A sense of autonomy is preserved under Chinese reproductive policies

Attitudes Towards Prenatal Genetic Counseling, Prenatal Genetic Testing, and Termination of Pregnancy among Southeast and East Asian Women in the United States

Recognizing the heterogeneity of the Asian population with regards to acculturation, education, health awareness, and cultural values is vital for tailoring culturally sensitive and appropriate care. Prior studies show that cultural values influence perceptions of genetics within Asian populations. The reputation of the family unit factors into decisions such as pregnancy termination and disclosure of family medical history, and the nondirective model of American genetic counseling may conflict with the historical Asian model of paternalistic health care. Previous studies also provide conflicting evidence regarding correlations between education, acculturation, age, and awareness and perceptions of genetic testing. The aims of this study were to describe attitudes towards prenatal genetics among Southeast and East Asian women living in the United States for varying amounts of time and to explore sociocultural factors influencing those attitudes. Twenty-three Asian women who were members of Asian cultural organizations in the United States were interviewed via telephone about their attitudes towards prenatal genetic counseling, prenatal genetic testing, and termination of pregnancy. Responses were transcribed and coded for common themes using a thematic analysis approach. Four major themes emerged. In general, participants: (1) had diverse expectations for genetic counselors; (2) tended to weigh risks and benefits with regards to genetic testing decisions; (3) had mixed views on termination for lethal and non-lethal genetic conditions; and (4) identified cultural factors which influenced testing and termination such as lack of available resources, societal shame and stigma, and family pressure. These findings may allow prenatal genetic counselors to gain a richer, more nuanced understanding of their Asian patients and to offer culturally tailored prenatal genetic counseling.

Family characteristics and the use of maternal health services: a population-based survey in Eastern China

BACKGROUND AND OBJECTIVES

Despite the benefits of maternal health services, these services are often underutilized, especially in the developing countries. The aim of the present study is to provide insight regarding factors affecting maternal health services use from the family perspective.

METHODS

We use data from the fourth National Health Services Survey in Jiangsu province of Eastern China to investigate the effect of family characteristics on the use of maternal health services. Family characteristics included whether or not living with parents, age of husband, husband's education, and husband's work status as well as family economic status. Demographic variables, social and environmental factors, and previous reproductive history were taken as potential confounders. Multiple logistic regression models were used to examine the independent effects of the family characteristic variables on maternal health service utilization.

RESULTS

The data indicate that the percentages of prenatal care, postnatal visits and hospital delivery were 85.44, 65.12 and 99.59 % respectively. Living with parents was associated with less use of prenatal care and husband's age, education and employment status had no effect on the use of prenatal care after adjusting for potential confounding variables.

CONCLUSIONS

Our findings suggest that maternal health education (especially the role of prenatal care) needs to be extended beyond the expectant mothers themselves to their parents and husbands. The difference of health care delivery as a result of traditional family culture may highlight the differences in factors influencing the use of postnatal visits and those influencing the use of prenatal care; which may be worthy of further study.

Dreams of tigers and flowers: child gender predictions and preference in an urban mainland Chinese sample during pregnancy

In an urban, mainland Chinese sample, we investigated expectant mothers' stated gender preference for a boy or girl child, their conjectures on the fetal gender, the culture-specific beliefs for making their predictions, and their relations to sociodemographic variables. A total of 174 women were interviewed at 12-19 weeks gestation. Among 84 women who made a prediction on gender, 56 (67%) thought they were carrying a boy, and 28 (33%) expected a girl. The most frequent reasons cited for their speculation were personal feelings (36%), food/taste preference (13%), feedback from others (13%), somatic responses (13%), and dreams (7%). Out of 63 women who stated a wish for a boy or girl child, 45 (71%) wished for a girl and 18 (29%) wished for a boy. Women with undergraduate or graduate degrees were more likely to indicate a preference for boys. Older expectant mothers were more likely to report that they thought they were carrying boys. In conclusion, the majority of the women did not state a distinct choice for gender of the child. When they expressed a gender preference, more mothers expressed a desire to have a girl. However, boy child conjectures were more frequent than girl child conjectures. Greater boy child preference and prediction among the most highly educated and older expectant mothers might be reflective of implicit social status in having sons in urban China.