# 27. Pregnancy and childbirth: From confirming pregnancy to discharge and paperwork This section first looks at mortality risks — both for the mother and the unborn baby. Later on, we discuss costs and the time required for various procedures. These two sets of calculations are not combined or compared. The focus here is solely on “what needs to be done at what stage.” Topics such as prenatal nutrition or fetal education lack solid evidence or have minimal impact, so they are not covered here. Details on maternity benefits, leave entitlements, and child-rearing expenses can be found in Section 18. Guidance on caring for a newborn is provided in Section 20, while emergency situations are addressed in Section 13. According to World Health Organization figures, in 2023 roughly 260,000 women worldwide died as a result of pregnancy or childbirth. About 75% of these deaths stemmed from five main causes: severe postpartum bleeding, infections, hypertensive disorders of pregnancy (such as preeclampsia and eclampsia), complications during delivery, and unsafe abortions. The WHO also notes that “most maternal deaths are preventable, since effective medical measures for prevention and treatment of complications already exist.” The most important actions outlined in this section are precisely those aimed at preventing these problems before they occur. ### 1. Starting daily folic acid supplementation at 0.4 mg before pregnancy and continuing through the first trimester - Cost: A bottle costs only a few dozen yuan. Rural women receive it for free through the national folic acid supplementation program. The real challenge is remembering to take one pill every day. - In plain terms: Taking one folic acid pill daily before and during early pregnancy can cut the risk of neural tube defects in babies by roughly 70%. These defects include conditions like anencephaly and spina bifida. For women who’ve already had a child with such a defect, this regimen reduces the likelihood of a repeat occurrence to about one third of the original risk. - Benefit: A Cochrane systematic review pooled data from 5 trials involving 6,708 deliveries, rating the evidence as high quality. Daily folic acid intake before and during pregnancy lowered the relative risk of fetal neural tube defects to 0.31 (95% CI 0.17–0.58), a reduction of roughly 70%. For women with a prior child affected by neural tube defects, the relative risk dropped to 0.34 (95% CI 0.18–0.64), equating to a one third reduction in risk. No difference in effectiveness was observed between 0.4 mg and higher doses, nor between folic acid alone and multivitamin supplements. - Evidence grade: A - Notes: The key point is to start taking folic acid *before* pregnancy. A fetus’s neural tube closes within 28 days of conception; by the time a pregnancy is detected, most of this window has already passed. Therefore, if you’re planning to conceive, begin supplementation three months in advance. The same review found no clear evidence that folic acid prevents cleft lip and palate, congenital heart disease, or miscarriage — so don’t expect it to address these issues. - Sources:De-Regil LM, Peña-Rosas JP, Fernández-Gaxiola AC, Rayco-Solon P (2015). Effects and safety of periconceptional oral folate supplementation for preventing birth defects. Cochrane Database of Systematic Reviews, (12), CD007950. ### 2. Register for the Maternal and Child Health Handbook at a community health center before 13 weeks of pregnancy to claim free prenatal checkups - Cost: No cost at all — this is part of the national basic public health service program. You’ll need to make several visits based on your gestational age. - In plain terms: You are entitled to at least five free prenatal checkups during pregnancy, plus home visits after delivery and a 42-day postpartum checkup, all paid for by the state. To access these services, you must register for the Maternal and Child Health Handbook at a community health center before 13 weeks of gestation. Failing to do so means you lose out on all these free services. - Benefit: The third edition of the National Basic Public Health Service Standards outlines specific maternal health management services available to all permanent residents who are pregnant. These include one health checkup in early pregnancy, two in mid-pregnancy, two in late pregnancy, one postpartum home visit, and one 42-day postpartum checkup. Registration for the handbook must be completed before 13 weeks of pregnancy, at which point your first prenatal checkup will also be scheduled. The two mid-pregnancy checkups occur between 16–20 weeks and 21–24 weeks respectively, while the two late-pregnancy checkups are scheduled for 28–36 weeks and 37–40 weeks. Local service lists also include a full set of initial lab tests and postpartum depression screening as part of these free services. - Evidence grade: A - Notes: These five free checkups represent the minimum number of services provided; they do not cover all possible prenatal tests. Depending on your individual health needs, your doctor may recommend additional ultrasounds, blood glucose tests, or fetal heart rate monitoring, all of which will incur extra costs. Registering for the handbook as early as possible also allows for earlier assessment of your pregnancy risk level. This risk grading system categorizes pregnant women based on their individual risk factors, ensuring those identified as high-risk receive timely care at specialized medical facilities. Even if you live in a different district than your registered household location, you can still register at your current place of residence — there is no requirement to return to your place of household registration. - Sources:国家卫生计生委 (2017). 国家基本公共卫生服务规范（第三版）. ；靖江市人民政府. 国家基本公共卫生服务项目——孕产妇健康管理服务（地方服务清单公开）. ### 3. Getting tested for HIV, syphilis, and hepatitis B during the first prenatal visit — free prevention options available - Cost: No cost involved; the maternal and infant transmission prevention program provides these tests at no charge. - In plain terms: During your very first prenatal checkup, you can get tested for HIV, syphilis, and hepatitis B at no personal expense. Even if results show a positive diagnosis, there are still effective ways to prevent transmission to your baby. The government offers free medication and treatment plans to block the spread of these infections from mother to child — this is known as maternal and infant transmission prevention. - Benefit: Maternal and infant transmission is how infections pass from a mother to her unborn or newborn child. The “Work Specifications for Preventing Maternal and Infant Transmission of HIV, Syphilis, and Hepatitis B (2020 Edition)” mandates that during early pregnancy or at the first prenatal visit, healthcare providers must share relevant information and “offer appropriate, standardized free testing” — meaning these three tests are completely free. Follow-up counseling and referrals are also provided based on test results. A positive diagnosis is not a dead end: Article 44 of the “Regulations on HIV/AIDS Prevention and Control” guarantees free treatment and counseling for pregnant women living with HIV to prevent transmission to their babies. Article 43 further requires that such women receive services including transmission prevention, treatment, postpartum home visits, infant follow-ups, and testing. For mothers who test positive for hepatitis B surface antigen, newborns receive both hepatitis B vaccine and hepatitis B immunoglobulin at birth (see Section 20, Item 2). - Evidence grade: A - Notes: Early testing is especially valuable for these three conditions, as both prevention and treatment require sufficient time to be effective. Article 3 of the “Regulations on HIV/AIDS Prevention and Control” also states that “no entity or individual may discriminate against people living with HIV/AIDS, AIDS patients, or their family members”; their legal rights related to marriage, employment, medical care, and education are fully protected by law. General prevention measures and routine testing are covered in Section 1, while post-exposure prophylaxis after high-risk behaviors is detailed in Section 13. - Sources:国家卫生健康委办公厅 (2020). 预防艾滋病、梅毒和乙肝母婴传播工作规范（2020 年版）. （新疆维吾尔自治区卫生健康委员会转载）；国务院 (2006). 艾滋病防治条例（第四十三、四十四条）. （北京市卫生健康委员会转载） ### 4. No smoking or drinking at all throughout pregnancy — and no one else in the house should smoke either - Cost: There’s no cost at all; in fact, it saves money on cigarettes and alcohol. The real challenge is getting everyone living in the same house to quit alongside the pregnant woman. - In plain terms: Smoking during pregnancy raises the chances of premature birth, a baby being born underweight, and cleft lip or palate. It also doubles the risk of abnormal bleeding during pregnancy and childbirth, and increases the risk of sudden infant death syndrome. Secondhand smoke from anyone smoking indoors counts just the same. It is never too late to quit, no matter when you start. - Benefit: According to the U.S. Centers for Disease Control and Prevention, smoking during pregnancy can result in babies being “born at full term but still underweight” and “more likely to be born prematurely.” It “doubles the risk of abnormal bleeding during pregnancy and childbirth,” raises the risk of birth defects such as cleft lip and palate, and “damages the developing lungs and brain of the fetus, with effects lasting into childhood.” Babies born to mothers who smoke during pregnancy, as well as infants exposed to smoke after birth, face a higher risk of sudden infant death syndrome. Official guidance states that “it is best to quit smoking before getting pregnant, but quitting while already pregnant still provides benefits,” and “it is never too late to quit.” - Evidence grade: A - Notes: Secondhand smoke from anyone smoking indoors is just as harmful to the fetus as direct smoking. Therefore, this rule applies to the whole household, not just the pregnant woman. The same principle holds true for alcohol: there is no known safe level of alcohol consumption during pregnancy, so the safest approach is to avoid it entirely. The impact of smoking and drinking on the health of adults themselves is covered in Section 2. - Sources:Centers for Disease Control and Prevention. Smoking During Pregnancy. ### 5. For women at high risk of preeclampsia, start taking one low-dose aspirin tablet daily after week 12 of pregnancy - Cost: A few dozen yuan. One tablet per day must be taken until delivery. The hard part is remembering to take it every single day. - In plain terms: Preeclampsia is a type of high blood pressure that occurs during pregnancy. Women falling into any of these six categories are at high risk: those who had preeclampsia in a previous pregnancy, women carrying multiples, women with chronic hypertension, women with diabetes prior to pregnancy, women with kidney disease, and women with autoimmune diseases. For these women, taking one low-dose aspirin tablet daily starting at week 12 can reduce the risk of preeclampsia by roughly 15%, the risk of premature birth by about 20%, and the risk of perinatal death by nearly 20%. Women not in these categories should not take it on their own. - Benefit: The US Preventive Services Task Force gives this a Grade B recommendation: for women at high risk of preeclampsia, taking low-dose aspirin (81 mg per day) after week 12 of pregnancy can help prevent the condition. Preeclampsia is a hypertensive disorder unique to pregnancy. Results from multiple studies combined show the following outcomes, with 95% confidence intervals provided as ranges of reliability. The relative risk of preeclampsia drops to 0.85 (95% CI: 0.75 to 0.95, based on 16 studies), a reduction of roughly 15%. The relative risk of premature birth is 0.80 (95% CI: 0.67 to 0.95, based on 13 studies), a drop of about 20%. The relative risk of perinatal death — death occurring around the time of childbirth — is 0.79 (95% CI: 0.66 to 0.96, based on 11 studies), a reduction of roughly 21%. The relative risk of small-for-gestational-age infants or intrauterine growth restriction is 0.82 (95% CI: 0.68 to 0.99, based on 16 studies), a decrease of around 18%, meaning fetuses are less likely to be smaller than expected for their gestational age. - Evidence grade: A - Notes: The groups considered high risk include women who had preeclampsia in a prior pregnancy, those carrying twins or multiples, women with chronic hypertension, women with type 1 or type 2 diabetes prior to pregnancy, women with kidney disease, and women with autoimmune diseases such as systemic lupus erythematosus or antiphospholipid syndrome. Women not in these groups should not take aspirin on their own. This medication requires a doctor’s prescription; be sure to share your full medical history during prenatal checkups so your doctor can make an appropriate assessment. Most low-dose aspirin tablets sold in China are 100 mg enteric-coated tablets, and they must be taken strictly as directed by your doctor. - Sources:US Preventive Services Task Force (2021). Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: Preventive Medication. ### 6. Get screened for gestational diabetes at 24 weeks of gestation or later — don’t mind drinking the sugary solution - Cost: Several tens to over a hundred yuan. You must fast beforehand, and several blood draws will take up half a morning. - In plain terms: Gestational diabetes is high blood sugar that appears only during pregnancy. At 24 weeks or later, spending half a morning drinking a sugary solution and having several blood tests can detect it. Skipping this test raises the risks of having a macrosomic baby, difficult labor, cesarean delivery, preeclampsia, and neonatal hypoglycemia. - Benefit: The U.S. Preventive Services Task Force recommends screening for gestational diabetes at 24 weeks or later for asymptomatic pregnant women — those who feel no symptoms at all. Gestational diabetes is high blood sugar that appears only during pregnancy. This single screening test should be done at 24 weeks or later. The Task Force concluded that current evidence does not show any clear benefits or harms from screening before 24 weeks (Grade I). Untreated gestational diabetes increases the risks of macrosomia, difficult labor, cesarean delivery, preeclampsia, and neonatal hypoglycemia. - Evidence grade: A - Notes: Most women diagnosed with gestational diabetes can control their blood sugar through diet and exercise alone; only a minority need insulin injections. Don’t skip this test out of fear of being told you need insulin. After giving birth, you must get another blood sugar test — women who’ve had gestational diabetes face a significantly higher risk of developing type 2 diabetes later on. - Sources:US Preventive Services Task Force (2021). Gestational Diabetes: Screening. ### 7. Memorize this “go to the hospital immediately” checklist — it applies throughout pregnancy and the first year after childbirth - Cost: No cost at all. It takes just five minutes to memorize, and it’s a good idea to share it with anyone living in the same household. - In plain terms: If any of the following symptoms appear, head to the hospital on the same day — do not wait until the next morning. Persistent or worsening headaches, changes in vision, fever reaching 38°C. Severe swelling of the hands or face, trouble breathing, chest pain or a rapid heartbeat. Unrelenting severe abdominal pain, no fetal movement or a noticeable drop in fetal movement. Vaginal bleeding or fluid leakage. Swelling, pain and redness in one arm or leg. Thoughts of harming yourself or your baby. The full list is included in the Benefits section below. These guidelines apply equally in the first year after childbirth. - Benefit: These are all emergency warning signs during pregnancy and postpartum listed by the US Centers for Disease Control and Prevention. Persistent or worsening headaches, dizziness or fainting, changes in vision, a body temperature of 38°C or higher. Severe swelling of the hands or face, thoughts of harming yourself or your baby. Difficulty breathing, chest pain or a rapid heartbeat. Severe nausea and vomiting, unrelenting severe abdominal pain. Absence or significant reduction of fetal movement during pregnancy, vaginal bleeding or fluid leakage during pregnancy or postpartum. Abnormal vaginal bleeding or discharge after childbirth. Severe swelling, redness and pain in one arm or leg. None of these issues disappear after the postpartum recovery period — they can all occur within the first year after childbirth. - Evidence grade: A - Notes: This checklist serves to clearly distinguish between situations where you can wait a little longer and those that demand immediate medical attention. Headaches paired with blurred vision and upper abdominal pain are typical signs of preeclampsia, a form of pregnancy-related hypertension. Swelling and pain in one lower leg often indicates deep vein thrombosis (see Section 13). According to the World Health Organization, severe postpartum hemorrhage can be fatal to a healthy woman within just a few hours. If any of these symptoms appear, go to the hospital right away — do not delay by waiting at home overnight. - Sources:Centers for Disease Control and Prevention. Hear Her — Urgent Maternal Warning Signs. ；World Health Organization. Maternal mortality fact sheet. ### 8. If your water breaks, lie down flat, elevate your hips, and call 120 — don’t walk around or take a shower - Cost: No cost at all - In plain terms: If your water breaks, there’s no time to calmly gather your things and head out. The right thing to do is lie down right where you are, raise your hips, and call 120 immediately. Walking around while standing up causes amniotic fluid to leak even faster, and the umbilical cord can be pulled out along with it. This is a life-threatening emergency for the baby. - Benefit: This is exactly what the Beijing Municipal Health Commission recommends: “Immediately lie down flat to prevent further loss of amniotic fluid,” “Do not walk around casually,” and “Call emergency services at 120 right away.” While waiting for help, inform family members so they can bring necessary items to the hospital. Medical sources further explain why this is essential: when a person stands, amniotic fluid drains much more quickly, increasing the risk of umbilical cord prolapse — a critical emergency for the fetus. Therefore, lying down and elevating the hips is crucial; a left-side lying position is ideal. - Evidence grade: B - Notes: The three main signs of impending labor are regular contractions, vaginal bleeding, and water breaking. With the first two, you can still prepare calmly, but water breaking demands immediate action: lie down and call for help. Common mistakes include showering, squatting on the toilet, or driving yourself to the hospital. Be sure to note the exact time water broke and its color; tell the doctor if it appears yellow-green or contains meconium, as this indicates fetal distress and oxygen deprivation. If you also experience regular contractions, a marked drop in fetal movement, fever, or chills, emphasize that this is a true emergency. - Sources:北京市卫生健康委员会. 每周急救话题：准妈妈羊水早破怎样办？ ；北京市顺义区妇幼保健院. 孕晚期在家破水怎么办？ ### 9. Ask for labor analgesia — it does not raise the risk of C-section - Cost: Several hundred to over 1,000 yuan; prices vary by region. Be sure to ask the hospital and anesthesiology department in advance whether this service is available. The main hurdle is simply bringing it up yourself. - In plain terms: Labor analgesia involves injecting anesthetic into the lower back to dull the pain of childbirth. It works far better than other pain‑relief options and does not make a C-section more likely. The claim that “it causes lifelong back pain” is also unfounded. Nowadays it is offered as a separate charge, so hospitals are more willing to provide it. - Benefit: A Cochrane systematic review found that epidural analgesia is more effective than non‑epidural methods at reducing labor pain and improving maternal satisfaction. Labor analgesia uses exactly this technique. The same review states that epidural analgesia has no effect on the risk of C-section or long‑term back pain. Instrumental delivery — using tools to assist birth — shows no increased incidence in studies published after 2005. Starting in 2024, the National Healthcare Security Administration introduced separate pricing categories for “labor analgesia,” “doula‑assisted childbirth,” and “family‑member labor support,” precisely because previously there were no dedicated rates to motivate hospitals to offer these services. - Evidence grade: A - Notes: Both popular myths — “epidural analgesia causes lifelong back pain” and “it makes a C-section more likely” — lack any scientific basis. Cochrane’s comparison of epidural analgesia with other pain‑relief methods confirms it has no impact on C‑section risk or chronic back problems. Real side effects may include low blood pressure, fever, weak legs, difficulty urinating, longer first‑ and second‑stage labor, and a higher need for oxytocin. The decision to use it is yours; don’t let unfounded rumors deter you. Availability also depends on whether the hospital has an anesthesiologist on duty 24/7 — be sure to ask during prenatal visits. - Sources:Anim-Somuah M, Smyth RMD, Cyna AM, Cuthbert A (2018). Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database of Systematic Reviews, (5), CD000331. ；国家医疗保障局 (2024). 重构产科服务价格项目 助力构建生育友好型社会. ### 10. Don’t request a C-section without medical indication, and avoid scheduling one just to pick a “lucky” date - Cost: No direct cost. The real challenge is resisting pressure from family members. - In plain terms: According to the World Health Organization, once the C-section rate in a region exceeds 10%, further reductions in maternal and neonatal mortality become unlikely. When a C-section is medically necessary, it must be performed. However, opting for one solely to choose a favorable date or to avoid labor pain means undergoing a major abdominal operation for no real reason. - Benefit: A 2015 WHO statement notes that when C-section rates rise to roughly 10% in a population, maternal and neonatal deaths decline. Beyond that threshold, there is no evidence of additional mortality benefits. WHO also stresses that every effort should be made to provide C-sections to women who truly need them, rather than aiming for a specific percentage target. - Evidence grade: A - Notes: This guidance does not oppose C-sections. When medically warranted, they are life-saving procedures and should be performed without hesitation. What it discourages is undergoing a C-section when there is no medical need—such as to avoid labor pain, to pick an auspicious date, or to influence a child’s future age for school enrollment. The trade-offs are significant: C-sections are major abdominal surgeries with slower recovery times, and they increase risks of placenta previa, placenta accreta, and uterine rupture in subsequent pregnancies—factors that may affect a woman’s decision to have more children. - Sources:World Health Organization (2015). WHO Statement on Caesarean Section Rates（WHO/RHR/15.02）. ### 11. Check your yibao enrollment status before getting pregnant — even unemployed spouses can claim maternity medical expenses - Cost: Zero cost. Just call the social insurance or medical insurance hotline once. - In plain terms: If your employer pays into yibao, both maternity medical costs and maternity leave benefits come out of that fund. Even if your spouse isn’t employed, they can also claim maternity medical expenses. You must confirm beforehand whether you’ve met the minimum enrollment period and whether you need to register in advance for childbirth outside your local area — these details cannot be fixed later. - Benefit: Article 54 of the Social Insurance Law states that employers who pay yibao premiums provide their employees with full maternity benefits. Unemployed spouses of these employees are also entitled to maternity medical coverage under national regulations, with funds drawn from the yibao pool. These benefits fall into two categories: maternity medical expenses (costs directly related to childbirth) and maternity allowances (payments received during maternity leave). Article 56 further specifies three scenarios qualifying for allowances: childbirth, family planning procedures, and other legally defined situations. Allowances are calculated based on the employer’s prior year’s average monthly payroll, not individual employee wages. - Evidence grade: A - Notes: Two critical points require advance verification since retroactive adjustments are impossible. First, confirm you’ve satisfied the minimum continuous enrollment period required by local regulations; otherwise eligibility is denied. Second, if planning childbirth outside your enrollment area, verify whether pre-registration is mandatory — failure to do so may force you to pay upfront and file manual claims later, or even forfeit coverage entirely. Detailed calculations for maternity leave duration and allowances are outlined in Section 18.2. - Sources:全国人大常委会 (2010). 中华人民共和国社会保险法（第五十四、五十六条）. （国家税务总局广东省税务局转载） ### 12. Get the “Medical Certificate of Birth” sorted out before discharge; decide on the baby’s name early and avoid typos - Cost: No cost at all. It can be arranged effortlessly while completing discharge procedures. - In plain terms: This certificate is a prerequisite for registering the child’s hukou, enrolling in yibao (basic medical insurance), and sending the child to school. Only the medical institution where the delivery took place can issue it for the first time. If you try to obtain it after discharge, you’ll have to follow a completely different process and submit extra documentation. Also, make sure the characters you pick for the baby’s name can be entered into the household registration system without any issues. - Benefit: Article 23 of the Maternal and Infant Health Care Law stipulates that medical institutions and home birth attendants must issue the standardized Medical Certificate of Birth for newborns as required by the State Council’s health administrative department. This certificate is a mandatory prerequisite for all subsequent procedures: registering hukou, signing up for medical insurance, applying for a health insurance card, and enrolling in preschool or school. The initial issuance can only be handled by the delivery hospital. Any later applications require a separate process and additional supporting documents. - Evidence grade: A - Notes: Before filling out the form, double-check every character in the parents’ names, their ID numbers, and the baby’s name. The characters chosen for the name must be compatible with the household registration system — using rare or uncommon characters can lead to endless complications down the line. Both name changes and certificate reissues involve reissuance procedures, which are far more expensive than simply verifying the details at the time of application. Once you receive the certificate, store it separately from other important documents: it holds the same legal weight as your household register and ID card. - Sources:全国人大常委会 (1994, 2017 修正). 中华人民共和国母婴保健法（第二十三条）. ### 13. Don’t skip newborn heel‑prick and hearing tests - Cost: In most areas these tests are free; otherwise they cost only a few dozen yuan. Some extra screening items may require out‑of‑pocket payment. - In plain terms: A single heel‑prick blood test and one hearing test can detect hypothyroidism, phenylketonuria, and hearing loss even when the baby appears perfectly healthy. By the time symptoms become obvious, any intellectual damage is already irreversible. - Benefit: Article 3 of the “Administrative Measures for Newborn Disease Screening” lists congenital hypothyroidism, phenylketonuria, other inherited metabolic disorders, and hearing impairment as nationally mandated screening targets. All of these conditions show no outward signs early on; once symptoms appear, lasting intellectual harm has already occurred. Early detection and prompt treatment—such as thyroid hormone replacement, special formula milk, hearing aids, or cochlear implants—yield excellent outcomes. Article 10 further stipulates that any positive screening result must be promptly communicated to parents for confirmatory diagnosis. - Evidence grade: A - Notes: Article 11 requires that before screening, parents be fully informed of the tests, eligibility criteria, procedures, sensitivity rates, and associated costs, and must give written consent. Consequently, you’ll receive an informed‑consent form. Carefully review which conditions are covered by the state program and which extra items incur personal fees. A positive initial result does not mean a definitive diagnosis; most infants are cleared after a single follow‑up test, so there’s no need to panic at this stage. If a newborn fails the initial hearing screen, follow the instructions for a repeat test—don’t assume “if the baby seems to hear, it’s fine.” - Sources:卫生部 (2009). 新生儿疾病筛查管理办法（卫生部令第 64 号，第三、十、十一条）. ### 14. Enroll your newborn in yibao right after getting the birth certificate — don’t wait until household registration is complete - Cost: You pay the yibao premium just once a year; it usually costs a few hundred yuan. - In plain terms: As soon as you receive the birth certificate, you can enroll your baby in yibao online — no need to wait for household registration. Once enrolled, most hospitalization costs can be reimbursed right at discharge. Newborn hospital bills can be quite high, so having yibao makes a big difference. - Benefit: According to the Chinese government website in 2024, “Newborns can enroll in yibao online using their birth certificate alone; household registration is not required first.” It also states that “after discharge, newborns can get medical expenses reimbursed immediately.” Previously, families had to complete household registration first, pay all hospital costs out of pocket, and then apply for reimbursement. The average processing time for enrollment has also dropped from 28.7 working days at the start of the year to just 6.4 working days now. - Evidence grade: A - Notes: Premature birth, phototherapy for jaundice, and neonatal pneumonia are common reasons newborns end up in the hospital — often resulting in bills of tens of thousands of yuan. Having yibao versus not having it makes a huge difference in such cases. Local rules vary regarding how many days after birth a child must be enrolled to qualify for coverage starting from birth; always check with your local medical insurance office for exact details. Before discharge, calling 12393 is the easiest way to get clear answers. - Sources:中国政府网 (2024). 健全基本医疗保险参保长效机制国务院政策例行吹风会. ### 15. Registering a newborn’s birth at a police station within one month - Cost: No cost involved; just a single trip to the police station’s hukou office. - In plain terms: The law sets a strict one‑month deadline — it’s not a suggestion that you can ignore when convenient. Completing the hukou registration is a prerequisite for vaccinations, preschool enrollment, school admission, and obtaining an ID card. The longer you wait, the more additional documents you’ll need to provide. - Benefit: Article 7 of the *Regulations on Hukou Registration* states: “Within one month after a baby’s birth, the head of household, relatives, guardians, or neighbors must report the birth to the local hukou registration authority.” This is a legal requirement, not a mere recommendation. Securing hukou is essential for all subsequent steps: vaccinations, preschool and school entry, and ID issuance. Delaying registration inevitably leads to a heavier paperwork burden. - Evidence grade: A - Notes: Bring the following documents: the medical birth certificate, both parents’ ID cards and hukou books, and the marriage certificate. You may choose to register the child under either parent’s hukou, but policies differ between locations, affecting school districts and insurance eligibility. Make this decision before you go, as later changes can be cumbersome. Unmarried parents may also register their newborn without any restrictions. - Sources:国务院 (1958). 中华人民共和国户口登记条例（第七条）. （广东省人民政府转载） ### 16. Don’t skip that 42-day postpartum checkup — it also screens for postpartum depression - Cost: It’s free; it’s part of basic public health services. It takes half a day. The hard part is that right after childbirth you often feel too lazy to go. - In plain terms: This checkup costs nothing and includes a complete blood count, vaginal discharge test, plus a screening for postpartum depression. Serious problems can arise at any time during the first year after birth, so don’t assume you’re out of danger just because the postpartum period is over. - Benefit: According to the “National Standards for Basic Public Health Services (3rd Edition),” postpartum care requires one home visit and one health checkup at 42 days. Local service lists confirm this visit includes lab tests (blood count, vaginal discharge) and a postpartum depression screening. Severe complications may appear throughout the first year. Items on the “Go to the hospital immediately” list in Section 7 — such as “thoughts of harming oneself or the baby,” “abnormal vaginal bleeding or discharge,” or “severe swelling/pain in one limb” — all fall under postpartum risks. - Evidence grade: A - Notes: Postpartum depression isn’t a sign of weakness or something that can be fixed by family telling you to “cheer up.” There are specific screening questionnaires and treatments available, and recovery is possible. Handling suicidal thoughts is covered in Section 1. Legal options if caring for a newborn proves impossible are outlined in Section 9, Item 20. This checkup also evaluates wound healing, uterine recovery, pelvic floor function, and discusses contraception — remember, the absence of menstruation after childbirth doesn’t mean pregnancy is impossible. - Sources:国家卫生计生委 (2017). 国家基本公共卫生服务规范（第三版）. ；靖江市人民政府. 国家基本公共卫生服务项目——孕产妇健康管理服务（地方服务清单公开）.