A Fight at the Hospital – Abortion in China

As many of you know I work in a large public hospital with over 2,000 medical personnel. We treat over 1,000,000 patients every year. Sometimes, things do not go well. Mistakes are made, and families get upset.

About once a week there will be a small group of people who try to come into the building where I work to complain to the hospital administrators about an unfavorable outcome (often this is hospital speak for death). Generally there is a lot of yelling, the police will come, and after 30 minutes or so they all leave quietly. I don’t know what, if anything, is ever done to help these people, but you can always hear the pain in their voices.

Today I witnessed the largest of these protests that I have seen over my 8 months here, nearly 60 family members gathered outside. This has been one of the few times in my 4 years in China that I was actually worried about my personal safety. The details came out slowly, and I only know the parts that my Chinese co-workers were willing to pass on. The family was so upset over this outcome that a physical fight between them and the police ended with a few people being taken to another hospital.

I learned later that the family had been expecting a healthy baby. Today that baby was born, but with a major birth defect, it was missing an arm. The family was angry because the hospital had missed this during the ultrasound (or perhaps it was something that was not obvious on the ultrasound). They were shouting, “How can our baby live without an arm?”

I couldn’t believe it. This large protest was not over a death, but over a life. They were upset because they had missed their opportunity to have an abortion (or euphemistically “stop the pregnancy”). They were demanding compensation from the hospital because they would have to raise a child with a disability.

This attitude towards the disabled, and the nonchalant way in which abortions are discussed I feel are a direct result of the one child policy (which I discussed in more detail here).

According to policy, ultrasounds may only be used for diagnosing health problems in the baby, and should never be used to reveal the sex of the child. This policy was created to try to prevent sex-selecting abortions. The result of this is that ultrasounds are now (supposedly) solely to diagnose health problems so that parents can decide if they want to have an abortion. Also according to the policy, children with serious birth defects do not count as your one child. This in some ways ensures that disabled people in China will never be treated as equals (even slaves counted as 3/5th of a person in early America).

One of my Chinese co-workers felt unwell in the early stages of her pregnancy and casually commented to me before her ultrasound, “If there is something wrong, I will stop the pregnancy, and we will try again,” (luckily the baby was fine, and she will give birth in about a month). When I told her that some Americans think that abortion is the same as murder she was shocked and said, “but it’s just a fetus now, not a baby.”

I don’t mean to preach morality, or condemn my co-workers, but to simply share an experience.

Please do not leave comments about the morality or immorality of abortion here, there are plenty of other places for that. Comments that do not respect this request will be deleted.

If you are a religious person I ask you to keep this family in your thoughts and prayers, they are clearly in a great amount of pain.

40 responses to “A Fight at the Hospital – Abortion in China”

  1. So what’s your angle on the story then? Personally, I could see the direction where the no-arm-baby family was coming from. But I agree with you that the situation you describe is ultimately brought about by the one-child policy.

    • Tom says:

      I’m very saddened that this baby is coming into the world being seen as a burden on the family instead of the joy that they are. My understanding is that there are no other birth defects, lacking an arm seems to be a fairly manageable disability.

  2. I completely understand where the Chinese family is coming from, China has almost no adaption for disabled children, it costs far more to raise a disabled child than most families can afford, and there’s no support network provided by the state for parents with disabled children. On top of that a child is the financial safety net for your old age and given the levels of discrimination in Chinese society with an abundance of well educated, perfectly formed people competing for a shortage of jobs, this means this child has little chance at employment condemning both the child and his/her parents to serious hardship in later life.

    • Tom says:

      Just rephrasing here to make sure I understand your point. You agree with the family, because of the hardships, but at the same time acknowledge that those are hardships caused by gov’t policies, and a lack of a social safety net.
      Also I think that a physical deformity and being mentally disabled are very different things, especially in China. While this child will never work on an assembly line, it’s disturbing to think that he’s completely incapable.

      • I don’t think it’s government policy to have no safety net, so much as there’s no money for a safety net as yet. In another of your blog posts you place China’s wealth equivalent per capita at 110th in the world (or something like that) just behind Tanzania/Tunisia (?).

        Neither of those countries provide a safety net for the infirm either.

        I see many physically disabled people here daily in Shenzhen, begging sadly because they can’t find work. I am yet to see a physically disabled person in work (though there are rumours of uni professor here who is – but I haven’t met him).

        I don’t think this is China policy so much as China reality all told – I might not like it, but it is how it is.

      • Tom says:

        Again though I would argue that for the reasons I pointed out in the post, physically disabled people are looked down upon at least partially because of gov’t policies. I work with a Chinese charity organization that helps train mentally impaired adults for working in the private sector, and also have read about autistic teenagers finding work in Beijing hotels. If companies are hiring mentally disabled workers, I have to imagine that they are also hiring people with physical disabilities.
        China’s wealth per capita is far behind other developed countries, but even as it’s GDP as boomed little has been done to set up social safety nets (I believe Tunisia’s economy was fairly stagnant before the gov’t there was overthrown). I think that this is not because it lacks the money, but instead lacks the politcal will and logistical capabilities to effectively implementing such a system.

  3. I tend to disagree in the 2000 WHO report China’s health system was ranked less than 160th in the world – sadly improvements are impossible to track as the WHO no longer compiles the report because it’s too expensive – however given the evidence that TCM is still the dominant form of “medicine” one assumes that investment in health care generally needs to be a priority.

    With a GDP coming in at less than $3,000 USD per head, it doesn’t leave much money for basic health care let alone a social security system. No nation wants to watch its children starve (250 million people in China live below the internationally accepted poverty line of $1.25 US a day, 100 million people are below China’s definition of 1,200 RMB a year (less than $200 US a year), but as that’s exactly what is happening at the moment – it seems unlikely that there will be spare cash for shoring up disabled rights any time soon.

    It’s ugly – I agree, however I also agree with the prority of pulling 250 million people out of poverty over improving social security.

    • Tom says:

      Is improving social security really completely separate from reducing poverty? Is China’s current priority pulling people out of poverty or is it growing GDP? Should disabled people accept that they are of lower importance and wait patiently until everyone else is out of poverty?

      I’d be curious to see the data that suggests TCM is the dominant form of medicine, while it is popular for minor ailments, when people are very sick they come to the western hospital.

      • First things first, poverty here is absolute, it’s not relative, which means that 250 million people cannot feed themselves properly – on my list of things to do feeding those people is more important than making sure the disabled can get equal treatment. It’s not that I like that choice but it is a coldly rational one.

        Wen Jia Bao and Hu Jin Tao have been clear that the priority under the last 2 plans (and the current one) is to alleviate poverty – the fate of the party rests on this, with far more awareness of the divide between the haves and the have nots, if the gap isn’t closed things could get ugly.

        As for Western medicine the vast majority of Chinese have no access to it, ignoring Tier 1 and some Tier 2 cities most hospitals here are TCM. And even those that are Western haven’t got a basic grip on actual medicine – my wife just visited our local hospital in Shenzhen for thrush, so they prescribed an antibiotic drip… clearly they’re unaware that antibiotics can cause thrush but have absolutely no effect in curing it because it’s a fungus and not a bacteria. Worse they made her go back 3 times, and because they’re the “professionals” it took another week of misery before she’d use the Canesten I’d bought for her in the pharmacy to fix it.

      • Tom says:

        The figure of 250 million people living in poverty does not necessarily mean that they cannot properly feed themselves. I lived in rural China for 2 years. Many of my students came from below the $1.50 line, their parents were subsistence farmers, they grew enough to eat, but not enough to sell for much income.
        Secondly there have been dozens of speeches about alleviating poverty, but as a person who works closely with a Chinese charity, I know that many of these speeches rarely become actions. That’s why China has spent billions of RMB on high-speed rail, but little money for projects that help the poorest of the poor.
        Also anti-biotic drip might not be the right treatment, but it is still western medicine.

      • Tom it’s only Western medicine if it’s done right – otherwise it’s idiots in a white coat medicine.

        I work closely with Chinese people everyday too – they’re all adamant that $1.25 isn’t enough to live on, including my wife who comes from rural Sichuan and whose parents I have to subsidise because of that.

        Working with a charity is good but it doesn’t change the realities of life here, which is that many people are starving (even the Chinese government nods 100 million people through the door using their measure, which incidentally they are considering raising to 1800 RMB a year in the next few weeks, getting ever closer to the international definition of total poverty).

        However despite all that, in the last 10 years – 300 million people have been raised above the poverty line, that’s impressive however you want to cut it.

        Forget the headlines of bleating and complaining from Western sources, 300 million people have become “comfortable” (in the loosest sense of the word – I wouldn’t want to live many of their lives) in 10 years.

        There are many things about China that don’t meet my standards but raising 5 times the population of the UK (my home) out of poverty in 10 years? That’s pretty good, no matter how you cut it.

      • Tom says:

        I’m wondering what your definition of starving is?
        Of course in Shenzhen $1.25 a day isn’t enough to live on, but most of the people who are living with that little pay are farmers in the countryside.
        I also didn’t say that say that no one rose out of poverty during the past ten years, what I said was that gov’t speeches don’t equal gov’t action. I have never denied that China’s gov’t has helped lift millions out of poverty and mentioned it specifically in my post does China’s growth mean communism works.

      • I guess I’d take starving as the WHO’s estimate that nearly 23% of Chinese children are malnourished, and that that number rises to 88% in the poorest districts. I know you’re trying to make an indirect moral case against what happened in this instance – in the same way as I’m trying to make an indirect moral one in favour – but no-one denies people are starving in China.

        For the record I don’t pray because I’m an atheist but I’d still like the world’s ills fixed all the same. I don’t see embryos as sacred, or miniature children though because they aren’t.

  4. Tim says:

    Tom, really good article. This story touches so many very deep nerves in a lot of people. I feel like I could write a really, really long comment.

    I will definitely be thinking of this family and the many others that are in similar situations.

  5. Joel says:

    I share your sentiments, but I don’t think we can blame this situation or typical Chinese attitudes toward abortion primarily on the One Child Policy. Infanticide has a long, on-going history in China; ultrasounds have made it easier and the One Child Policy one more big reason to do it (while extreme economic hardship is less and less of a reason). These attitudes aren’t rooted in the One Child Policy, nor (@Nick) are they primarily caused by economic hardship (consider attitudes to abortion among the much more affluent Taiwanese). These are both significant exacerbating factors, sure, but not causes nor the primary factors, imo. Much deeper cultural factors play a much deeper role, I think. (btw — I suppose you’ve seen the recent story about the ring of pregnant thieves, who got pregnant, stole for a while, had late-term abortions, and then did it again and again? Here and here)

    We wrote about our own encounters with abortion in China here: “Painless”, “cozy”, “cheerful”, “3-minute”, “sweet dream” abortions in Tianjin, China

    • Tom says:

      Thank you for linking to your article, there was a lot more that I wanted to point out about abortion in China, but a lot of that information leaks a bit more than I probably should (there is so so much that you don’t want to know). I hope to hear something more about Chinese attitudes about abortion. I know that these preferences for baby girls carry over when the families move to other countries, but I haven’t too much about the attitude towards abortion prior to the one child policy. My feeling is that it made it far more acceptable.
      After reading your post, I was reminded of a student in Chengdu who had had an abortion. She was devastated, but felt that she could talk to no one about her feelings since it was supposed to be the right thing to do.

      • Joel says:

        Yeah, there is so much I wish I didn’t know related to abortion in China — stuff I would not believe had I not seen the photos. Even if we somehow accidentally had a personal encounter with that stuff, I doubt I’d ever blog about it. I have no doubt that in the hospital you’ve come across similar things.

        And I don’t mean to downplay the impact of the One Child Policy on abortion in China — surely it’s huge. I just wouldn’t call it the source. I’m also curious about Chinese attitudes and ideas about abortion. Unlike in the West, where at least some people draw a sharp distinction between abortion and infanticide (though see here here and herefor a sad but interesting case where that line was recently blurred), but I wonder if, given the more recent history and still ongoing practice of infanticide, abortion is understood basically as a modern extension of that general phenomenon.

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  7. Bill Rich says:

    The real root cause of this incident is the ignorance of this family about the shortcomings of ultrasound. You don’t see a lot. Many things can be hidden. You will probably need MRI to find all the arms, legs, fingers and toes. And even MRI can’t tell you whether the liver is working correctly.

    • Tom says:

      This is true, but MRI’s aren’t common for trying to gauge the health of the baby, and is far out of the price range of most Chinese parents. I think it’s most likely that the family was devastated by not having a fully formed baby, and let that turn into anger at the hospital.

  8. Laura says:

    I am truly sad that they had such a reaction to their child. I feel really bad for the kid to be born in that family, I can’t imagine how they will treat him/her. My best friend was born without her right forearm, and I have to say that she is amazing. She does more things with her one arm then I can do with my two. She makes all kinds of handicrafts, beaded jewelry, cross-stitching, knitting, etc. She can do a lot because her family didn’t treat her “differently”. She is not disadvantaged. I hope they will give their child the chance to become everything they can be.

  9. Sasha says:

    Wow this is a really tough issue! I can sympathies with the families frustrations at having a baby born with a birth defect, especially when in China people with disabilities really are treated like dirt. However what about basic humanity, it’s not like they are going to only have half a life because their missing one arm they can still do things. I think really this is a greater issue in China, more about humanity, what is just and what is fair. I think to destroy a life before it’s begun because of one missing arm is pretty extream, I couldn’t do it. However I can’t really judge them I don’t know their life circumstances I just hope that now this kid has entered the world they will still treat it like they would have had they had both arms!

  10. Chopstik says:

    Ok, thought I had responded to this earlier but apparently I am more tired than I thought. 🙂

    Anyway, just to add a little bit of input here, I think it is important to note that we are talking about moral points of view (at least from some of the postings here) and morals are dangerously subjective. Without taking one side or another (since I can see the different points of view and their respective validity – though I certainly do have a particular point of view in this case), it would be wise to note that morals, when historically applied from one culture to another, have not always produced good results. In this particular case, the arguments appear to be macro vs. micro and there does not seem to one panacea that can be simply applied to the relative satisfaction of all (at least for now). Hopefully this will be changed in the future with greater assistance from both the social and governmental support structures, but for now it is apparent that there are no good answers.

  11. Samuel says:

    Tom, sorry to hear the hospital violence, but this kind of conflicts in hospitals is quite common in China. Many parents blame or beat health workers even for the nurse needles their child twice for once shot. I’m not sure whether a hospital in any western countries should pay for the compensation like this case. As I know, lots of hospitals in China have to do so although they don’t cause a disability, or diagnose improperly from the ultrasound reports. And it’s truly unfair for both of these families and the health workers.

  12. […] For a look at a very different problem caused by the One-Child Policy, read A Fight at the Hospital […]

  13. […] The big set back is that China has built tens of thousands of new buildings in the last 20 years, without any standards for accessibility. I hope that very soon this will become a priority for the gov’t, because at the moment children with physical handicaps are still seen as such a burden on the family that some would rather have them aborted (read my post, A fight at the hospital). […]

  14. […] A fight at the hospital – Abortion in China […]

  15. Tang Xiang says:

    Excellent post, Tom. Thank you for sharing. It is so sad how negatively a child with disabilities can be perceived. I will keep this family in my prayers. Best of luck.

  16. Amy says:

    I was so sad to read this post today because I am the mother to a beautiful little boy with one arm whom I adopted from China several years ago. He is not a burden or a curse, but one of my greatest blessings. He can do everything he sets his mind to – and everyone who meets him falls in love with him. How I wish I could meet his birthparents in China to tell them what an amazing and intelligent little boy he is, and to thank them for putting him somewhere safe where he could be found and taken to the orphanage. Of course your story hurts me on a personal level, since it could have been my son these relatives were arguing over and wishing had never been born. HOW BLESSED this world is that he did come into it and is now showing everyone he meets that people with disabilities can do anything they put their minds to.

    I take comfort in knowing that only 50 years ago in the US, people still often institutionalized their children born with special needs. Since the US has changed dramatically to welcome inclusion of children with birth defects, it is my hope that China will someday do the same. And while I wish my son could have stayed in his birthcountry to grow up with his biological parents – I give thanks every day that he is with me and that every opportunity is available for him to excel despite his special need.

  17. adann says:

    “but it’s just a fetus now, not a baby.”

    I agree with her^
    In Canada there is no law against abortion and we’re doing fine!
    Americans are too uptight and religious.

  18. hellosunshine says:

    I feel sorry for the child. 🙁 may God bless their parents & open the eyes of their heart to accept the child. 🙁

  19. […] have become increasingly common in China, and I’ve written about such an instance before (A fight at the hospital – Abortion in China), but it is a topic that deserves further […]

  20. Anonymous says:

    I appreciate your story. My husband and I are in the process of adopting a little boy from China that has a missing hand. I struggle trying to understand how parents can abandon a child, as in my son’s case just because of a missing hand. His missing hand is just a minimal thing for us. I just hope that my son and all the other adopted children grow up to believe that they are amazing and better off.

  21. Mikecheck says:

    I would love to see a scale for birth defects that people in China would consider neccessitating an abortion. I wonder if a cleft pallate or albinism would be severe enough a defect? Too bad important things like stupidity can’t be seen in an ultrasound.

  22. […] Anger over abortion that wasn’t. “I learned later that the family had been expecting a healthy baby. Today that baby was born, but with a major birth defect, it was missing an arm. The family was angry because the hospital had missed this during the ultrasound (or perhaps it was something that was not obvious on the ultrasound). They were shouting, ‘How can our baby live without an arm?’ // I couldn’t believe it. This large protest was not over a death, but over a life. They were upset because they had missed their opportunity to have an abortion (or euphemistically ‘stop the pregnancy’).” [Seeing Red in China] […]

  23. Because the admin of this website is working, no doubt very soon it will be renowned,
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  24. BlessedMama says:

    Hopefully we changed a few attitudes regarding children missing limbs this past summer. While back in China with our daughter (adopted, missing hand and lower leg) we got lots of stares and inquisitive looks. Out in public we treated her as an equal along with her sister (also from China). She laughed, played and accomplished anything she set her mind to (even nimbly climbing up to the top bunks on the sleeper train with no ladder which caused our compartment doorway to often have an inquisitive person or two staring in amazement). One interesting thing we encountered was several different people commented to our guide that we probably adopted because we get regular payments from our gov’t to adopt their special needs children. We were able to tell them that was absolutely not true, we chose to adopt her simply because we love her and knew she needed a chance to grow up in a place that would accept her differences and allow her to reach her full potential. So glad her birthmom didn’t see her as ‘just a fetus’. I hope to thank her someday.

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