| Abstract: | In China the effort to develop maternal and child health (MCH) care has been ongoing. Initially, attention was directed primarily to promulgating a modern method of delivery in an effort neonatal tetanus and puerperal fever. The next stage was the systematic management of MCH care. Pregnant women and puerperants were given a series of checkups and guidance from conception until the 42nd day after delivery. The purpose was to prevent and treat complications. In some cities, perinatal care has developed to the point of health care management of the health of both mother and child. This extensive health care system includes preconception and pregnancy care, puerperant care, and neonatal care. Premarital checks have become the rule in the urban areas. MCH care organizations at the grassroots level and community health workers take responsibility for advising newly married couples about health care. In addition, some medical colleges and their affiliated hospitals provide consultation services for these couples. The Shanghai Railway Medical College uses a computer to make projections on multigenic genetic diseases. It provides information on incidence risk of the next generation to help couples make their childbearing decisions. The majority of pregnant women get their 1st prenatal check prior to the 12th week of pregnancy, followed by 9 re-examinations to screen out high risk factors. Difficult labor, infections, obstetric trauma, postpartum hemorrhage, and fetal distress are prevented at childbirth. Newborns are scored with Apgar comments; those with low marks are specially protected. In some cities, an investigation system has been established to deal with perinatal deaths. Perinatal care is managed at 3 levels: community MCH centers and MCH departments of hospitals, clinics, and industrial enterprises form the 1st level of care; MCH centers of city districts and hospitals at the district level make up the 2nd level of care; and MCH institutes or hospitals at provincial or city levels, hospitals attached to medical colleges, and hospitals under government ministries form the 3rd level of care. |
