What causes our country to have a low popularization rate of labor analgesia?

Recently, a media report on painless labor indicates that our country's labor analgesia popularization rate is around 30%, and less than 10% in many hospitals in middle and western regions. At the same time, statistics show that in other countries, the popularization rates of labor analgesia are as high as 80% to 90%. Behind the statistical difference is the pain endured by many Chinese women who went through natural childbirth, which is as painful as "experiencing 12 broken ribs". However, to a large extent, this pain can be avoided as labor analgesia is a mature technique.

Labor analgesia is a medical term which most people refer to as painless labor. This technique first originated from the anesthetic techniques in Western dentistry, and has a history of over 100 years. As early as the 1850s, the queen of England had used chloroform to ease the pain and improve the experience of childbirth. At the time, Scottish obstetrician Simpson was awarded the Baron title for his innovative contributions in the field of labor analgesia. However, as a medical technique developed several decades before antibiotics, it is still not popularized in China to benefit women. Women who are afraid of experiencing labor pain choose to go through Caesarean sections, which is more harmful to the body. Others choose Caesarean sections after realizing the pain of natural delivery was unbearable, and had to suffer twice.

Carrying out painless labor is not difficult. There were two reasons for the low domestic popularization rate in the past. One was the influence of traditional values, with many worrying the anesthetic technique in painless labor will affect the physical and intellectual development of fetuses. This results in psychological resistance in many women, and especially their relatives. The other is the realistic reason of the shortage of anesthetists and the lag in forming pricing policies, which made many hospitals unable to provide the medical service of anesthetic painless labor. Recently, with the extensive popularization of the scientific knowledge about painless labor, people have raised their trust in the technical safety of painless labor, but the realistic issues preventing the popularization of painless labor remain unsolved. Even top hospitals in first-tier eastern cities cannot provide the medical service, and one can imagine the situation in middle and western regions where there is a lack of resources.

An anesthetist once talked about their dilemma. While knowing labor analgesic treatment can reduce women's labor pain, anesthetists who participate in painless labor "are tired, make little money, and face medical risks." Currently, we have a shortage in the number of anesthetists. In a statistical report published by the Anesthesiologist Branch of the Chinese Medical Doctor Association in June 2019, the number of domestic anesthetists are only 92,000, for every 10,000 people, there are only 0.6 anesthetists. Whereas in developed countries, there are 2.5 to 3 anesthetists for every 10,000 people. To anesthetists, compared with other surgeries, painless labor needs to take into consideration the woman’s stage of labor and the obstetrician’s advice. This means anesthetists need to invest long hours into the process of painless labor, some might even need to be on call 24 hours. Compared with the hard work, their salary does not reflect the labor value. A qualified anesthetist needs to have at least 10 years of training in medical education from undergraduate to postgraduate studies and intern periods. However, under the current pricing policy, their incomes are not high. According to specialists, two years ago, the fee for anesthetic technique used in painless labor in Beijing was only 200 yuan, adding up to a total of less than 1,000 yuan including equipment fees.

To solve the problem of the overall lack of talents in an industry, fundamentally, we need to resort to market rules to increase the industry’s salary and welfare, to enhance the appeal to talents. Of course, for anesthetists, their revenue gain should not be passed on to ordinary people, we need health policies with greater impacts. In 2019, the National Health Commission of the People's Republic of China organized 913 hospitals to conduct painless labor trials, and required health and related departments of all levels to provide medical insurance reimbursement and other policy support for painless labor. However, seeing painless labor’s low popularization rate, the result of implementation in these regions seems pessimistic.

Painless labor is an important modern trend. In the current era with slow population growth, the importance of painless labor is self-evident. Accelerate the formation, implementation, and improvement of public policies related to painless labor is the best comfort and respect that can be shown to every Chinese mother.

Writer: Yue Zhong, media commentator