Pregnancy and childbirth: From confirming pregnancy to discharge and paperwork✳
The first half of this section measures death risk for the pregnant woman and the fetus. The second half measures money and the time spent running errands. The two accounts are not converted into each other. The content only covers “what to do when.” Things without hard evidence, or with only a small effect — prenatal nutrition, fetal education, and the like — are not written here. Maternity allowances, maternity leave, and the money side of raising a child are in Section 18; how to care for the child after birth is in Section 20; emergencies are in Section 13. Figures from the World Health Organization: in 2023, about 260000 women worldwide died from pregnancy and childbirth. About 75% of those deaths came from five causes: postpartum hemorrhage, infection, hypertensive disorders of pregnancy (blood pressure that rises after pregnancy, including preeclampsia and eclampsia), complications during delivery, and unsafe abortion. The WHO also says that “most maternal deaths are preventable, because the health-care solutions to prevent or manage complications are well known.” The items in this section with the largest effect are exactly those that catch these problems early. Items in this section are grouped by theme below; numbers in parentheses are the item numbers. What you can do yourself before and during pregnancy: start folic acid when you are preparing to conceive (Item 1); no cigarette and no drink of alcohol (Item 4); you do not need to rehome the cat (Item 17); inactivated influenza vaccine (Item 18); from 28 weeks onward, lie on your side when you fall asleep (Item 19). Prenatal care and screening: register for the Maternal and Child Health Handbook (Item 2); HIV, syphilis, and hepatitis B (Item 3); low-dose aspirin (Item 5); gestational diabetes screening (Item 6). Go to the hospital at once when something is wrong: the “go to the hospital immediately” list (Item 7); if your water breaks, lie flat where you are (Item 8). During childbirth: if you want labor analgesia, say so directly (Item 9); do not ask for a cesarean without a medical indication (Item 10). After birth: the 42-day postpartum checkup (Item 16); breastfeeding is not the same as contraception (Item 20). Money and documents: confirm maternity insurance (Item 11); the Medical Certificate of Birth (Item 12); heel-prick screening and hearing screening (Item 13); enroll the child in resident yibao (医保 — basic medical insurance) (Item 14); file the birth registration (Item 15).
English, Russian and Spanish use dlgrv’s unofficial translations. Newly revised entries appear in the Chinese original until a checked translation is available. The author’s latest Chinese text is authoritative. Translation revision: dlgrv/HowToLiveBetter · b25fa8a
Taking one folic acid pill daily before and during early pregnancy can cut the risk of neural tube defects in babies by roughly 70%. These defects include conditions like anencephaly and spina bifida. For women who’ve already had a child with such a defect, this regimen reduces the likelihood of a repeat occurrence to about one third of the original risk. The national supplementation program specifies taking it from 3 months before pregnancy through the first 3 months of pregnancy.
Cost
A bottle costs only a few dozen yuan. Rural women receive…
Benefit
A Cochrane systematic review pooled 5 trials and 6708 births and rated the evidence high quality. Daily folic…
You are entitled to at least five free prenatal checkups during pregnancy, plus home visits after delivery and a 42-day postpartum checkup, all paid for by the state. To access these services, you must register for the Maternal and Child Health Handbook at a community health center before 13 weeks of gestation. Failing to do so means you lose out on all these free services.
Cost
No cost at all — this is part of the national basic public…
Benefit
The third edition of the National Basic Public Health Service Standards outlines specific maternal health mana…
At the first prenatal visit, get the three tests for HIV, syphilis, and hepatitis B done. The initial HIV screen does not come out of your pocket. A positive result is not a dead end. If HIV is found, the state provides free treatment and counseling. If syphilis is found, treat early with penicillin. If hepatitis B is found, the newborn gets vaccine and immunoglobulin at the same time at birth, which blocks transmission from mother to child.
Cost
HIV counseling and initial screening are free under the re…
Benefit
Mother-to-child transmission means the disease passing from mother to child. The Work Specifications for Preve…
Smoking in pregnancy raises the chance the baby is born early, is born too small, or has a cleft lip or palate, and doubles the risk of abnormal bleeding in pregnancy and at delivery. When the pregnant person smokes, or the baby breathes smoke after birth, the risk of sudden infant death is higher. Quitting is still useful whenever you do it. There is no known safe amount of alcohol in pregnancy; avoid it throughout pregnancy.
Cost
There’s no cost at all;
Benefit
The US Centers for Disease Control and Prevention’s framing: smoking in pregnancy can leave a baby “born too s…
Preeclampsia is a hypertensive disorder of pregnancy. Previous preeclampsia, multiple pregnancy, chronic hypertension, diabetes before pregnancy, kidney disease, or autoimmune disease make a person high risk. From 12 weeks, high-risk patients should take low-dose aspirin daily as prescribed; preeclampsia is about 15% lower, and premature birth and death around delivery about 20% lower. Others should not take it on their own.
Cost
A few dozen yuan. Take the medicine daily as prescribed un…
Benefit
The US Preventive Services Task Force gives this a Grade B recommendation: for women at high risk of preeclamp…
Gestational diabetes is high blood sugar that appears only during pregnancy. At 24 weeks or later, spending half a morning drinking a sugary solution and having several blood tests can detect it. Skipping this test raises the risks of having a macrosomic baby, difficult labor, cesarean delivery, preeclampsia, and neonatal hypoglycemia.
Cost
Several tens to over a hundred yuan. You must fast beforeh…
Benefit
The U.S. Preventive Services Task Force recommends screening for gestational diabetes at 24 weeks or later for…
Go to the hospital immediately if any of the following occurs; this also applies within the first year after birth. A headache that will not ease or keeps getting worse, vision that looks different, fever of 38 °C or higher, severe swelling of the hands or face. Trouble breathing, chest pain or a fast heartbeat, severe abdominal pain that does not ease, fetal movement that stops or drops clearly. Vaginal bleeding or fluid leaking, one arm or leg that is both swollen and painful, thoughts of harming yourself or the baby.
Cost
No cost at all. It takes just five minutes to memorize, an…
Benefit
These are all emergency warning signs during pregnancy and postpartum listed by the US Centers for Disease Con…
If your water breaks, there’s no time to calmly gather your things and head out. The right thing to do is lie down right where you are, raise your hips, and call 120 immediately. Walking around while standing up causes amniotic fluid to leak even faster, and the umbilical cord can be pulled out along with it. This is a life-threatening emergency for the baby.
Cost
No cost at all
Benefit
This is exactly what the Beijing Municipal Health Commission recommends: “Immediately lie down flat to prevent…
Labor analgesia is a shot of anesthetic in the lower back that takes the edge off labor pain. It works better than other pain relief and does not make a cesarean more likely. The claim that “it leaves you with lifelong back pain” has no basis either. It now has its own billing item, so hospitals are more willing to offer it.
Cost
Several hundred to over 1,000 yuan;
Benefit
A Cochrane systematic review found that epidural analgesia is more effective than non‑epidural methods at redu…
WHO states that above a population cesarean rate of 10%, there is no evidence of further reduction in maternal or newborn deaths. Have a cesarean when medically needed. In later pregnancies after cesarean, placenta previa and accreta are more common. Choosing surgery only for a lucky date or fear of pain is not worth it.
Cost
No direct cost. The real challenge is resisting pressure f…
Benefit
A 2015 WHO statement notes that when C-section rates rise to roughly 10% in a population, maternal and neonata…
When the employer pays maternity insurance, medical costs of childbirth and the allowance during maternity leave both come from that fund. If the spouse has no job, the medical-cost part can still be claimed. Whether you have enough months of enrollment, and whether birth outside the local area needs advance filing, must be asked early.
Cost
Zero cost. Just call the social insurance or medical insur…
Benefit
Article 54 of the Social Insurance Law: when the employer has paid maternity insurance premiums, the employee…
This certificate is the prerequisite for hukou (户口 — household registration), insurance enrollment, and school. If birth was in a hospital, collect it from the facility that attended the birth. If birth was outside a midwifery facility, you need a parentage test first. For characters in the name, confirm the hukou system can type them.
Cost
No cost at all. It can be arranged effortlessly while comp…
Benefit
Article 23 of the Maternal and Infant Health Care Law: medical and health-care institutions and persons engage…
A heel-prick blood test and hearing test can find hypothyroidism, phenylketonuria and hearing impairment before a baby looks unwell. Once symptoms emerge, intellectual damage from hypothyroidism and phenylketonuria is irreversible. Detecting hearing loss enables early hearing aids.
Cost
In most areas these tests are free;
Benefit
Article 3 of the Newborn Disease Screening Measures lists congenital hypothyroidism, phenylketonuria and other…
As soon as you receive the birth certificate, you can enroll your baby in yibao online — no need to wait for household registration. Once enrolled, most hospitalization costs can be reimbursed right at discharge. Newborn hospital bills can be quite high, so having yibao makes a big difference.
Cost
You pay the yibao premium just once a year;
Benefit
According to the Chinese government website in 2024, “Newborns can enroll in yibao online using their birth ce…
Register the birth for household registration within one month, and obtain the vaccination certificate from the birth hospital or the vaccination provider where you live. These are separate procedures: vaccinate on schedule even without household registration; do not wait for it to be completed.
Cost
No cost involved;
Benefit
Article 7 of China’s Household Registration Regulations requires the household head, a relative, caregiver, or…
This checkup costs nothing. On local published service lists it includes a complete blood count, a vaginal discharge exam, and one postpartum depression screen. Serious problems can still appear in the first year after birth; do not assume you are safe once the confinement month ends.
Cost
It’s free; it’s part of basic public health services. It t…
Benefit
Under maternal health management in the National Basic Public Health Service Standards (Third Edition), after…
Toxoplasma is a parasite. A first infection during pregnancy can cause miscarriage, and the baby’s eyes and brain can be damaged. Living with a cat does not make infection more likely, so the cat does not have to go. What matters more is undercooked meat and handling soil without washing your hands. Having someone else scoop the litter every day is enough.
Cost
Free. Hand the litter box to someone else in the household…
Benefit
The US Centers for Disease Control and Prevention says a first toxoplasma infection shortly before or during p…
Pregnant people who get flu are more likely to be hospitalized than people who are not pregnant. One flu shot in pregnancy cuts your own flu hospitalizations by about four tenths. In the child’s first 6 months, confirmed flu falls by about half, and flu hospitalizations by about seven tenths. No rise in miscarriage, stillbirth, or birth defects was seen after the shot.
Cost
Self-pay, a few dozen to a little over 100 yuan per shot.…
Benefit
The WHO 2022 position paper pooled existing studies. Pregnant people with flu were more likely to be hospitali…
After 28 weeks, falling asleep on your back is associated with clearly higher stillbirth risk than on your side. Either side is fine; choose the comfortable one. If you wake on your back, do not panic: turn onto your side. The finding relies on retrospective recall and remains debated.
Cost
No money spent. The hard part is changing posture if you a…
Benefit
Stillbirth here means the baby dying in the womb after 28 weeks. One pool merged raw data from five studies. F…
You can conceive again as early as 3 weeks after birth, even while breastfeeding and before periods return. Breastfeeding only blocks pregnancy when all three hold: exclusive breastfeeding, no period yet, and the child under 6 months. Conceiving again within half a year after birth raises the next child’s preterm risk. The World Health Organization advises waiting at least two years after birth before trying again.
Cost
A box of condoms is a few dozen yuan. An IUD or an implant…
Benefit
The UK National Health Service (NHS) says you can conceive again as early as 3 weeks after birth, even while b…
