Thursday, March 27, 2014

What are you having?

Top Secret information obtained in the U.S.
What's the first question people ask when they find out that you're pregnant? The first may very well be, “How far along are you?” But any proceeding questions, in my experience, depend on what
country you're in. In America, it's usually, “Do you know what you're having?” with “Was this planned?” coming in at a distant third. In China, people never ask you about the sex of the baby, as couples aren't (suppose to be) told. Due to a cultural preference for boys and the added pressure of the One Child Policy, selective abortion became a huge problem in China once ultrasounds become popular. These days, doctors are (technically) forbidden from disclosing the sex of fetus. A kind reminder for patients not to ask is also posted outside the ultrasound room. I have heard of foreigners who told the sex, or discretely given a piece of blue or pink candy. Ming and I were under the impression that we would not be told, though I had the chance to satisfy my curiosity while in the U.S.

As for the third question, the ever-so-awkward, “Was this planned?”, I can't imagine being asked this by a Chinese person. The question did pop up a few times when announcing my pregnancy to close friends and family members back home. In the U.S., unplanned pregnancies are becoming the norm, as well as drastically increasing among single women. The situation in China is vastly different, as it is hard to get official documentation for your child if s/he is born out-of-wedlock. Couples are also required to obtain a special certificate, more-or-less granting them permission to procreate (valid for two years!), before becoming pregnant. Furthermore, it still seems to be somewhat rare for a Chinese couple to choose to be child-free. I'm under the impression that most pregnancies in China are planned, or at the very least, it is best to pretend they are. In any case, it would be very inappropriate to ask if a pregnancy was an “oops.”

So what do Chinese people tend to ask pregnant women? The most common question, the question I've nearly exclusively been asked, is: “Are you having a vaginal delivery or C-section?” While many personal issues suddenly seem fair game to the general public once you are pregnant, this still strikes me as a somewhat invasive question, especially from an acquaintance or stranger. Luckily, after having lived in China this long, I'm not much bothered by probing personal questions. I let everyone who asks know what my plans are.

A "black" place?
But why is this anyone's business? Why is this question on the forefront of people's minds? After becoming pregnant, I was surprised to learn how common C-sections are in China and how often they are encouraged by doctors. I initially thought it was because doctors genuinely believed them to be safer, but after learning more about it, it seems like they are often pushed as a means to make more money for the hospital, with a kickback going to the physician. One of my students and I were discussing medical procedures and hospitals recently and perhaps she put it best when she said, “Hospitals in China are blacker than you might guess.” Indeed, there seems to be some rather unethical money-making schemes going on. I've gotten a sense of this during my pre-natal visits, as I am encouraged to have an ultrasound every time I see the doctor, despite having a low-risk pregnancy. Every ultrasound costs 100 RMB (US$15), which doesn't sound like a lot by Western standards, but compared to the cost of visiting the doctor (a few RMB), it is significant.

You'd think that these practices would make me really angry and in a way, they do. I think it's sad that many Chinese people feel they can't trust doctors and have to be somewhat skeptical of prescribed tests and treatments. On the other hand, I do have some sympathy for doctors and hospitals. Most hospitals appear to be understaffed and underfunded. Doctors and (especially) nurses are paid poorly, yet it's important to keep costs down so patients can afford treatment. If you don't have the money for treatment, you can quite literally expect to be left out in the cold.
City Center Hospital, Chengde.
Where William will be born.

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