued marriage certificate – a rule they insisted on following despite the fact that I’ve had a Chinese name since birth.
8. Make a “contribution,” get a hukou: I wrote about my daughter’s de facto dual citizenship status in a previous post, but the situation is different for our second child due to China’s one-child policy, which entails that my son can technically only be an American citizen at this point. But as you’ve probably noticed, there are still many of Chinese families who have multiple munchkins. Oftentimes, they are entitled to do so under certain conditions – i.e. if both parents are only children, or if the parents are members of a minority ethnic group that is exempt from the one-child policy. However there are just as many families who do not qualify but still have two children with legal hukou (household registration) – these are obtained after the parents make a “contribution” of a few hundred thousand kuai to something called the She Hui Fu Yang Fei (社会抚养费) – roughly translated as “The Social Levy Fund” (otherwise known as a “fine” to me and you). This has been common practice for years now and when you consider how cities like Shanghai are already loosening one-child policy restrictions one can only assume that Beijing will follow suit at some point soon.
9. No matter how much mental preparation you try to give your older child, she is bound to flip out: We spent months talking our daughter about how great it will be to have a little brother and how she will be a wonderful big sis. It seemed to be sinking in little by little and she was curious and excited to see him at the hospital, but when we finally brought him home she completely flipped out. It took an hour to calm her down and the next morning the sight of Mama breastfeeding her baby brother set her off again. Since then she’s been gradually accepting her new sibling (in fits and starts) but judging from the similar experiences all of our friends who have had second children have shared, this comes with the territory. I’ll have more to say about this in a future post.
10. Circumcision is not regularly practiced in Chinese hospitals: Like many baby boys in the West, I got the snip fresh out of the womb, and I wanted my son to have the same painless experience to save time and trouble. Unfortunately we found out that circumcisions are not routinely performed at AmCare and most other Chinese hospitals. The doctors told us that they were once regularly done at Peking Medical Union (Dr Gai performed quite a few herself back in the day), but they apparently only had “one instrument” that has fallen into disrepair and no doctors who are trained to perform the procedure. We ended up scheduling an appointment at Beijing United Family Hospital for early next month where circumcisions can be performed for around RMB 4,000 (not including consultation fees).