Pregnancy and childbirth: From confirming pregnancy to discharge and paperwork✳
This section first looks at mortality risks — both for the mother and the unborn baby. Later on, we discuss costs and the time required for various procedures. These two sets of calculations are not combined or compared. The focus here is solely on “what needs to be done at what stage.” Topics such as prenatal nutrition or fetal education lack solid evidence or have minimal impact, so they are not covered here. Details on maternity benefits, leave entitlements, and child-rearing expenses can be found in Section 18. Guidance on caring for a newborn is provided in Section 20, while emergency situations are addressed in Section 13. According to World Health Organization figures, in 2023 roughly 260,000 women worldwide died as a result of pregnancy or childbirth. About 75% of these deaths stemmed from five main causes: severe postpartum bleeding, infections, hypertensive disorders of pregnancy (such as preeclampsia and eclampsia), complications during delivery, and unsafe abortions. The WHO also notes that “most maternal deaths are preventable, since effective medical measures for prevention and treatment of complications already exist.” The most important actions outlined in this section are precisely those aimed at preventing these problems before they occur.
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Starting daily folic acid supplementation at 0.4 mg before pregnancy and continuing through the first trimester
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.
Cost
A bottle costs only a few dozen yuan. Rural women receive…
Benefit
A Cochrane systematic review pooled data from 5 trials involving 6,708 deliveries, rating the evidence as high…
02Evidence A
Register for the Maternal and Child Health Handbook at a community health center before 13 weeks of pregnancy to claim free prenatal checkups
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…
03Evidence A
Getting tested for HIV, syphilis, and hepatitis B during the first prenatal visit — free prevention options available
During your very first prenatal checkup, you can get tested for HIV, syphilis, and hepatitis B at no personal expense. Even if results show a positive diagnosis, there are still effective ways to prevent transmission to your baby. The government offers free medication and treatment plans to block the spread of these infections from mother to child — this is known as maternal and infant transmission prevention.
Cost
No cost involved;
Benefit
Maternal and infant transmission is how infections pass from a mother to her unborn or newborn child. The “Wor…
04Evidence A
No smoking or drinking at all throughout pregnancy — and no one else in the house should smoke either
Smoking during pregnancy raises the chances of premature birth, a baby being born underweight, and cleft lip or palate. It also doubles the risk of abnormal bleeding during pregnancy and childbirth, and increases the risk of sudden infant death syndrome. Secondhand smoke from anyone smoking indoors counts just the same. It is never too late to quit, no matter when you start.
Cost
There’s no cost at all;
Benefit
According to the U.S. Centers for Disease Control and Prevention, smoking during pregnancy can result in babie…
05Evidence A
For women at high risk of preeclampsia, start taking one low-dose aspirin tablet daily after week 12 of pregnancy
Preeclampsia is a type of high blood pressure that occurs during pregnancy. Women falling into any of these six categories are at high risk: those who had preeclampsia in a previous pregnancy, women carrying multiples, women with chronic hypertension, women with diabetes prior to pregnancy, women with kidney disease, and women with autoimmune diseases. For these women, taking one low-dose aspirin tablet daily starting at week 12 can reduce the risk of preeclampsia by roughly 15%, the risk of premature birth by about 20%, and the risk of perinatal death by nearly 20%. Women not in these categories should not take it on their own.
Cost
A few dozen yuan. One tablet per day must be taken until d…
Benefit
The US Preventive Services Task Force gives this a Grade B recommendation: for women at high risk of preeclamp…
06Evidence A
Get screened for gestational diabetes at 24 weeks of gestation or later — don’t mind drinking the sugary solution
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…
07Evidence A
Memorize this “go to the hospital immediately” checklist — it applies throughout pregnancy and the first year after childbirth
If any of the following symptoms appear, head to the hospital on the same day — do not wait until the next morning. Persistent or worsening headaches, changes in vision, fever reaching 38°C. Severe swelling of the hands or face, trouble breathing, chest pain or a rapid heartbeat. Unrelenting severe abdominal pain, no fetal movement or a noticeable drop in fetal movement. Vaginal bleeding or fluid leakage. Swelling, pain and redness in one arm or leg. Thoughts of harming yourself or your baby. The full list is included in the Benefits section below. These guidelines apply equally in the first year after childbirth.
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…
08Evidence B
If your water breaks, lie down flat, elevate your hips, and call 120 — don’t walk around or take a shower
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…
09Evidence A
Ask for labor analgesia — it does not raise the risk of C-section
Labor analgesia involves injecting anesthetic into the lower back to dull the pain of childbirth. It works far better than other pain‑relief options and does not make a C-section more likely. The claim that “it causes lifelong back pain” is also unfounded. Nowadays it is offered as a separate charge, so hospitals are more willing to provide 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…
10Evidence A
Don’t request a C-section without medical indication, and avoid scheduling one just to pick a “lucky” date
According to the World Health Organization, once the C-section rate in a region exceeds 10%, further reductions in maternal and neonatal mortality become unlikely. When a C-section is medically necessary, it must be performed. However, opting for one solely to choose a favorable date or to avoid labor pain means undergoing a major abdominal operation for no real reason.
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…
11Evidence A
Check your yibao enrollment status before getting pregnant — even unemployed spouses can claim maternity medical expenses
If your employer pays into yibao, both maternity medical costs and maternity leave benefits come out of that fund. Even if your spouse isn’t employed, they can also claim maternity medical expenses. You must confirm beforehand whether you’ve met the minimum enrollment period and whether you need to register in advance for childbirth outside your local area — these details cannot be fixed later.
Cost
Zero cost. Just call the social insurance or medical insur…
Benefit
Article 54 of the Social Insurance Law states that employers who pay yibao premiums provide their employees wi…
12Evidence A
Get the “Medical Certificate of Birth” sorted out before discharge; decide on the baby’s name early and avoid typos.
This certificate is a prerequisite for registering the child’s hukou, enrolling in yibao (basic medical insurance), and sending the child to school. Only the medical institution where the delivery took place can issue it for the first time. If you try to obtain it after discharge, you’ll have to follow a completely different process and submit extra documentation. Also, make sure the characters you pick for the baby’s name can be entered into the household registration system without any issues.
Cost
No cost at all. It can be arranged effortlessly while comp…
Benefit
Article 23 of the Maternal and Infant Health Care Law stipulates that medical institutions and home birth atte…
13Evidence A
Don’t skip newborn heel‑prick and hearing tests
A single heel‑prick blood test and one hearing test can detect hypothyroidism, phenylketonuria, and hearing loss even when the baby appears perfectly healthy. By the time symptoms become obvious, any intellectual damage is already irreversible.
Cost
In most areas these tests are free;
Benefit
Article 3 of the “Administrative Measures for Newborn Disease Screening” lists congenital hypothyroidism, phen…
14Evidence A
Enroll your newborn in yibao right after getting the birth certificate — don’t wait until household registration is complete
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…
15Evidence A
Registering a newborn’s birth at a police station within one month
The law sets a strict one‑month deadline — it’s not a suggestion that you can ignore when convenient. Completing the hukou registration is a prerequisite for vaccinations, preschool enrollment, school admission, and obtaining an ID card. The longer you wait, the more additional documents you’ll need to provide.
Cost
No cost involved;
Benefit
Article 7 of the *Regulations on Hukou Registration* states: “Within one month after a baby’s birth, the head…
16Evidence A
Don’t skip that 42-day postpartum checkup — it also screens for postpartum depression
This checkup costs nothing and includes a complete blood count, vaginal discharge test, plus a screening for postpartum depression. Serious problems can arise at any time during the first year after birth, so don’t assume you’re out of danger just because the postpartum period is over.
Cost
It’s free; it’s part of basic public health services. It t…
Benefit
According to the “National Standards for Basic Public Health Services (3rd Edition),” postpartum care requires…