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Closure of obstetric departments no small matter

China Daily | Updated: 2024-04-01 07:49

Physicians from Thailand receive patients in the gynecology and obstetrics department at the Affiliated Hospital of Gansu University of Chinese Medicine in Lanzhou. [Photo provided to chinadaily.com.cn]

Obstetric services are basic medical services that are related to the safety and health of mother and baby, and are related to the happiness of thousands of households. Obstetric services should not only be considered in economic terms, but also from the human aspect. It is essential for pregnant and postpartum women to have a sufficient number of delivery beds. Therefore, the news that some hospitals nationwide have stopped obstetric delivery services has attracted public attention.

The National Health Commission issued a notice on Friday emphasizing that counties (cities, districts) with a population of more than 300,000 should have at least two public medical institutions capable of providing obstetric services, while those with a population of less than 300,000 should have at least one. Areas with a sparse population and inconvenient transportation should ensure that relevant grassroots medical and health institutions are capable of providing midwife services.

The reasons for the closure of obstetric departments in hospitals are quite complex, of which the most direct one may be the declining birth rate. According to data released by the National Bureau of Statistics, the number of newborns in 2023 was 9.02 million, a decrease of 540,000 from 2022.

Besides the decline in the birth rate, the difficulties facing obstetric departments should also be recognized. The outpatient and inpatient fees for obstetrics are relatively low, yet the operating costs and risks for hospitals are rather high: obstetric departments must have maternity wards and operating rooms open 24 hours a day, while obstetric doctors, neonatologists, anesthesiologists, midwives, and other personnel must take turns to be on call at any time. Any problems during delivery may also lead to medical disputes, which might affect the income and career development of those involved, leading to the loss of staff.

As emphasized by the NHC, public medical institutions planning to close their obstetric departments should widely solicit opinions from pregnant women who have established health records, and seek written opinions from local township governments and county-level health administration departments, to effectively safeguard the rights and interests of those requiring obstetric services. Obstetric departments that do not have enough demand can be closed, but the closures should be based on reasonable adjustments that effectively meet the needs of pregnant women.

With the decline in demand for delivery services, it is an opportunity to improve the quality of obstetric diagnosis, treatment, and services, and help pregnant women have a more comfortable childbirth experience.

Scientific decision-making and cautious handling are required to ensure the accessibility of midwife services. In particular, public medical institutions should bear the responsibility of providing basic obstetric services.

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