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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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©2019 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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What Are Weibo’s “Super Topics”?

Explaining Weibo’s “Super Topics”

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What are Weibo’s “Super Topics” (超级话题) and what makes them different from normal hashtags?

Over the past year, Weibo’s so-called “Super Topics” (超级话题) have become more popular on the social media platform as online spaces for people to connect and share information.

Weibo’s “super topic” function has been around since 2016. The function allows Weibo users to create and join interest-based content community pages that are online groups separated from the main Weibo space. One could perhaps compare these Weibo Super Groups to ‘mega-threads’ or ‘subreddits’ on Reddit.

These are the most important things to know about Weibo’s Super Topics:

 

#1 A Super Topic is Not the Same as a Hashtag

Similar to Twitter, hashtags make it possible for Weibo users to tag a topic they are addressing in their post so that their content pops up whenever other people search for that hashtag.

Different from Twitter, Weibo hashtags also have their own page where the hashtag is displayed on top, displaying how many people have viewed the hashtag, how many comments the hashtag is tagged in, and allowing users to share the hashtag page with others.

A Super Topic goes beyond the hashtag. It basically is a community account where all sort of information is shared and organized. People can ‘follow’ (关注) a Super Topic and can also ‘sign in’ (签到).

On the main page of every Super Topic page, the main subject or purpose of the super topic is briefly explained, and the number of views, followers, and posts are displayed.

A super topic-page can be created by any Weibo user and can have up to three major hosts, and ten sub-hosts. The main host(s) can decide which content will be featured as essential, they can place sticky notes, and post links to suggested topics.

 

#2 A Super Topic Is a Way to Organize Content

Super Topic pages allow hosts to organize relevant content in the way they want. Besides the comment area, the page consists of multiple tabs.

A tab right underneath the main featured information on the page, for example, shows the “sticky posts” (置顶帖) that the host(s) of the page have placed there, linking to relevant information or trending hashtag pages. Below the sticky notes, all the posts posted in the Super Topic community are displayed.

One of the most important tabs within the Super Topic page is called “essential content” (精花), which only shows the content that is manually selected by the host(s). This is often where opinion pieces, articles, official news, or photos, etc. are collected and separated from all the other posts.

Another tab is the “Hall of Fame” (名人堂), which mainly functions as a reference page. It features links to the personal Weibo pages of the super topic page host(s), links to the Weibo pages of top contributors, and shows a list of the biggest fans of the Super Topic. Who the biggest fan of the page is, is decided by the number of consecutive days a person has “checked-in” on the page.

 

#3 Super Topics Are a Place for Fans to Gather

Although a Super Topic could basically be about anything, from cities to products or hobbies, Super Topics are often created for Chinese celebrities, video games, football clubs, or TV dramas.

Through Super Topic pages, a sense of community can be created. People can be ranked for being the most contributive or for checking in daily, and comment on each other’s posts, making it a home base for many fan clubs across China.

The host(s) can also help somebody’s page (e.g. a celebrity account) grow by proposing them to others within the group.

Super Groups are ranked on Weibo based on their popularity. This also gives fans more reason to stay active in the group, making their Super Topic top ranking within their specific category (TV drama, food, photography, sports, games, etc).

What makes the Super Topic group more ‘private’ than the common Weibo area, is that people posting within the Super Topic can decide whether or not they also want their comment shared on their own Weibo page or not. If they choose not to, their comments or posts will only be visible within the Super Topic community.

 

By Manya KoetseGabi Verberg, with contributions from Boyu Xiao

Spotted a mistake or want to add something? Please let us know in comments below or email us.

©2019 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com

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Why Trump Has Two Different Names in Chinese

Why does ‘Trump’ have multiple names in Chinese?

Manya Koetse

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First published , updated version published March 7, 2019

It is confusing even for Chinese netizens and journalists: why does Donald Trump have multiple names in Chinese? And which is the right one to use? What’s on Weibo explains.

Donald Trump has two most commonly used different names in Chinese. In Mandarin*, they are Tèlǎngpǔ (特朗普) and Chuānpǔ (川普). Both names have been used by Chinese mainstream media and netizens for years.

*(Due to the scope of this article, we’ll just use the Mandarin pinyin here.)

In the Chinese translation of Donald Trump’s autobiography The Art of the Deal (1987), the ‘Tèlǎngpǔ’ transliteration is used, whereas the translation of the George Ross book Trump-Style Negotiations (2008) uses ‘Chuānpǔ’ as the Chinese name for Trump.

Considering that Trump is making headlines every day, more people are wondering why Trump has two Chinese names, and which one is the correct name to use. There are even discussions about the topic on Chinese social media.

 

Why are foreign names translated?

 

Why are non-Chinese names actually translated into Chinese at all? With English and Chinese being such vastly different languages with entirely different phonetics and script, the majority of Chinese people will find it hard to pronounce a foreign name that is written in English.

Writing foreign names or terms in Chinese script has a long history and practical reasons which won’t be further elaborated on here. At present, aside from being standardized, it does not just help Chinese speakers to pronounce these words, it also makes it easier to remember them. Most Chinese names usually consist of two or three characters; the first character is the surname, and the last character(s) is the given name.

Translating a name to better adapt to the culture in which it is used does not only happen with English names in China; you often see the same happening with Chinese names in foreign countries.

In that case, the first character (surname) is moved to the back, and the given name changed into an English one. Alibaba’s Ma Yun, for example, has become globally known as ‘Jack Ma.’ Film star Zhao Wei is called ‘Vicky Zhao’, Tencent’s Ma Huateng is known as ‘Pony Ma,’ and the popular actress Lin Yun is called ‘Jelly Lin.’

 

The right way to translate a foreign name in Chinese

 

There are multiple ways to translate a foreign name to Chinese. Most commonly, a name is translated into Chinese characters that are phonetically similar to the original name, without necessarily being very meaningful. The transliteration of ‘Hillary’ (Clinton), for example, is ‘Xīlālǐ’ (希拉里). ‘Bush’ is translated as ‘Bùshí’ (布什).

Another option is to choose a name purely based on meaning rather than phonetics. One example is Elvis Presley, who is called ‘Cat King’ (Māo Wáng 猫王) in Chinese, which stays close to his nickname “The Hillbilly Cat.”

The best option when translating a foreign name into Chinese, however, is to make sure it stays close to its original pronunciation while also using elegant characters. In other words; it is nice when a name’s translation makes sense both phonetically and semantically. Marilyn Monroe’s last name in Chinese is Mènglù (梦露), for example, which sounds like ‘Monroe’ and has the characters for ‘Dream Dew’ – a perfect transliteration for such a dreamy actress.

Even when the characters used for a foreign name in Chinese are not necessarily intended to convey a certain meaning, it is important that they do not have any negative connotations. Nobody wants a character in their name associated with divorce, disease or death – it is believed to bring bad luck.

Another thing is that it is considered helpful for foreign names in Chinese is to maintain a ‘foreign flavor’ to it, to make it clear that the name is actually a transliteration. To give an example raised in this Nikkei article: President Reagan’s name is generally translated as Lǐgēn 里根 in Chinese – the characters being somewhat uncommon for a Chinese name.

The same name could also be written with the characters 李根, very common for a Chinese name, but then it would be difficult to know whether a media report is talking about Reagan the President or just a local Chinese person by the same name. Transliterations of foreign names, therefore, are often easily recognizable as foreign names on purpose.

 

Trump, Tèlǎngpǔ, and Chuānpǔ

 

In the case of Trump, his Chinese names are mainly chosen for phonetic reasons, with different sources using different characters. Part of the challenge in deciding the right Chinese translation for his name, is the fact that Chinese does not have consonant cluster ‘tr’ as one sound.

The Chinese-language Nikkei newspaper dedicated an op-ed written by Chinese scholar Ke Long (柯隆) to the matter, who argues that although it may all seem trivial, it is actually quite confusing and unpractical for president Trump to have more than one name in Chinese.

The Chinese media in Taiwan, Hong Kong, and most overseas Chinese-language media, refer to Trump as ‘Chuānpǔ’ (川普).* According to the World Journal, the biggest Chinese-language newspaper in the US, it is the only proper way to translate this name, yet most Chinese state media and Chinese-language UK media (such as BBC) all use ‘Tèlǎngpǔ.’

* (The Chinese version of The New York Times 纽约时报中文版 is an exception, as ‘Tèlǎngpǔ’ 特朗普 is generally also used in this publication.)

Author Ke Long explains that Chinese translations of foreign names try to stay as close as possible to the pronunciation of a name in its original language. This is why the name of the city ‘Paris’ is pronounced ‘Bālí’ (巴黎) in Mandarin Chinese, staying close to the French pronunciation, and ‘Amsterdam’ being ‘Āmǔsītèdān’ (阿姆斯特丹), which follows the city’s Dutch pronunciation.

If the British would pronounce ‘Trump’ as ‘te-lan-pu,’ then it would thus perhaps be more understandable why media such as the BBC would write Tèlǎngpǔ. But they don’t pronounce it like that, Ke Long argues, saying that the use of ‘Tèlǎngpǔ’ thus does not make sense, and is actually closer to the Japanese way of writing Trump’s name (‘トランプ’: to-ra-n-pu).

More so, the author writes, it does not make sense for Chinese media to take over the British transliteration of the Trump name. Considering Trump is American, Chinese media should follow the translations made by American media. He also notes that if it would be about the Prime Minister of Britain, the Chinese transliteration should follow the one used by the media in the UK.

Although the Nikkei author seems to advocate for a singular use of ‘Chuānpǔ’ by all media, no Chinese media are necessarily ‘wrong’ in their transliteration of the name Trump. The ‘Tèlǎngpǔ’ 特朗普 translation follows the example of outlets such as the BBC, while Chuānpǔ 川普 follows that of other media.

Some Chinese bloggers argue that Chuānpǔ 川普 is the best way to write Trump’s name, because the first character, that actually means ‘river,’ is commonly used in Chinese, making the name sound more ‘natural’ and easy to pronounce than ‘Tèlǎngpǔ.’ Moreover, they argue that the Mandarin ‘chuan’ sound is more appropriate to convey the pronunciation of ‘tr’ than the ‘te-lang’ way.

In the end, the reason why Trump has two names most commonly used in Chinese is just a matter of media, with various mainstream outlets adopting different names since Trump first made headlines, and without there being any clear consensus on which Chinese name to use across all these different Chinese-language media platforms around the world.

 

Chuángpù and Chuángpò?

 

On Chinese social media, President Trump even has more than two names. There are also netizens referring to him as 床鋪, 闯破 or 床破 (Chuángpù/Chuángpò); these are all transliterations that contain strange or negative characters, making the name unrefined and harsh-sounding on purpose to make the name ‘Trump’ look and sound bad.

Although there have been online discussions on the right transliteration for the name Trump, it is unlikely that there will be one official Chinese name for the US President in the near future. Xinhua News, China’s official state-run press agency, has consistently been using Tèlǎngpǔ 特朗普 for years, and will probably continue to use it.

Many netizens simply use both versions of his name in one post to avoid confusion, and some news reports have even started using both names in its headlines (image below).

Despite the somewhat confusing situation at hand, there are also those who do not seem to mind at all. “Who cares if it is Tèlǎngpǔ or Chuānpǔ anyway?” one netizen says: “In this day and age, we all know who it is we are talking about.”

– By Manya Koetse
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This article first appeared in 2017 and has been republished with various corrections:
– The first version did not properly convey the argument made by author Ke Long in his Nikkei piece, which is more clearly laid out in this version.
– This version has added some extra information coming from sources after 2017.

Spotted a mistake or want to add something? Please email us.

©2019 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com

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