Debate in China over reported spike in maternal deaths

A woman carrying a child outside a nursery school in Beijing, on Sept 28, 2016.
A woman carrying a child outside a nursery school in Beijing, on Sept 28, 2016.PHOTO: AFP

Some blame older mums now having second child, but others say figures are unreliable

BEIJING • Did China's maternal mortality rate surge by nearly one-third in the first half of the year, as a top health official reportedly said last week?

An anxious, sceptical debate has broken out over the drastically higher figure, announced by Mr Ma Xiaowei, deputy director of the National Health and Family Planning Commission, at a meeting on improving maternal health.

In reports carried widely in the Chinese news media, Mr Ma said at the meeting that China's maternal mortality rate rose to 18.3 deaths for 100,000 live births in the first six months.

That was an increase of 30.6 per cent over the same period last year.

Mr Ma also said at the meeting last Wednesday that maternal mortality for the whole of last year was 20.1 per 100,000 women.

Online, people called for better healthcare for pregnant women or warned of the health effects of pregnancy on "old mothers" who may have rushed to have a second child after the end of the one-child policy on Jan 1.

  • 18.3 Reported number of maternal deaths per 100,000 live births in the first six months of this year

    30.6% Increase over maternal deaths in the same period last year

Others said they simply did not believe the figures, a lack of confidence that highlighted concerns over the reliability of Chinese data among both Chinese and foreigners.

In an article in its health section, Sohu.com quoted Mr Ma as saying that the increase was "an urgent problem". He also called for greater investment in hospitals, maternal healthcare and in training obstetricians in an era of the two-child policy.

"Fishy," said Ms Wang Ling, the author of A Beijing Pregnancy, a novel about pregnancy, abortion and birth, on Population Internal Reference, her private WeChat site. Ms Wang, who uses the pen name Lingzi, did not immediately respond to a request for an interview.

"Under what circumstances could the rate be 30 per cent higher in the first half of this year than in the same period last year, if last year's overall maternal mortality rate was 20 per cent and this year's so far is 18 per cent?" she asked.

Such an increase in the first half of the year could be achieved only if the rate had been a very low 14 per 100,000 in the first half of last year and a very high 26 per 100,000 women in the second half, according to figures on Ms Wang's WeChat account.

On her account, Ms Wang wrote: "If it really has gone up by 30 per cent (it's a frightening figure), then the health commission must offer a clear answer why. And how to avoid it going forward."

The commission did not reply to a request for clarification.

China has experienced drastic improvements in maternal mortality in recent decades.

Health commission figures show a fall in maternal mortality to 20.1 per 100,000 women last year from 88.8 per 100,000 in 1990.

The World Health Organisation says maternal mortality in the country last year was 27 per 100,000 live births, higher than the Chinese government figure. But it was not clear if the Chinese figure had been calculated using the same standard of live births. Like the Chinese figures, the WHO's numbers show a marked decline overall, from 97 per 100,000 in 1990.

The WHO gives the maternal mortality rate in the US as 14 per 100,000 live births for last year, up from 12 in 1990.

Rates in sub-Saharan Africa are the highest in the world, with 882 women dying per 100,000 live births in the Central African Republic, according to the WHO.

Some Chinese news reports tied the apparent surge in maternal deaths to the two-child policy after 36 years when most urban families were restricted to one child.

"After the 'two-child policy', maternal mortality rises by one-third," read a headline on Ifeng.com, the website of Phoenix Television.

The sharp increase in maternal deaths is likely linked to many women above the age of 35 trying to have a second child after the one-child policy was scrapped, said Mr Duan Tao, director of Shanghai First Maternity and Infant Hospital Corp.

Pregnant women older than 35 have a greater risk of developing complications such as hypertension and cardiovascular diseases, he told Caixin news website.

Hospitals, which were already understaffed, are now struggling to cope with the rising number of pregnancies, Mr Duan said.

NYTIMES

A version of this article appeared in the print edition of The Straits Times on October 03, 2016, with the headline 'Debate in China over reported spike in maternal deaths'. Print Edition | Subscribe