Implications on Prenatal Care

Dr. Leung Wing-Cheong, a consultant Obstetrician from the Department of Obstetrics & Gynecology, Kwong Wah Hospital HKSAR brought up the point today at the conference that many of the mainland women seeking to give birth in HKSAR, when asked about prenatal care recieved, explain that this is thier second child. Since in many cases, the One-Child policy limits state-substidized care for second (and all subsequent births), pre-natal care suffers dramatically for those families that choose to have more than one child in spite of governmental bans. I see several potential effects of this:

1. Those 'illegal' second children born in the mainland will have significantly lower access to healthcare, schooling, and other social benefits, creating a sub-class of children within the middle- and upper-classes (for whom the one-child policy most stringently applies) who do not accure the usual benefits of thier class. This is especially interesting, as many of those seeking to have additional children inspite of laws against this do so in order to have a son. This means that these highly desired sons are nevertheless inelligible for the health and educational benefits that would facilitate them achiving the positions that thier families would seek for them (in order for them to fulfill the traditioanl role of elder son- providing economically and socially for the family). As a result, even in families with strong son preferences, the female child born first will still often be in a position of being the primary family provider in adulthood.
There is also a risk that son unable to live up to expectation will find themselves disenfranchised and ostracized from thier peers and family. A large population in such a position poses a significant political and criminal risk to what was a stable element of society.

2. Many mainland mothers have sought to give birth in Hong Kong, or overseas, to avoid these penalties. This affords these second children a long-term position of privilage, as they accrue the benefits of overseas or HKSAR citizenship. I have long-argued that the one-child policy creates a super-elite within Chinese society. Those that it applies to most stringently, middle- and upper-class urban families, already formed an elite within Chinese society, especially given the disproportionately rapidly growing wealth in this demograpic. The only-children of this group enjoy all the fiancial and emotional support of parents and grandparents. They essentially have an unpredented amount of education, healthcare, familial care, and attention paid to them, ensuring the best possible opportunity for success, as it is defined by the class culture (primary prestige- and financially-based). Second children, who previously were forced to share these resources without the advantages of being first-born, are now able to access the superior education, healthcare, and economic opportunity afforded to HKSAR residents. Although initially at a disadvantage, due to poor pre-natal care and long commutes across the border for schooling and healthcare, in the long-term, these children accrue a long-term advantage that is just as significant as thier only-child counterparts. Perhaps the only one who is at a disadvantage in this case is the first-born child, which now has to share resources without the advantages of HKSAR residency. This may prove even more profound when that first-born is a female; whatever advantages accured to women as single-children are mitigated when a second child son is born with status in another governmental area, particuarily if that status requires more expense that similiar status in the mainland would (schooling/heathcare is more expensive in HKSAR, for example).