Who’s to blame for expectant mother’s death—pain or deprived rights?
A pregnant woman named Ma Rongrong, 26, jumped off the fifth floor window of a hospital in northwest China’s Shaanxi province, killing herself and her unborn baby. The police have investigated into the matter and confirmed Ma “committed suicide”. Later, the official Webo account of Yulin No.1 Hospital where the tragedy happened publicized a video clip, which reportedly shows the expectant mother in acute pain kneeling down three times to beg for her family’s permission to a Cesarean section.

More medical rights for women in labor

The news has shocked China’s social media and incurred widespread condemnation of Ma’s family for disregarding her sufferings. Along with the anger also come deep concerns among young females about China’s laws to grant expectant mothers’ families instead of themselves rights to make decisions for major surgical operations including C-section.

“She (Ma Rongrong) had several times got out of delivery room due to pain, to ask for C-section permission from her family. The doctor, nurses and hospital management in charge of her treatment proposed C-section on three different occasions, but were all refused by her family,” said a hospital statement.

Some furious Internet commentators argued “only those who’re in labor should have the say because they know what they’re going through.” In the fatal case, the pregnant Ma could not have C-section as she wanted because her family refused to give up natural delivery citing reasons like “of course it hurts, no one gives birth without going through this.”

Chinese law stipulates that medical institutions must seek permission from family members before carrying out major surgical procedures. Three years ago, a pregnant woman died from multiple organ dysfunction syndrome caused by amniotic embolism, a rare childbirth emergency. It’s reported later her hospital proposed to get her uterus removed for saving her life, although the patient’s mother-in-law wishing to have a second grandchild refused to grant permission.

Both cases aroused debate on expectant women’s medical rights. A furious netizen commented, “How could people just get married and then lose controlling rights over their own body. It sounds like married women are not even entitled to the right to life and survival.”

Painless birth not popularized in China

The bereaved family later refuted what the hospital said, insisting that they just followed hospital’s instructions and did not fight against C-section all along. They said it was the hospital that refused to perform the operation on Ma. Although it cannot be fully ascertained “who’s lying” at present, one fact is clear—the unexpected suicide is triggered by long hours of severe pain and consequent hysteria.

It’s reported Ma had suffered more than eight hours before taking the fatal jump. Her baby was due on September 5, but she was admitted to the hospital on Aug. 30 after contractions started. And she belonged to one of the 90 percent of Chinese pregnant women who are not lucky enough to have painless labor, a medical procedure featuring anesthesia to help women in labor relieve pain.

For women in pre-delivery, they averagely suffer from eight hours of pain. While when the period of rapid progress comes, the pain would become even more severe. Related research has found that the process of giving birth usually lasts longer for Chinese women than for Westerners. However, only 10 percent of pregnant women in China have access to painless birth, in western countries, the usage rate of the medical procedure has gone over 80 percent.

This March, Harmonicare Medical, China’s biggest private maternity hospital issued China’s Painless Birth White Paper, noting that using intravertebral anesthesia (one of the most widely used painless birth method) in childbirth is now capable of “achieving the best result at a very low price.”

On December 19, 2004, the Xinhua News Agency published news on the topic, indicating that back then, only one percent of pregnant women in China could have painless birth and it’s challenging to push the wide use of the pain-relieving procedures among medical institutions. Now, more than a decade later, only 10 percent of pregnant women in China give painless birth.

With science and technologies used in the medical procedure becoming mature, why is painless birth not popular in China? The reason is that performing painless birth procedures would not be good bargains for big comprehensive hospitals considering human resources and economic costs.

“There are only a few private and special hospitals in the city that could facilitate painless birth, while many first-class state-owned hospitals not providing the service or not voluntarily recommending it, reported the Southern Daily, a newspaper based in south China’s Shenzhen this May.

“We’re not doing it because we’re short-handed,” said a doctor with a first-class hospital, “We don’t have enough anesthetists with five years’ experience or more to accomplish painless birth, although the procedures are actually not that advanced or complicated.”

“It’s not like painless birth just needs one injection,” said Li Yuantao, director of the Anesthesiology department of Shenzhen Maternal and Childcare Hospital, “Painless birth needs an anesthetist to do spinal puncture, injection and a whole-process monitoring. Delivering a baby usually takes several hours or even longer hours. Wide use of the procedure means more anesthetists for hospitals.”

“Management problems would also push up the human and material costs of painless birth,” said Zheng Xingshu, director of the Obstetrical department of Harmonicare Medical, noting it is especially no good bargain for comprehensive public hospitals.

In the Pearl River Delta of China where the economy has been enjoying more robust growth nationwide, the service of painless birth has already been covered by medical insurance. While compared with C-section that usually costs several thousand yuan, the average price of around 700 yuan on painless birth remains negligible for hospitals.

“We did 5,000-6,000 cases of painless birth last year, with unsatisfactory rate of returns,” said Li, noting that’s the reason for big hospitals to stay away from the procedure that could really help expectant mothers relieve pain and save them more energy to give birth. 

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