3.7 Childbirth, family planning, and mother and child health care

3. 7.1 Infant survival and mortality rates

The survival rates for babies born to women of the three age cohorts were as follows:

- elderly cohort, 71.7%,
- middle-age cohort, 90.5%,
- young cohort, 93.6%.

The mortality rates for babies within six months after birth were:

- elderly cohort, 12.8%,
- middle-age cohort, 6.2%,
- young cohort, 5.6%.

The improvement is attributable to economic growth and the improvement of people's living standards in general, and the development of mother and child health care in particular. In pre-liberation times, poor sanitary conditions and unsterilized midwifery caused high infant mortality from tetanus. After liberation, while transforming old-type midwives, the health departments trained a large number of modern midwives and primary health workers to serve the rural areas. Meanwhile, drinking water and environmental sanitation have been improved, and health protection measures for children such as planned immunization have been carried out step by step in the rural areas. Since then, infant mortality has steadily declined.

(See tables 3.17-3.20 for other data on the birth and survival of children.)

Table 3.18 Pregnancies and birth statuses

	Elderly		Middle-age		Young
	No.	%	No.	%	No.	%
Hengtang
Live births	707	88.1	336	80.4	53	73.6
Stillbirths	21	2.6	4	0.9	2	2.8
Abortions	43	5.4	53	12.7	17	23.6
Miscarriages	31	3.9	25	6.0	0	0
TOTAL PREGNANCIES	802	100	418	100	72	100
Jiahong
Live births	733	90.4	390	74.7	76	73.8
Stillbirths	20	2.4	9	1.7	0	0
Abortions	8	1.0	104	19.9	21	20.4
Miscarriages	50	6.2	19	3.7	6	5.8
TOTAL PREGNANCIES	811	100	522	100	103	100

3.7.2 Family planning

The frequency of pregnancy among the women surveyed has declined as a result of family planning. (See table 3.21.) The average and maximum number of pregnancies for each age cohort were as follows:

- elderly cohort, average 6.7, maximum 14;
- middle-age cohort, average 3.8, maximum 9;
- young cohort, average 1.3, maximum 4.

Table 3.19 Duration Of life Of Children home by the Women surveyed

	Elderly		Middle-age		Young
	No.	%	No.	%	No.	%
Hengtang
Died within 6 months	92	13.0	18	5.4	3	6.0
Died at 6-12 months	13	1.8	1	0.3	0	0
Died at 1-5 Years	52	7.4	6	1.8	0	0
Died at 5-18 years	7	1.0	1	0.3	0	0
Living	544	76.8	307	92.2	47	94.0
TOTAL	708	100	333	100	50	100
Jiahong
Died within 6 months	93	12.6	27	6.9	4	5.3
Died at 6-12 months	38	5.2	1	0.3	0	0
Died at 1-5 years	90	12.2	11	2.8	1	1.3
Died at 5-18 years	24	3.3	4	1.0	0	0
Living	490	66.7	349	89.0	71	93.4
TOTAL	735	100	392	100	76	100

In Hengtang 97.6% of the women in the middle-aged cohort and 76.8% in the young cohort practiced birth control; in Jiahong the figures were 90% and 57% respectively (table 3.22). The rates for the young cohort were low because some of the newly married women had no children yet at the time of the survey.

The most popular contraceptive used in the two townships is the IUD; some women have had tubal ligation, and some men have had vasectomy (table 3.23). When an IUD fails, abortion is resorted to. There is a need for improving the efficacy of contraceptive devices.

Table 3.20 Causes of children's deaths

	Elderly		Middle-age		Young
	No.	%	No.	%	No.	%
Hengtang
Disease	144	88.3	20	71.4	3	75.0
Accident	3	1.8	1	3.6	1	25.0
Hunger	3	1.8	0	0	0	0
Cold	5	3.1	7	25.0	0	0
Other causes	8	5.0	0	0	0	0
TOTAL	163	100	28	100	4	100
Jiahong
Disease	213	87.3	29	70.8	4	80.0
Accident	0	0	1	2.4	1	20.0
Hunger	10	4.1	1	2.4	0	0
Cold	20	8.2	8	19.5	0	0
Other causes	1	0.4	2	4.9	0	0
TOTAL	244	100	41	100	5	100

Table 3.21 Frequency of pregnancy

	Hengtang			Jiahong
	Av	Max	Min	Av	Max	Min
Elderly	6.5	14	0	6.9	14	1
Middle-age	3.3	6	0	4.4	9	0
Young	1.3	4	0	1.3	4	0

Table 3.22 Proportion of women practicing birth control

	Elderly		Middle-age		Young
	No.	%	No.	%	No.	%
Hengtang
Practicing	65	52.4	122	97.6	43	76.8
Not practicing	59	47.6	3 2.4	13	23.2
Jiahong
Practicing	12	10.1	108	90.0	45	57.0
Not practicing	107	89.9	12	10.0	34	43.0

Table 3.23 Contraceptive methods used

	Elderly		Middle-age		Young
	No.	%	No.	%	No.	%
Hengtang
Oral contraceptive	5	7.7	7	5.8	4	9.3
IUD	50	76.9	38	31.1	36	83.7
Tubal ligation	10	15.4	77	63.1	2	4.7
Other methods	0	0	0	0	1	2.3
TOTAL	65	100	122	100	43	100
Jiahong
IUD	6	50.0	27	25.0	43	95.6
Tubal ligation	0	0	13	12.0	1	2.2
Vasectomy	3	25.0	65	60.2	0	0
Safe period	0	0	0	0	1	2.2
Other methods	3	25.0	3	2.8	0	0
TOTAL	12	100	108	100	45	100

3.7.3 Changing views on childbearing

Present government population policy encourages late marriage, late pregnancy, fewer children, eugenics, and the practice of one child for each couple. Though the idea of having only one child runs counter to the Chinese traditional belief that more children mean more blessing, the new policy finds general acceptance in the two townships. This is the result of intensive publicity work and mother and child health measures that make the overwhelming majority of the people understand and support family planning. The old preference for having many children is waning. It is especially easier for the women in the middle-age and elderly cohorts to accept the idea of family planning because almost all of them had a difficult time bringing up many children with a low family income. They are now convinced that with fewer children, mothers not only can concentrate more on production and increasing family income but can take better care of their own health and their children's and give them better education. But most people accept the idea of one child for each couple because they understand that China has a big population but a poor economic base and insufficient arable land. The only way out is to control the growth of the population. Actually most couples would like to have two children-a son and a daughter. They settle for one child out of consideration for the nation's overall interest.