In the 1970s, Zhu's mother, after already bearing one infant, terminated her second, accidental, pregnancy with an abortion. But unmarried 26-year-old Zhu has already experienced two unintended pregnancies. Both resulted in abortions, because she was not ready to be a mother.

Although efficient contraceptive devices including pills, condoms, contraceptive suppositories and jellies are not hard to obtain in China, unintended pregnancies are not rare among young women of Zhu's generation in Shanghai. And now they are happening at an ever earlier age.

Some of these women will hurry to get married and bring the baby into the world, but more will choose to have an abortion, for various reasons.

Family planning

"About 80 per cent of the women having abortions in Shanghai hospitals are unmarried, aged from 19 to 30 years old, with migrant women accounting for the largest percentage," said a doctor from Shanghai's Punan Hospital in Pudong District.

The middle-sized public hospital deals with about 600 abortion cases every month, half take oral abortion pills while the other half require surgery.

The abortion rate is closely linked to educational background and social status, statistically correlated with ignorance and poverty.

"High rates of unexpected pregnancy and abortion result from a few basic factors: insufficient sex education, inadequate contraception, and social acceptance of abortion," said Xia Guomei, professor of the Sociology Institute at the Shanghai Academy of Social Sciences.

The increasing prevalence of pre-marital sex in China is a widely acknowledged fact, but a big gap remains as far as sexual and contraceptive education is concerned. Unmarried women have become the most endangered group in regard to unintended pregnancies.

Local married women have ready access to contraceptive information, either from hospitals or family planning organizations; they can also get face-to-face guidance in the communities where they live.

Premarital sex

Unmarried women face far greater obstacles, however. Since pre-marital sex is still not publicly accepted in China, unmarried women are often reluctant to consult a doctor.

"I did not have the courage to seek medical advice and my mother never told me such basic information, though she knows I have a boyfriend," said Zhu. "All the contraceptive information I obtained came from reading books and magazines."

Nowadays, people have a wide choice of reliable contraceptive devices. Even in cases of unprotected sex, or contraceptive failures such as condom slippage, rupture, or miscalculation of safe periods, emergency contraception can be highly successful at preventing possible pregnancies.

"But many women don't know how to deal with such failures, and have to fall back upon an abortion when they find they're pregnant months later," said a doctor.

Unaware of the importance of birth control measures, some women are unwilling to take contraceptive pills due to the side effects, or take chances on having sex just inside the safe period.

Many unexpected pregnancies can be attributed to the failure of men to take any responsibility for contraception, by refusing, for instance, to use condoms during sexual intercourse. "In many cases women give in, although they realize the danger of having sex without condoms," explained Xia. "It's an obvious effect of a male-dominated society, in which men enjoy sex while women just provide sex services."

Hidden problem

Medical development has made abortion much less painful and more convenient. In the case of early pregnancy (within 49 days), women can take the abortion pills Mifepristone (RU486) or Misoprotol, which are nearly painless. With surgical abortions, the anesthetized woman feels as if she is having a nap during the operation.

But even this can have negative results. "Some women ignore the harm to their bodies and have abortions many times. One of my patient had nine abortions," said the doctor.

In Shanghai, only hospitals with adequate medical staff and equipment can provide medical abortion services, including pills and surgical methods.

In advance of an abortion, women are required to take a series of physical checks, then they take abortion pills under doctors' guidance and close inspection in the hospitals over two days. The minimum cost is about 200 yuan (US$24).

Some women think that medical abortions in hospitals are too expensive and the process too complicated and time-consuming, so they go to private clinics providing abortion pills illegally.

They can just pay for the pills and then take them at home. This can be very dangerous, however, with embryo tissues remaining in the matrix, which can lead to infection or serious bleeding.

Migrant women

The situation among migrant women is more serious. Professor Xia carried out a sample survey on migrant women in a local district and found to his surprise that over 50 per cent had aborted at least one pregnancy.

About 3.7 million migrant workers are making a living in Shanghai, 40 per cent of whom are women - with the majority at a fertile age. Compared with local women, migrant females have less knowledge of contraception measures due to their low-level of education and poor financial situation.

(Shanghai Star October 30, 2002)