Between birth and death

The mother needs her family’s consent for a C-section birth

Why is a woman’s consent not enough to allow a hospital to perform a C-section?

That’s the question many Chinese are asking after Ma Rongrong, a heavily pregnant 26 year-old, jumped to her death at a public hospital – after her family allegedly refused her requests to have the operation.

Ma was expecting her first child when she checked into Yulin First Hospital in Shaanxi province on August 30, more than a week past her due date.

The doctors carried out an ultrasound and determined the baby was possibly too large for a natural birth. They recommended a caesarean section and went to secure the required consent from Ma’s husband.

But according to hospital records, he, his parents and Ma’s mother refused three times.

Hospital video footage shows Ma emerging from the labour ward to talk to them around six in the evening. She looks distressed and falls to her knees twice, apparently because of labour pains.

Two hours later she slipped into a disused operating theatre on the fifth floor, climbed out onto a window ledge and jumped. She and her unborn child died.

“We dispatched medical staff immediately but her injuries were too severe,” the hospital said in a statement. However, the tragedy has led to bitter disputes between the hospital and Ma’s family about the events leading to her suicide.

The family denied withholding their consent and said doctors told them the baby could be born naturally. “It wasn’t about the money,” said her mother, who lives in a traditional Shaanxi cave dwelling.

Natural delivery usually costs about Rmb5,000 ($763) in government hospitals, while caesareans cost upwards of Rmb10,000. It was not clear if Ma had health insurance.

Yet in a country with a long record of curtailing women’s reproductive rights, Ma’s case caused outrage. So much so that government censors started removing comments about her from social media.

Many blamed Ma’s family. “How can a mother tolerate her daughter’s pain so indifferently,” ask one person on weibo.

“Why were the families’ feelings considered more important that the woman’s?” asked another.

The problem dates back to a regulation set in 1994 that requires family members to consent to an operation as well as the patient. However, there is no clear rule on how the hospital should proceed in case of disagreement between the patient and the family.

In Ma’s case she had also signed a power of attorney giving her husband the right to decide on her treatment.

China has been trying to reduce the number of C-sections since rates reached almost 50% in 2007. (The World Health Organisation says that about 15% of births require caesarean procedures for health reasons; in China some opted for them to ensure the baby was born on an auspicious day.)

The end of the One-Child Policy and the government’s drive to get people to have more children is also playing a role – should a woman opt for a natural birth after a C-section there are greater health risks.

Yet for many women Ma’s case illustrates the pitfalls of marrying and having kids. “That’s why girls nowadays do not want to get married or have a baby, their families take over and they don’t even have the right to decide how to give birth,” said one on weibo. “In China, a husband’s rights always exceed the woman’s rights,” fumed another.

Others blamed the hospital for not keeping a closer eye on Ma. “Even if her family refused the C-section she should not have had the opportunity to throw herself out of the window,” said one.

The head of the obstetrics department has been suspended while an investigation is carried out.

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