title: Consequences of birth policies and practices in post-reform China.
abstract: This paper comments on the provision of birthing services in Sichuan and Shanxi Provinces in China within a policy context. The goal was to understand possible unintended and harmful health outcomes for women in the light of international evidence, to better inform practice and policy development. Data were collected from October 2005 to April 2007 in 25 hospitals across 13 counties and one city. Normal and caesarean birth records were audited, observations made of facilities and interviews conducted with officials, administrators, health workers, women who delivered in hospital facilities and women who delivered at home. We argue that in the context of a neo-liberal health economy with poorly developed government regulatory policies, those with the power to pay for maternity care may be vulnerable to a new range of risks to their health from those positioned to make a profit. While poor communities may lack access to basic services, wealthier socio-economic groups may risk an increase in maternal morbidity and mortality through the overuse of avoidable intervention. We recommend a stronger evidence base for hospital maternity services and changes to the role of the State in countering systemic problems.
authors.affiliation: Graduate School for Health Practice, Institute for Advanced Studies, Charles Darwin University, Darwin, Australia. amanda.harris@cdu.edu.au
authors.forename: Amanda
authors.initials: A
authors.lastname: Harris
authors.forename: Yu
authors.initials: Y
authors.lastname: Gao
authors.forename: Lesley
authors.initials: L
authors.lastname: Barclay
authors.forename: Suzanne
authors.initials: S
authors.lastname: Belton
authors.forename: Zweng Wei
authors.initials: ZW
authors.lastname: Yue
authors.forename: Hao
authors.initials: H
authors.lastname: Min
authors.forename: Xu
authors.initials: X
authors.lastname: Auqun
authors.forename: Liao
authors.initials: L
authors.lastname: Hua
authors.forename: Zhou
authors.initials: Z
authors.lastname: Yun
mesh_terms: D002681:China / Q000453:epidemiology; D005251:Fees, Medical; D005260:Female; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D008428:Maternal Mortality; D008485:Medical Audit; D009773:Obstetric Nursing / Q000331:legislation & jurisprudence*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012424:Rural Population; D012923:Social Class