A guide to pregnancy and giving birth in China

25 July 2019

In this guide we take a look at birth and prenatal care in the private and public health systems in China, as well as some of the local traditions and beliefs when it comes to pregnancy.  We also give you a summary of what you can expect to pay if you don’t have health insurance. 

Private vs public 
You’ll have a choice between giving birth in a public, private or international hospital – although this may depend on which region you’re living in. But, what’s the difference between them? Really, it comes down to your budget and the level of luxury and personal care that you’re after. Whichever you choose, you should be in safe hands. 

The public healthcare system in China is built around a three-tier system which is subsidised by social security contributions. Primary care should happen in community walk-in clinics before being escalated to regional hospitals. From there, complicated cases should be referred to specialist hospitals in major cities. These hospitals tend to employ top Chinese doctors. 

Expats can use public hospitals and benefit from the lower prices; however, the local community walk-in centres have a poor reputation and many locals jump straight to the specialist hospitals. This disrupts patient flow and results in long waiting times and patients queuing outside hospitals for appointments. 

Some public hospitals have VIP wards, or gaogan bingfang, where you’re able to receive a more private and luxurious service, but you’ll need to be prepared to pay a bit more.  

Unless your health insurance is provided by a Chinese insurer, you’ll need to pay for any treatment in a public hospital up-front, and often in cash. Make sure you keep the invoices and receipts for your treatment, so you can send it to us to make your claim.

Private hospitals in China are still quite new and have been introduced to try and ease the demand on public hospitals. 

International hospitals are a type of private hospital that meet certain international standards. They are popular with expats because they generally have more personalised care and English-speaking staff who have trained and worked around the world.  

Giving birth in a public hospital is significantly cheaper than a private or international hospital – your prenatal care will usually cost between RMB 8,000 and RMB 15,000 – and your delivery could cost anywhere from RMB 10,000 to RMB 13,000. It will cost slightly more if you’ve chosen to use a VIP wing in a public hospital. 

In an international hospital, prenatal care can cost RMB 15,000 to RMB 25,000, a routine delivery can be RMB 50,000 to RMB 60,000, and a C-section can cost between RMB 70,000 and RMB 100,000. A private hospital will cost somewhere between the cost of a VIP wing and an international hospital, but the quality of service can be less predictable.

Prenatal care 
In most cases, you’ll choose a hospital and book your appointments with a doctor, who you’ll see for the rest of your prenatal check-ups. At your first prenatal check-up, the doctor will confirm your pregnancy and give you a little red book. You’ll need to keep this safe and take it to all of your appointments – it’s a record of your progress and test results. 

Many international hospitals offer packages for prenatal check-ups at a discount, but these commit you to using the same hospital for all of your check-ups. If you pay for your prenatal check-ups individually, you can switch hospitals and doctors fairly easily.

You’ll usually have one prenatal appointment a month for the first few months, then one every two weeks, and one a week towards your due date. At twenty weeks you’ll have a scan where you can see or hear your baby’s heartbeat. 

Your delivery 
In China, the relationship between doctor and patient is very traditional – the doctor will make decisions and tell patients what to do. In international hospitals, doctors will work alongside you to provide the experience you want. 

Although China has been working to reduce the number of babies delivered by C-section since 2012, the rate is still high. Just over 40% of babies were delivered by C-section in 2016 so make sure you tell your obstetrician (OB) if you have a strong preference for how you deliver. Read more about c-sections here. 

If you opt to use a public hospital, you’ll give birth in a delivery room, which you’ll share with other women.  Men are not usually allowed in the delivery room, and your baby’s father may have to wait outside until you’re moved to a maternity ward. The maternity ward will also be shared with several other women in a public hospital. 

In China, a woman’s extended family usually looks after her in hospital. In a public hospital, this can include washing and changing the baby, providing clean bed linen and sanitary products, and bringing food. In fact, it’s not uncommon for public hospitals in China to provide no food at all – it’s normal to bring food with you or have it delivered to you.  

Because it’s common for family to play a big role in providing care, wards tend to be bustling with visitors. If you use the international or private hospitals, or opt for a VIP ward in a public hospital, you’ll usually have your own private room. 

Pregnancy and parenthood – cultural traditions in China 
It’s worth bearing in mind some of the cultural traditions and beliefs in your new country, as some might affect what you do throughout your pregnancy and when the baby arrives.

In China, many people want their baby to be born on a particular day or in a particular year for good luck. People may schedule a C-section in order to give birth on a particular day or even put off getting pregnant during a particularly unlucky year. 

The first month after the baby arrives is referred to as the zuo yuezi or ‘sitting month’. New mums generally won’t see friends and family or leave the house in this time. Some locals hire personal nurses to stay with them and look after them and their new baby throughout the sitting month. These nurses are called yue sao and will cook and clean during this time, while the new mum rests. The cost of a yue sao can be anything between RMB 10,000 and 20,000 for a month, depending on their experience. 

Breastfeeding is common in China. The Chinese government have been running a campaign to encourage breastfeeding after rates became very low between the 1970s and 1990s. Now, most women plan to breastfeed, and it’s largely acceptable to do so in public. However, there often isn’t much organised support for new mothers starting breastfeeding in hospital or in postnatal care. 

Finding the support you need 
If you’re new to parenting and to the neighbourhood, it can be overwhelming if you don’t have your support network around. There are a number of mums’ groups that you can join where you’ll be able to connect with other new parents – as both locals and expats. You’ll be able to find out more about these groups and how to join them by asking your doctor or OB, and by doing some online research. 

Our World of Wellbeing hub contains lots of useful tips and information about being a parent abroad. Whether you’re about to have your first baby, or you’re moving your whole family to a new country, there’s plenty of advice about how to help things go smoothly. 

And if you’re ever unsure of anything, no matter where you are, we’ll always do our best to put you at ease. There’s a team of midwives on hand through our health information helpline who’ll be able to answer any questions you might have about your pregnancy. You’ll just need to call +44 (0)1892 556 753 between 8am to 8pm Monday to Friday, until 4pm on Saturday and until 12pm on Sunday (UK time).

If you have any questions about making a claim with us or what your policy covers, you can call us anytime, day or night on +44 (0)1892 503 856. 

Sources: 
1. https://www.internations.org/go/moving-to-china/healthcare 
2. https://www.justlanded.com/english/China/China-Guide/Health/Health-care-in-China 
3. https://www.havingababyinchina.com/ 
4. https://www.healthandsafetyinshanghai.com/shanghai-maternity.html 
5. https://www.bmj.com/content/360/bmj.k817 
6. https://elephant-room.com/2018/05/23/stories-from-the-maternity-wards-inside-chinas-public-hospitals/ 
7. https://www.theglobeandmail.com/news/world/the-day-every-chinese-woman-wants-to-give-birth/article1052189/ 
8. http://en.acftu.org/28609/201407/15/140715154244163.shtml 
9. https://gbtimes.com/traditional-chinese-beliefs-about-pregnancy-and-childbirth 
10.https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-4-6