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China’s Online Gay Revolution and Rainbow Warrior Geng Le

China is in the midst of a gay revolution. Geng Le, founder of gay app ‘Blued’, is one of the instigators. He is both a smart businessman and an advocate for China’s gay emancipation: a true rainbow warrior.

Manya Koetse

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Love is in the air on Sina Weibo this weekend, especially since the Blued gay dating app and Taobao online shopping platform have launched a unique Valentine campaign: they will award ten lucky gay couples with an arranged trip to the United States in order to get married and celebrate their honeymoon. In the campaign video, Blued founder Geng Le poses with a rainbow flag. “We have to support all kinds of love,” he says: “For all those gay girls and guys out there, let’s celebrate your love. Let’s go and get you married in a place where you can.” This campaign can be seen in the light of a larger online gay revolution that has been going on in China for the past few years. Geng Le is one of the instigators of this ‘revolution’. He is both a smart businessman (a ‘pink economy’ pioneer) and an advocate for China’s gay emancipation: a true rainbow warrior. 

Founder of gay app Blued and Danlan website Geng Le (耿乐) was once threatened for openly being gay and publishing about the LGBT (Lesbian, Gay, Bisexual & Transgender) scene. Luckily, much has changed over the last decade. Geng Le’s company is a remarkable success story. Not only does its gay app Blued currently have around 15 million users, the company maintains good relations with the Chinese government and is worth an estimated 300 million dollars. The success of Geng Le’s company and its products has shown two things: that the Chinese ‘gay market’ is a very profitable one, and that online platforms can help promote the emancipation of homosexuals in China. A win-win scenario.

 

Blued: A Success Story

 

Blued is a social network app for gays. Geng Le, who originally was a police man, started his website Danlan eight years ago. It is a platform for Chinese homosexuals that translates a huge amount of foreign news on LGBT issues and discusses local gay activist groups. Social media app Blued was later added to the site. Blued can be compared to gay dating app Grindr. Users can look for other users based on their location. Through the app, they can connect through chat and arrange a date.

 

gengleGeng Le in the video for the Valentine campaign (What's on Weibo).

 

Geng Le and his associates launched Blued in November 2012. It was the perfect timing: not just because China’s mobile market was exploding, but also because of a growing demand for social media apps aimed at gays who would otherwise mainly meet in gay bars or nightclubs. Homosexuality only became legal within the People’s Republic of China (PRC) in 1997, and over the last decade, it has gradually become less of a taboo. The coming-out of Apple CEO Tim Cook in 2014 was an important moment for Blued. After Cook publicly announced he was proud to be gay, homosexuality became a much-discussed topic on China’s social media. One week later, an American company invested 30 million dollars in Geng Le’s company.

 

China’s ‘Pink Economy’

 

According to Paul Thompson, founder of LGBT Capital, the Chinese ‘gay market’ is currently worth around 300 billion dollar: a macro calculation of the estimated spending power of China’s* LGBT market (a ‘GDP’ for the gay market). This makes China one of the top three most profitable ‘pink economies’, together with the US and Europe. Thompson believes that the financial power of gays (which he calls “pink dollar” power) cannot be ignored; not just because of the opportunities it offers for businesses, but also because serving the needs of LGBT consumers is a way of creating equality and promoting acceptance. This is commercially and socially important for the Chinese market; there is enormous potential in gay-related products and services such as apps, datingsites or news platforms.

By now, there are multiple social media platforms for gays in China. There are many organisations and individuals that speak out for homo-emancipation through Weibo and Weixin. Besides the official accounts of Geng LeDanlan and Blued, there are others such as the Gay Support Group, the Gay Rights Movement, the Gay Voice or the Beijing ‘Comrade’ Center*. These platforms translate foreign gay news, share the stories of the Chinese LGBT community, provide support in ‘coming out’ and organise events or offer possibilities for gays to get in touch.

 

Being gay: not about politics

 

“Chinese society is experiencing a gradual process of tolerance towards gays,” CBN Weekly writes in an article about Blued: “Although they often joke about it, younger generations are really starting to openly discuss homosexuality.” Geng Le’s app and website (danlan.org) are not blocked by Chinese authorities. In an online environment that is heavily controlled, the allowance of these gay platforms is somewhat surprising. One of the reasons Geng Le has managed to keep them unblocked is because he convinced the government that openness about homosexuality is crucial in the prevention of HIV. This is an important issue in China, where 100,000 new HIV infections were reported over the previous year; a 15% increase from 2013. Danlan and Blued spread information about safe sex, but also warn users against the use of drugs.

 

bluedshotScreenshot of the Blued smartphone app, that allows users to 'explore' users based on location or other preferences, scroll through news, or chat. Blued shows users a warning, saying: "Cherish life, stay away from drugs. Blued wants to promote healthy friendships together with you" 
(Image: What's on Weibo).

 

For Geng, the emancipation of gays should not become a political issue. He argues that LGBT issues are not about politics, but about human rights. “We should let gay people in China live in dignity,” says Geng, who does not necessarily want to strive for same-sex marriage in China: “Gay marriage is a legal concept – the general improvement on gay issues in China does not lie in marriage, it lies in anti-discrimination. This is what we focus on.”

 

“Two guys in love, so what?”

 

China still has a long way to go concerning the emancipation of gays. Until 2001, homosexuality was still defined as a mental disorder. The court case against a Chongqing medical center for ‘conversion shock therapy’ continues; the clinic gave electric shocks to homosexuals in order to ‘cure’ them. Many homosexuals are still afraid to come out of the closet. This is also one of the reasons why Blued is such a succes: although coming out ‘in real life’ might be a big step, the Blued community is only one click away. Through the app, gays can freely talk to each other from behind their smartphone screens.

China ‘online gay revolution’ has promoted the growing acceptance of homosexuals in China. This has also become visible offline. Last month, a gay wedding proposal in the streets of Shanghai drew the attention of bystanders. The pictures became trending on Sina Weibo. Although some Weibo netizens mocked the couple, others found it romantic or did not care about it too much. One user said: “Two guys in love, so what?” China’s gay emancipation might still have a long way to go, but the first big steps have been taken.

 

gayvalentineThe Shanghai gay proposal that became a trending topic on Sina Weibo. 

 

The initiative to send ten gay couples to the US to get married is another breakthrough in China’s online revolution. The campaign received lots of attention on social media, where users can vote which couples they would like to win. The fact that the campaign is also endorsed by Taobao, China’s biggest e-commerce platform, speaks volumes; supporting homosexuality has become a marketing tool. As a business man and gay right activist, Geng Le is in the right spot. “I still see a long road ahead,” he says. I bet it’s paved with rainbows.

 

rainbowThe Valentine campaign by Taobao and Blued: ten of these couples will win an arranged trip to 
California to get married and celebrate their honeymoon (Image: Weibo).   

 

– by Manya Koetse

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* In this calculation, Thompson speaks about ‘Greater China’, which includes Mainland China, Hong Kong and Taiwan.                  

*Although ‘comrade’, tongzhi, originally is a Communist term, it is now used as slang for members of the LGBT community.

 

Sources:

– Chinese CBN weekly article about Blued (link).

– Live event about gay pride in China with Geng Le as one of the speakers, blogged by What’s on Weibo (link).

– Another version of this article was previously published in the Dutch 360 Magazine (link).

– On Geng Le, also read: Interview with Geng Le by Vice magazine (link).

– On gay markets, also read: “A look at Brazil’s Booming (Yet Closeted) Multi-Billion ‘Pink Dollar’ Gay Market” (link).

Appreciate this article and want to help us pay for the upkeep costs of What’s on Weibo? You can do so here! Every penny helps.

 
©2014 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com.

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Manya Koetse is the editor-in-chief of www.whatsonweibo.com. She is a writer and consultant (Sinologist, MPhil) on social trends in China, with a focus on social media and digital developments, popular culture, and gender issues. Contact at manya@whatsonweibo.com, or follow on Twitter.

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Backgrounder

“Opposing Dog Meat Consumption Is Hypocritical” – Weibo Users Respond to Anti-Dog Meat Protests in South Korea

Eating dog meat is a personal choice, many commenters argue.

Manya Koetse

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Man eating dog meat during anti-dog meat protest; image via https://udn.com/news/story/6812/3928149

Last week’s anti-dog meat protests in South Korea have triggered discussions on Chinese social media on the status quo of the dog meat industry in China. An overview of the sentiments on social media and the background of dog eating in the PRC.

South Korea’s dog meat industry made headlines on Friday after protesters in Seoul, joined by actress Kim Basinger, called for an end to the decade-old dog meat trade in the country.

Not far from the protesters were farmers who raise dogs that are sold to restaurants. They brought steamed dog meat and ate it with kimchi (featured image).

In China, where the eating of dog meat has a long history, the Seoul protests triggered some discussions on social media.

The hashtags “Hundred People Gather in South Korea to Stop the Eating of Dog Meat” (#韩国百人集会呼吁停食狗肉#) and “Big Protest in South Korea against Eating of Dog Meat” (#韩国大规模抗议吃狗肉#) received over 83 million views.

In South Korea, the overall demand for dog meat has plummeted over the years. Earlier this month, one of the largest dog meat markets in the country, the Gupo dog meat market, was shut down. In November of 2018, Seongnam city already demolished South Korea’s largest dog slaughterhouse.

Friday’s protesters hope to shut down dog meat trade in the country completely. The latest protests have put the thorny issue of the dog meat industry back in the limelight.

 

HYPOCRITICAL PROTESTS?

“I don’t eat dog meat, but I don’t oppose it.”

 

On Chinese social media site Weibo, hundreds of netizens expressed their opinion on the matter, that has been a hot topic in China for years.

According to polls from the past and present, the topic of dog meat in China is clearly a divisive one.

But over the past few days a seeming majority of commenters on Weibo spoke out about the issue in a remarkably similar way, with thousands of netizens highlighting one issue in the matter: hypocrisy.

“I won’t oppose to the eating of dog meat,” one person writes: “Because if I support the anti-dog meat movement today, then tomorrow it will turn against the eating of cows, then the eating of pigs, and then the eating of fish..”

Many people on social media agree with this point of view, arguing that no matter one’s personal ideas about dog meat, condemning the dog meat practice in specific would be hypocritical: “Pigs are so cute, why do we eat pigs then?” many say, with others arguing: “Aren’t cows also spiritual animals?”

Dog meat restaurant in Jilin.

“I also raise dogs, I also love dogs,” another commenter says: “But I think that if they legally breed dogs for the dog meat [industry], then we have no right to prevent them from doing so.”

“I don’t eat dog meat, but I don’t oppose it, as long as it’s legal it’s ok,” with others writing: “I am opposed to the eating of any living creature.”

“Eating dog is not illegal, why all this sentimental nonsense? Why don’t you also defend chickens, ducks, geese, pigs, sheep, and cows?!”

“As long as they’re not abused, I don’t see a problem with it.”

“Dog meat is tasty,” one commenter from Zhejiang writes: “I like it, although I rarely eat it. I don’t see a problem with it, it’s a personal choice.”

 

SHORT OVERVIEW OF DOG EATING IN CHINA

“To them, dog meat was just like any other meat.”

 

The tradition of dog eating in China can be traced back as far as the Shang Dynasty (ca. 1558 to 1046 BC), when dog meat was considered a delicacy for the upper class.

Later on in Chinese history, during the Han Dynasty (202 BC-220 AD), it became more and more common until the practice saw a general decline, especially in northern China, during and after the tenth century (Li et al 2017, 513-514).

Despite the rising and declining popularity of dog meat throughout China’s history, the practice of eating dog has never completely disappeared, particularly in southern China.

In a book on China from 1878 by John Henry Gray, the author notes the popularity of restaurants serving dog and cat meat in ‘Canton’ (Guangzhou):

I do not think (..) that I exaggerate in saying that there are no fewer than twenty such places in Canton. Each restaurant contains only one public apartment. The approach to this dining-room is generally through the kitchen, where cooks may be seen standing in front of slow fires over which the flesh of cats and dogs is being cooked. The flesh is cut into small pieces and fried with water chestnuts and garlic in oil. In the windows of the restaurant dogs’ carcasses are suspended, for the purpose, I suppose, of attracting the attention of passengers” (75).

He further writes:

The flesh of black dogs and cats is generally preferred because it is supposed to possess more nutriment than that of cats and dogs of any other color. At Ying-tong, a suburban district of Canton, a fair is held at which dogs are sold for food; and in one of the streets dogs and cats are daily exposed for sale. The dogs are put to death by strangling, stabbing, or felling with clubs” (76).

Something that has not changed since the days described in Gray’s book is the belief in the medicinal benefits of dog meat.

Dog meat dish, via Sohu.com.

Especially in summer, dog’s flesh is believed to serve as an antidote against summer heat, and to be nutritious and beneficial as a source to enhance male virility or to boost the liver. Even at present, Chinese media promote the eating of dog meat to boost the immune system and help stimulate better blood circulation.

It should be noted that although China has a long history of dog meat consumption, it also has a long history of dog domestication and dog-human comradery. Dogs were pets, guarded the house, used in hunting, and also used in rituals of sacrifice.

Ceramic crouching dog, excavated from Henan burial site, dating from Han Dynasty, 206BC-220AD, Henan Museum.

Most of the 20th century (1900-1978) was a tough time for people in mainland China, and it was a tough time for dogs too. In many times, there was barely enough food to eat, and under Mao’s rule, dogs were considered “parasites” and were outlawed as pets (Coren 2018; Li et al 2017, 514).

Those who kept pets were seen as part of the ‘bourgeoisie,’ and during the Cultural Revolution, pet dogs were reportedly seized and beaten to death in front of their owners (Coren 2008, ch. 21).

Much has changed since those days. Although (stray) dogs, as carriers of diseases and potentially aggressive, are often still considered a drain on society, having a dog as a pet has become much more commonplace in China since the late 1980s and early 1990s.

Eating dog meat has become less popular, especially among young people in China, who have grown up very differently from their parents and have different perceptions of dogs.

Chinese writer Bang Xiao looks back on the first time his mother served him dog meat during Chinese New Year, writing:

For them, dog meat was just like any of the other meats, and coming from a generation who lived through famine and the Cultural Revolution, I was told I should be grateful. For me though, it meant I was eating my own pet Duo Duo. I cried.”

Later on, he writes about his parents:

They weren’t “dog eaters”. They were just people that happened to have a different history that led to different animals being on the menu.

 

THE YULIN DOG MEAT FESTIVAL

“Don’t go, don’t eat it, don’t pay attention to it.”

 

Despite the general unpopularity of dog meat in China, there is one time of the year when the discussions on the practice of dog eating flare up again, and that is during the Yulin Lychee & Dog Meat Festival, an annual event that’s been held over the past decade in the Chinese city of Yulin intended to generate income from tourism (Brown 2018).

Some 10,000 to 15,000 dogs and cats are slaughtered during the 10-day event that starts on June 21st every year. The event attracts hundreds of people every day. There is a restaurant strip and a market where dozens of vendors cook various dog meat dishes in large woks and where live dogs are sold and slaughtered.

Yulin, image via 轉角國際udn Global

Although the voices of those people protesting the festival seem to grow louder year on year, the dog meat festival continues. It is not illegal, and its economic benefits have become of crucial importance for many in the city of Yulin.

Vendor selling dog meat at the Yulin festival.

A 2016 media survey held among 2000 people from various ages and places in China found that 64% of the people opposed to the festival, 52% thinks that dog meat should be banned in China, and 70% said they had never had dog meat themselves.

“Don’t go, don’t eat it, don’t pay attention to it. When there’s no business, the killing will stop,” one Weibo commenter suggests.

 

A MURKY MARKET

“There does not seem to be a Chinese dog meat market that is both cruel-free and completely legal.”

 

Apart from Yulin, the eating of dog meat is barely a celebrated tradition in China anymore.

For a What’s on Weibo article from 2015, we could still find 122 restaurants listed as ‘dog meat’ specialty restaurants in the city of Beijing on restaurant site Dianping. But at present, Dianping no longer publicly lists any restaurants when searching for ‘dog meat’ specialty places (note that there still are restaurants serving dog meat, but they might not be listed due to controversy or for fear for activists).

China’s biggest e-commerce websites sell different herb mixes for dog stews or dog meat hotpots (see tweet below), but the market could hardly be called thriving.

Yet, despite all those people on Chinese social media saying that eating dog meat should not be a problem for those who still want to eat it, China’s dog meat market does actually have a problem.

China has no law that bans the eating of dogs; eating dog meat is a personal freedom. But what makes the issue murky and troublesome is that China actually has no large-scale legal dog farms, nor legal dog slaughterhouses.

The very few dog farms in existence in China would never be adequate to provide the meat for the industry in southern China, let alone for the estimated 10,000+ dogs slaughtered in Yulin every year.

It is therefore not clear where the dogs that are used for their meat in China come from. Are they stray dogs? Are they stolen from the streets? And if so, would this not be considered illegal (Brown 2018; Cao 2014; Yan 2015, 46)?

Every now and then scandals appear in the media of restaurants slaughtering and killing dogs that were actually people’s pets (for example, this scandal in Jilin in 2018 or in Chengdu this year).

Another issue making the dog meat market a problematic one is the cruel treatment of the dogs.

China has seen countless of food scandals over the years, and some of them involve the selling of poisoned dog meat. As a result, many people have a general distrust in (frozen) meat products and want to make sure they are consuming good quality meat.

Dog meat markets such as Yulin, therefore, often sell living dogs. They are virtually like ‘wet markets’ for dogs, where those who want to eat dog meat can do so with the assurance that the meat they are eating is fresh and safe. The dogs are slaughtered at the spot or are sold alive for home consumption (Brown 2018).

Image via BBC.com.

The process of being transported, being displayed in tiny cases in the summer heat, and being killed in often cruel ways all add to the enormous stress and pain the animals at the live dog market are suffering.

China currently has no laws from the perspective of animal welfare to minimize the pain and suffering during transport, the selling, or at the point of slaughter (Brown 2018).

For the aforementioned reasons and more, festivals such as the Yulin Dog Meat one are getting more controversial year on year, with more and more Chinese calling for a boycott and a ban.

 

DISTORTED DISCUSSIONS

“If you eat dog meat of unknown origin, you might be participating in the killing of someone else’s pet.”

 

As the discussions on dog meat in China are ongoing following the South Korea protests, one blogger posted a survey asking netizens if they support the eating of dog meat.

Despite the many commenters who also defend the practice of dog eating, a majority of 67% percent among the 32.000 participants said they do not support it as “dogs are our friends.”

A recurring sentiment expressed on Chinese social media on the issue is that there essentially is nothing wrong with eating dog meat – and that it would be hypocritical to only oppose to eating dog without also opposing eating sheep, cows, chickens, and so on – as long as it is legal, and as long as the dogs are not stolen, poisoned, or abused.

But that’s the whole issue at hand: all those things are in fact happening in the dog meat industry today. It is difficult to discuss the eating of dogs based on the hypothetical assumption that these things are not occurring.

Consumers are not buying (frozen) meat from legal dog farms and certified dog slaughterhouses, they are mostly buying living dogs or dog meat from unknown origins, and the process of selling and slaughtering often goes hand in hand with cruel treatment.

“I don’t oppose to eating dog, but I hate the dog trafficking market,” one person says. Another commenter agrees, writing: “I don’t oppose to the eating [of dogs] that are bred for it, but I do oppose to those who steal other people’s dogs. Most of the dog meat I’ve seen comes from unknown origins. (..) If you eat dog meat that you don’t know the origin of, you might be participating in the killing of someone else’s pet.”

For now, China and South Korea are very different when it comes to their dog meat industries and their (legal) changes. The countries do seem to have one thing in common, which is that the practice of eating dog meat is no longer popular among the younger generations.

This might suggest that as sales are dropping, the dog meat market will shrink and might eventually disappear altogether if there is no interest in it.

“Don’t hype the dog meat festival,” one Weibo commenter writes: “It’s the hype that made it big and that led to more dogs being killed.

This basically reiterates the advice of one of the aforementioned commenters: don’t go, don’t eat it, don’t pay attention to it, and the business will, eventually, die out.

Want to read more? Also see:

20 Facts About Dogs & Dog-Eating in China
The Yulin Dog Meat Festival: 10 Views From Chinese Netizens
Tradition or Abuse? Chinese Views on the Yulin Dog Meat Festival

By Manya Koetse

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References

Brown. Hannah. 2018. “Yulin Lychee and Dog Meat Festival: A Shift in Focus.” In: Tourism Experiences and Animal Consumption: Contested Values, Morality and Ethics, Carol Kline (eds), Chapter 15. London: Routledge.

Cao Yin. 2014. “Experts: Dog Meat Festival ‘Illegal’.” China Daily (June 16). Online at http://www.chinadaily.com.cn/china/2014-06/16/content_17589087.htm [6.23.16].

Coren, Stanley. 2008. The Modern Dog: A Joyful Exploration of How We Live with Dogs Today. New York: Free Press.

–. 2018. “What Is China’s Current Attitude Concerning Dogs?” Psychology Today, Feb 21 https://www.psychologytoday.com/us/blog/canine-corner/201802/what-is-chinas-current-attitude-concerning-dogs [7.15.19].

Gray, John Henry. 1878. China: A History of the Laws, Manners, and Customs of the People (Volume II). London: MacMillan & Co.

Li, P. J., Sun, J., & Yu, D. 2017. “Dog “Meat” Consumption in China: A Survey of the Controversial Eating Habit in Two Cities.” Society and Animals, 25(6), 513–532. http://doi.org/10.1163/15685306-12341471

Xiao, Bang. 2018. “Chinese New Year: Remembering how I first ate dog meat, and how differences bring us together.” ABC, February 17 https://www.abc.net.au/news/2018-02-17/chinese-dog-meat-eating-linked-to-history-of-famine/9454394 [7.15.19].

Yan Wei. 2015. “Dog Meat Festival: Traditional Custom or Abuse?” Beijing Review (29): 46-47.

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Over a Third of China’s Babies Are Delivered via C-Section – The National Health Commission Wants to Change That

Fear of pain is a major reason for nonmedical cesarian deliveries on maternal request.

Manya Koetse

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Image by Sohu News

China’s National Health Commission wants to lower the nation’s high C-section rates. On Chinese social media, many women argue it should be up to the mother to decide how she wants to give birth.

In 2018 the percentage of deliveries by cesarean was 36.7% in mainland China, according to the latest Report on Women’s & Children’s Health (中国妇幼健康事业发展报告) that was launched by the National Health Commission on May 27.

This means that together with Hong Kong, Taiwan, Brazil, Egypt, and Turkey, the People’s Republic of China (PRC) now has the highest C-section rates in the world.

A World Health Organization report from 2010 estimated that 46% of Chinese babies were delivered via C-section. In 2017, another study found that this percentage was incorrect, although some urban and wealthier regions in China, such as Shanghai, did see C-section (CS) rates as a high as 68% (Black & Bhattacharya 2018, 1; McNeil 2017).

China’s CS rates have recently become a hot topic in Chinese newspapers and on social media. On May 27, the National Health Commission of the People’s Republic of China held a Beijing news conference in which Qin Geng (秦耕), the director, announced that more actions will be taken to encourage natural childbirth among Chinese women.

Qin Geng during the press conference on May 27.

These actions will, among others, include stricter regulation of cesarian section operations and the provision of more support and pain relief for laboring women, as well as a higher hospital income for natural births. The National Health Comission hopes to significantly reduce the number of unneccesssary C-sections without medical indication in this way (Beijing News 2019; Caijing 2019).

Since 1985, the international healthcare community has considered 10-15% to be “the ideal rate” for C-sections, of which the highest percentage are those CS deliveries with medical indications that can actually save the lives of mothers and babies.

Although the worldwide rates for CS deliveries have increased throughout the years, there is no evidence for the benefits of nonmedically indicated C-sections for women or children, according to the World Health Organization.

This is not the first time Chinese authorities try to combat the country’s high CS rates. After reports by the World Health Organization from 2010 and 2015 pointing out the potential hazards of unnecessary C-sections, there have been various state efforts to reduce the number of nonmedical cesarian surgeries.

Besides the introduction of free prenatal education classes, these efforts included monitoring public hospital CS rates and removing bonuses or cutting portions of a hospital’s income once their CS rates reached a certain threshold (e.g. 40%) (Wang 2017, 3). These government initiatives seem to have had effect: the country’s C-section growth rates have slowed down, but were not decreasing yet.

Since the Chinese government announced an end to its one-child policy in 2015, lowering cesarean sections rates has become a more urgent matter, as Chinese couples are now allowed to have a second child.

Although various studies from mainland China and beyond challenge the idea that nonmedical C-sections are less ‘safe’ than vaginal births for single deliveries, this risk changes when a woman who previously had a CS section plans another pregnancy: multiple cesarean sections are associated with additional risks including CS scar rupture and abnormal placental invasion (Biler et al 2017, 1074; Black & Bhattacharya 2018, 2; Liu et al 2015, 817).

 

Why So Many C-sections in China?

 

But why does China have such a high cesarian delivery rate at all? Since the early 1990s, mainland China saw a more dramatic rise in CS rates than, for example, the USA; from less than 10% (with only 3.4% in 1988), China went to one of the highest in the world (Hellerstein 2011; Wolf 2018, 13).

The answer to why this is, is not so straightforward and relates to socio-economic changes as well as cultural factors that come into play.

One reason is that there is a general belief in the ‘safety’ of cesarian births that influence women’s choices for a (nonmedical and planned) C-section (Black & Bhattacharya 2017, 2).

An insightful study into this matter is that of researcher Eileen Wang (2017), who found that anxiety about giving birth and fear of pain is also a major reason for nonmedical cesarian deliveries on maternal request, especially considering that only a minority of Chinese women are given any form of pain relief during labor. Besides traditional concepts, this is also because China faces a shortage of anesthetists and because obstetricians are not always well-informed to prescribe other forms of pain medication (2017, 5).

As noted by Wang, epidurals are denied to laboring women not just because anesthesiologists are too busy, but also because of various other factors: different from a scheduled C-section on their agenda, they are not always available during nighttimes and in weekends to administer anesthesia to women in labor, do not have the time to monitor a patient for hours during labor (whereas a cesarean could be done in an hour), or were not even trained to administer epidurals (2017, 5).

“Giving labor without pain: removing mom’s fear for giving birth” – image by Chinese website http://www.8bb.com/huaiyun/1381.html.

According to Wang, the concerns about labor pain result in more requests for C-sections, both before and during labor. With relatively low awareness and availability of labor pain relief methods many Chinese women simply opt for a C-section as a way to control their pain.

But there are also other factors that contribute to the relatively high rate of women requesting C-sections for nonmedical reasons. One of them is the importance placed in the astrological calendar: having a baby on that one ‘lucky day’ or within that ‘lucky year’ is considered enough reason to plan a cesarian birth for many Chinese families.

In early 2015, ahead of the Chinese New Year, many women rushed to the hospital to make sure their baby was born in the Year of the Horse (2014) as the Year of the Goat (2015) was coming up. There is an old Chinese saying that nine out of ten people born in the Year of the Goat are incomplete and will suffer from great misfortune throughout their life (“十羊九不全”).

Another factor that leads to more cesareans on maternal request relates to the existing concerns among women that vaginal delivery will affect their figure or sex life (Wang 2017, 2).

 

Responses on Chinese Social Media

 

Since the Beijing news conference of May 27, the hashtag “Reducing Unnecessary Cesarean Section Surgery” (#减少非必需剖宫产手术#) has taken off on Chinese social media.

On Weibo, the hashtag page received 340 million views at time of writing. One thread about this topic even received over 28400 comments.

“What do you call ‘unnecessary cesarian’?” one of the most popular comments said: “Isn’t it that so many women in labor choose to have a C-section because natural childbirth is too painful?”

Other commenters also called for a normalization of pain relief in labor, saying that the high percentage of C-sections lies in the fact that Chinese women lack access to “wútòng fēnmiǎn” (无痛分娩) or “painless birth,” meaning vaginal delivery with pain relief.

Some Weibo users also stress that women should have the freedom of choice on how they wish to give birth, saying: “C-section or natural should be my own choice” and “If you leave me no choice I might as well not give birth at all.”

Multiple commenters write: “The lower the C-section rate, the higher the suicides,” referring to an incident that occurred in Shaanxi in 2017 when a pregnant woman committed suicide by jumping from the fifth floor of the hospital after she was allegedly denied a CS delivery.

Other Chinese netizens also complain about the fact that it seems to be men who are promoting the new policies to combat the high C-section rates, writing: “Isn’t there a way to have them suffer the pain of labor instead?”

In her study, scholar Eileen Wang also argues that the lack of pain relief is one of the major issues that should be addressed by policymakers who are hoping to reduce the number of C-sections in China. Further improving the childbirth experience by, for example, integrating a midwifery model, is also essential in making natural childbirth more attractive for Chinese women, Wang argues.

For now, many hospitals in China are still offering C-section “packages”: some prices start at RMB 5800 ($840) for a C-section, other hospitals have packages that start from RMB 88,000 ($12,741) including a three-day hospital stay in a private room.

“It’s a pregnant’s woman body, so she should decide how she wants to deliver her baby,” one commenter on Weibo writes: “It should be a woman’s right to decide.”

By Manya Koetse

References

Biler, A., Ekin, A., Ozcan, A., Inan, A. H., Vural, T., & Toz, E. 2017. “Is It Safe to Have Multiple Repeat Cesarean Sections? A High Volume Tertiary Care Center Experience.” Pakistan Journal of Medical Sciences 33(5): 1074–1079.

Black, Mairead & Sohinee Bhattacharya. 2018. “Cesarean Section in China, Taiwan, and Hong Kong— A Safe Choice for Women and Clinicians?” PLOS Medicine 15(10): 1-3.

Caijing. 2019. “卫健委:全国剖宫产率为36.7% 积极推广分娩镇痛.” Caijing , May 27 http://economy.caijing.com.cn/20190527/4591594.shtml [5.31.19].

Hellerstein, Susan Celia. 2011. “Cesarean Delivery in China Analysis of Cesarean Deliveries Without Indication.” The American College of Obstetricians and Gynecologists: 20s.

McNeil, Donald. 2017. “Study Finds Lower, but Still High, Rate of C-Sections in China.” New York Times, Jan 9 https://www.nytimes.com/2017/01/09/health/c-section-births-china.html [6.2.19].

Wang, Eileen. 2017. “Requests for Cesarean Deliveries: The Politics of Labor Pain and Pain Relief in Shanghai, China.” Social Science and Medicine (173): 1–8.

WHO. 2015. “WHO statement on caesarean section rates.” World Health Organization, April https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/ [6.2.19].

Wolf, Jacqueline H. 2018. Cesarean Section – An American History of Risk, Technology, and Consequence. Baltimore, Maryland: Johns Hopkins University Press.

Featured image by Sohu News.

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