Pregnancy and childbirth: from the first positive test to discharge paperwork
When you are pregnant or about to give birth, what do you do and when, and which certificates must you get before discharge?
Tips from this section that apply in the United States. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription.
Taking one folic acid tablet a day from before pregnancy through early pregnancy cuts the chance of a neural tube defect in the baby by about 70%. Neural tube defects are birth defects such as anencephaly and spina bifida. For someone who has already had one baby with such a defect, the chance of another affected baby falls to about one third of what it was.
At your first prenatal checkup, get tested for HIV, syphilis and hepatitis B. You don't pay for the tests. Finding one is not the end of the road. The state provides medicine and a care plan free, to block the way the disease passes from mother to child; this is called blocking mother-to-child transmission.
Smoking in pregnancy raises the chance of premature birth, a baby that is too small, and cleft lip and palate. It doubles the risk of abnormal bleeding during pregnancy and delivery. It also raises the risk of sudden infant death. Family members smoking indoors counts just the same. It is never too late to quit.
Preeclampsia is a kind of high blood pressure disorder in pregnancy. You are at high risk if you had it in a previous pregnancy, are carrying more than one baby, have chronic high blood pressure, had diabetes before pregnancy, or have kidney disease or an autoimmune disease. For high-risk women, one low-dose aspirin a day from 12 weeks lowers preeclampsia by about 15%, and premature birth and death of the baby around birth each by about 20%. Others should not take it on their own.
Gestational diabetes is high blood sugar that first appears after you become pregnant. After 24 weeks, half a morning, one sugary drink and a few blood draws can find it. If it is not found and not managed, the risks of an overly large baby, a difficult birth, a cesarean section, preeclampsia and low blood sugar in the newborn all go up.
If any one of these appears, go to the hospital the same day; don't wait at home overnight. A headache that won't go away or keeps getting worse, changes in vision, a fever of 38 ℃. Severe swelling of the hands or face, trouble breathing, chest pain or a racing heart. Severe belly pain that doesn't ease, the baby's movements stopping or clearly decreasing, vaginal bleeding or leaking fluid. One arm or leg both swollen and painful, thoughts of hurting yourself or the baby. This also applies within a year after birth.
When the water breaks, you don't pack your things slowly and then set out. The right thing is to lie down on the spot, raise your hips on something, and call 120 (China's ambulance number). Standing and walking makes the fluid drain faster, and the umbilical cord may be swept down with it. That is an emergency that can kill the baby.
Painless labor (无痛分娩) means an anesthetic injection in the lower back that damps down the pain of giving birth. It works better than other pain relief methods and does not make a cesarean any more likely. The claim that “after the epidural your back hurts for life” has no basis either. It now has its own billing item, and hospitals are more willing to offer it.
The World Health Organization says that once a place's cesarean rate goes above 10%, deaths of mothers and newborns stop falling. When a cesarean is needed, it must be done. Having one to pick a date or because you fear pain is just going through major abdominal surgery for nothing.
One heel-prick blood sample and one hearing test can find hypothyroidism, phenylketonuria and hearing impairment while the baby looks completely normal. By the time symptoms show, the damage to intelligence can no longer be made up.
This checkup costs nothing. It includes a blood count, a vaginal discharge exam, and a screening for postpartum depression. Serious problems can occur at any time within a year after birth, so don't assume you are safe once the postpartum month is over.
Toxoplasma is a parasite. Catching it for the first time during pregnancy can cause a miscarriage, and the baby's eyes and brain may be damaged. Having a cat at home does not make a person more likely to catch it, so the cat does not have to go. What matters more is not eating undercooked meat and washing your hands after touching soil; as for the litter, it is enough to have someone else scoop it every day.
Moderate value
Evidence B
Buys life
For: Pregnant or trying
Mainland China only 5 tips
These tips describe mainland-China rules and do not apply in the United States; they are here for people living in China.
At least five prenatal checkups in pregnancy, plus a home visit after delivery and the checkup at 42 days postpartum, are paid for by the state. To get them, go to your community before 13 weeks of pregnancy and open a Maternal and Child Health Handbook. If you don't, these free visits are simply missed.
When an employer has paid into maternity insurance (生育保险), the medical costs of childbirth and the allowance during maternity leave come out of that fund. If your spouse has no job, the medical costs can still be reimbursed. Whether you have enough months of enrollment, and whether giving birth in another place requires registering first, are things to ask ahead of time; they can't be fixed afterward.
This certificate is required to register the baby's household registration, enroll in insurance and start school, and only the institution that delivered the baby can issue it the first time. Coming back after you leave the hospital means a separate process and more documents. For the characters in the name, first confirm that the household registration system can print them.
Once you have the Birth Medical Certificate, you can enroll the baby online without waiting for the household registration. Once enrolled, the hospital bill at discharge can be reimbursed on the spot. A newborn's hospital bill is not small, and there is a big difference between being enrolled and not.
The law gives you one month, not “whenever you have time.” The household registration holds up vaccinations, daycare and school enrollment, and getting an ID card afterward. The longer you put it off, the more documents you need to make it up.
