Moving abroad is an exciting time, but it can be a stressful experience as well. Sometimes, it’s a bit of a hassle to find a new doctor you trust and feel comfortable with – even more so if you’d like to talk about intimate issues, such as women’s health.
If you need to see a gynecologist for your regular check-ups while you are living in China, the following information should be useful.
Generally speaking, cancer as a cause of death is on the rise in China. However, despite the increasing mortality rates, there is no nationwide public screening program for cervical or breast cancer yet. Public health authorities have started awareness-raising campaigns and pilot projects on the provincial level, though.
If you are an expat woman with a private health insurance for China, it’s probably best to find a gynecologist in a clinic specializing on foreign patients. In the big expat destinations, like Beijing, Shanghai, and Guangzhou, both private hospitals and the so-called VIP wards of public hospitals provide this service. Their staff usually speaks English, and the clinics have state-of-the-art medical equipment. On the downside, these medical services are rather expensive.
Nonetheless, having your gynecological check-up exams there is the easiest option. Just get a Pap smear and clinical breast exam. If you are over 45 or 50, or if you belong to any other risk group (e.g. due to family history), these clinics can provide a regular mammogram or ultrasound, too. Of course, your new gynecologist will also treat you for acute illnesses or give advice on fertility or contraception.
Please note that female teachers working at Chinese state schools, including kindergartens and nurseries, may need to undergo mandatory health testing (including a gynecological exam). This may also apply to foreign nationals, even if they have already provided a health certificate for their employment visa. It may not be possible to see your regular doctor for this exam, but you could be obliged to attend a public health clinic instead.
When hearing "China" and "family planning", many expats will immediately think of the one-child policy. It was introduced by the Chinese government in 1979, due to the steep population growth of previous decades. Demographic figures climbed from about 540 million in 1949 to 940 million in the late 1970s.
However, the policy isn’t quite as strict as you might assume. It is enforced at the provincial level, but implementation varies from region to region. Moreover, there are plenty of exceptions. For instance, it doesn’t apply to members of ethnic minorities or to couples where both partners have no siblings. All in all, it covers about 35% of China’s population.
However, the one-child policy still leads to many social issues often criticized by human rights organizations: For example, sex-selective abortion in China is officially outlawed, but probably widely practiced, as many families prefer sons to daughters. (Other examples of gender-based discriminatory practices can be found in our article on discrimination in China.) Moreover, the so-called "4-2-1 problem" means that one child has to shoulder the burden of caring for two aging parents and four elderly grandparents.
Of course, the one-child policy doesn’t apply to expat couples. However, learning about it might help you to better understand attitudes towards contraception in China.
Contraception in China is very widespread: It has a prevalence of 85%, one of the highest rates worldwide. However, the most common contraceptive methods differ from many other countries. Intra-uterine devices are the most popular form of contraception, followed by male or female sterilization once people have one or two kids.
When it comes to contraception in China, using birth control pills and/or condoms happens less frequently. Rates for contraceptive failure are estimated to be fairly high for these methods in particular. Some statisticians claim that contraceptive failure could be responsible for up to 70% of all cases of abortion in China.
If condoms are your preferred method of contraception in China, make sure to only buy reputable brands from larger drugstores or pharmacies. Other condoms are sometimes counterfeit products of low quality – and that’s not something you want.
Birth control pills are available over the counter at most pharmacies. So you don’t even have to see a gynecologist to get a prescription. However, please be aware that pharmacists sell emergency contraception over the counter, too. The Chinese word bìyùnyào refers to both contraceptives. So you have to ensure you are getting the regular kind of birth control pill instead.
Furthermore, the number of brands available for hormonal contraception in China is rather limited. Marvelon, Yasmine, and a few others are sold frequently, but you might have to import other kinds of birth control from home.
Abortion in China is completely legal and available upon request. As mentioned above, parents shouldn’t be told the sex of the fetus anymore, to avoid the problem of sex-selective abortions. In practice, though, this isn’t always heeded – there is a suspicious surplus ratio of male to female births.
Though abortion in China is allowed up to six months into the pregnancy, most terminations occur during the first trimester. They are usually performed at local family planning clinics. For the earliest stages of pregnancy (i.e. six to eight weeks), medically induced abortions are also common.
You can find more information on contraception in China via the China Family Planning Association, a local NPO/NGO.
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