张宏玉说:“当人们只会有一个孩子时,他们会过于担心。他们担心缺氧,他们想孩子快点出生,得到一个健康的宝宝。他们还认为手术是简单快捷的。”
Women like Wan argue that not-so-subtle pressures from doctors scare women (or their husbands and in-laws) into asking for medically unnecessary C-sections. “The doctors always tell you the worst-case scenarios. First-time mothers always listen to the doctors,” she says. “Second-time mothers are much more confident.”
万歆笛等女性认为是医生们较为露骨的施压,吓得妇女们(或她们的丈夫和婆家人)在没有医疗需要的情况下要求剖腹产。万歆笛说:“医生总是告诉你最坏的情况。头胎妈妈总是会听医生的。二胎妈妈就有信心得多。”
For overcrowded urban hospitals, the financial incentives are clear. In Yichang, a natural birth costs about Rmb3,000 ($450) and requires a nurse or midwife’s attention for several hours. A C-section costs up to Rmb11,000 and only takes up about 30 minutes of the doctor’s time, providing a much more attractive revenue stream. Surgeries also yield a larger hongbao (a gift packet) from grateful families. Unscrupulous doctors can pad out revenues further by making quicker (but harder to heal) vertical incisions, charging per suture to close the wound or adding extra fees to remove gauze or stitches.
在人满为患的城市医院,经济动机是明显的。在宜昌,顺产费用约为3000元人民币(合450美元),且需要一名护士或助产士照顾几个小时。剖腹产的费用可高达1.1万元人民币,且只占用医生半个小时左右,提供了一个更有吸引力的收入来源。感恩戴德的家庭还会给大夫包上一个大红包。无良医生赚钱门路更多,他们可以采用更快的竖切(但更难愈合)手术,对每根缝合线都收费,又在拆纱布或拆线时另收费。
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