Sunday, 18 May 2014

Beijing’s 3-point reform plan for maternity services


by Michael Woodhead
Maternity services are to shift from hospitals to community health centres and women will not be allowed to have routine Caesareans unless there is a valid medical indication, Beijing health officials have announced.
New reforms are needed in maternity policies to cope with the expected increase in births as China moves to a two child policy, according to the city health department.
Under new measures, three new basic policies will be introduced. These are for women to register first with a community health centre rather than a maternity hospital. Following tests at six week of pregnancy, women will be enrolled on the maternity database, and women will then be graded into one of four levels according to risk of pregnancy. Only high-risk pregnancies (such as in older women) will be managed in tertiary level hospitals. Low risk births will be managed in local hospitals and clinics, the new policy states. In addition, women will no longer be offered caesarean section unless there is a good medical indication. The head of Beijing maternity services department says caesareans must be discouraged because China already has a 45% rate, which is much higher than the WHO benchmark of 14%. In addition, caesarean birth mean women spend longer in maternity hospitals, taking up scare resources, she said.
Health officials said the maternity system was already at breaking point with something like 94% occupancy of obstetric beds and thus no additional capacity to cope with a two child policy. Maternity services will be expanded but they also must be used more rationally, the officials said. By managing low risk pregnancies outside the hospital system, this will free up beds to deal with high risk pregnancies, they said.

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