Pain-free childbirth to be promoted

China will launch a pilot program aimed at getting more women to give birth naturally with painkillers to reduce the frequency of C-sections.

The National Health Commission said on Tuesday night it will select a number of hospitals across the country for the program, which will last until the end of 2020.

The country's lack of pain-free natural labor was brought into the spotlight in August last year, when a 26-year-old pregnant woman, Ma Rongrong, who was a week from her due date, jumped from the fifth floor of an inpatient building at First Hospital of Yulin in Shaanxi province, partly because she was in unbearable pain.

Participating hospitals will improve their practices and management of natural births with anesthesia intervention, and by enhancing the training of related medical personnel, including anesthesiologists, obstetricians and midwives, the commission said in a plan.

Upon completion of the pilot program, the commission will share the knowledge gained nationwide, it said. By the end of 2020, more than 40 percent of all deliveries in the pilot hospitals will be completed with the help of spinal or epidural pain-blocking anesthesia, or a combination of both. They are the two most common pain-killing techniques used in childbirth.

In a spinal procedure, a tiny needle in the lower back penetrates the dural membrane into the space occupied by the spinal cord and cerebral fluid. A painkiller is injected that numbs the lower body. In an epidural, the needle only penetrates to the epidural space, a narrow channel just outside of membrane.

The measures are expected to "improve the comfort of medical services for pregnant women so they are more satisfied", the commission said.

Although popular in many developed countries, including the United States, spinal or epidural anesthesia is woefully underused in China, in general, in part because of a lack of qualified anesthesiologists. Some experts estimate that only 10 percent of women who have babies in China do so naturally using pain-free techniques.

As a result, many women are forced either to give birth naturally with little pain intervention, or choose a C-section with anesthesia, which increases risks. About 35 percent of babies are born in China through C-section, far higher than the internationally recommended standard of less than 15 percent.

Huang Yuguang, who is head of Peking Union Medical College Hospital's anesthesia department and leads the committee of experts for the pilot program, said the pilot hospitals will be major hospitals or those that specialize in obstetrics services.

"The list of pilot hospitals will be released soon," he said.

A lot of work needs to be done to promote natural birth using spinal or epidural anesthesia in China, including better training of anesthetists and regulation of procedures to eliminate safety risks, Huang said.

"Different hospitals may vary greatly in their professional skills," he said. "We must establish unified guidelines and standards that all hospitals can follow to ensure high quality service and minimize risks to patients."

The price for performing natural birth with anesthesia should be raised to encourage physicians to opt for the practice, he said.

China's shortage of anesthesiologists poses a major obstacle to promoting pain-free natural labor and childbirth, he said. In many hospitals, understaffed anesthesia departments are kept busy with surgeries where anesthesia is required and don't have time for natural births, he said.