Motherhood in China comes with its own set of rules, many of which are cultural or based on certain medical perceptions. Besides traditions like “postnatal confinement,” also known as zuò yuèzi or sitting the month, Chinese mothers have long relied on caesarean birth as standard due to perceived safety concerns, auspicious birth date planning, family pressure, and of course overprotective mothers-in-law.
Or it could be simpler than that. According to Pang Ruyan, vice-president of the Chinese Maternal and Child Health Association, “the only reason the rate of C-sections is so high is that people expected to only have one child. They didn’t need to think about having another, or the risk of ruptures.” However, this is changing as many experienced mothers are choosing vaginal birth for their second child after the 2013 ending of the one-child policy.
VBAC, or vaginal birth after caesarean, is an increasingly common choice for Chinese mothers having their second child. According to the US-based think tank The National Center for Biotechnology Information (NCBI), China’s cesarean delivery rates reached a peak in 2010, with some of the highest rates in the world. Most cesareans were performed without a medical need for them. According to the same study, from 2007 to 2016, cesarean delivery rates at county-level and provincial-level hospitals decreased from 46 percent to 32 percent and 68 percent to 44 percent, respectively.
National and local government propaganda efforts which have strongly promoted natural birth, as well as the abolition of the one-child policy, has led this trend to continue, making vaginal births the norm in China. Many of these mothers had cesareans the first time around, but are looking to try VBAC.
Vaginal births have several advantages over cesareans, according to syndicated news outlet LiveScience. Besides shorter recovery times and less risk of infection, for some, vaginal birth allows for a more active role in delivery, which can create lifetime moments of bonding for mothers, partners, and babies. Most glaringly, mothers have a three times greater risk of death from C-sections than vaginal birth, mostly from blood clot issues.
Dr. Sahba Farhad from the Obstetrics and Gynecology Department at Beijing United Family Hospital told us; “Most maternal morbidity related to the trial of labor after a cesarean (TOLAC) occurs when a repeat cesarean delivery becomes necessary. Thus, VBAC is associated with fewer complications than an elective repeat cesarean delivery, whereas a failed TOLAC is associated with more complications. Consequently, the risk of maternal morbidity is related to a woman’s probability of achieving a VBAC. Women may decide after careful consultation with their doctor if they are appropriate candidates for a TOLAC.”
If you or a loved one are considering VBAC, there is a wealth of information online. Note that to be able to have a VBAC in China, you’ll need a “trial of labor after cesarean,” or TOLAC. All this means is that the mother can go into labor with the goal to deliver vaginally, but a C-section will be employed if there are complications. Nearly 4 out of 10 women who have a trial of labor during VBAC need to have a second C-section.
Photo: Adobe Photo Stock
This article appeared on p18 of beijingkids May 2018 issue