Reports of a spike in maternal deaths spur questions in China

Maternal mortality in China was 20.1 per 100,000 women in 2015. In the first six months of 2016, it was 18.3 and there was an increase of 30.6 per cent in the first half of 2016 over the same period in 2015

Did China's maternal mortality rate surge by nearly one-third in the first half of 2016, as a top health official reportedly said this week?

An anxious, sceptical debate has broken out over the drastically higher figure, announced by Ma Xiaowei, deputy director of the National Health and Family Planning Commission at a meeting on, Tuesday, on improving maternal health, in reports carried widely in Chinese news media.

Online, people called for better health care for pregnant women, or warned of the health effects of pregnancy on "old mothers" who may have rushed to have a second child after the end of the one-child policy on January 1.

Older mothers may face greater health risks, but not necessarily. Chinese women generally marry and have children in their late 20s, contributing to some popular suspicion of the appropriateness of older women having children.

Others said they simply did not believe the figures, a lack of confidence that highlighted concerns over the reliability of Chinese data among both Chinese and foreigners.

The highlights of what Ma said at the meeting were reported by Beijing News and Yicai, a Shanghai-based business media group also known as China Business Network. Ma said, maternal mortality in 2015 was 20.1 per 100,000 women. In the first six months of 2016, it was 18.3 and there was an increase of 30.6 per cent in the first half of 2016 over the same period in 2015.

In an article in its health section, Sohu.com quoted Ma as saying that the increase was "an urgent problem" and calling for greater investment in hospitals, maternal health care and in training obstetricians in an era of two children.

"Fishy," Wang Ling, the author of A Beijing Pregnancy, a novel about pregnancy, abortion and birth, said on Population Internal Reference, her private WeChat site. Wang, who uses the pen name Lingzi, did not immediately respond to a request for an interview.

"Under what circumstances could the rate be 30 per cent higher in the first half of this year than in the same period last year, if last year's overall maternal mortality rate was 20 and this year's so far is 18?" Wang asked.

Such an increase in the first half of 2016 could be achieved only if the rate had been a very low 14 per 100,000 in the first half of last year and a very high 26 per 100,000 women in the second half, according to figures on Wang's WeChat account.

The commission did not reply to a request for clarification.

China has experienced drastic improvements in maternal mortality in recent decades. Health commission figures show a fall in maternal mortality to 20.1 per 100,000 women in 2015 from 88.8 in 1990.

The World Health Organisation(WHO) says maternal mortality in the country in 2015 was 27 per 100,000 live births, higher than the Chinese government figure. But it was not clear if the Chinese figure had been calculated using the same standard of live births. Like the Chinese figures, the WHO's numbers show a marked decline over all, from 97 per 100,000 in 1990.

The WHO gives the maternal mortality rate in the United States as 14 per 100,000 live births for 2015, up from 12 in 1990. Rates in sub-Saharan Africa are the highest in the world, with 882 women dying per 100,000 live births in the Central African Republic, according to the WHO.

Some Chinese news reports tied the apparent surge in maternal deaths to the two-child policy that took effect on January 1, after 36 years when most urban families were restricted to one child, as older mothers rushed to have a second child before it was too late.

"After the 'two-child policy,' maternal mortality rises by one-third," read a headline on Ifeng.com, the website of Phoenix Television. That view apparently struck a chord among many online readers.

"This certainly has to do with lots of old women trying desperately to have a child," wrote gernsback-ex, the most popular comment on Ifeng.com.

But Yicai disagreed, with a headline that ran in part: "Scholars say it has nothing to do with the two-child policy."

If the one-child policy ended on January 1, it could not have caused the spike, because it is not possible to have a child within six months, the article said.

On her WeChat account, Wang wrote: "If it really has gone up by 30 per cent (it's a frightening figure), then the health commission must offer a clear answer why. And how to avoid it going forward."

© 2016 The New York Times News Service