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Contents Cover Story Teaching and Learning 01 Making Babies 33 Teaching the Science of Heritage How Science, Politics and Social Change Affect Conservation Human Reproduction 35 Clarity Comes with the Click of a Mouse 03 The Labour of Giving Birth 37 Investigating Human Rights Abuses 05 Birthing in Hong Kong 39 A 360-Degree Take on 07 Raising the Odds of Conception a Dynamic Hong Kong Community 09 The Limits of Artificial Reproduction 41 Nourishing the Middle Ground and Surrogacy 11 Bringing Hope for Congenital Disorders Knowledge Exchange Research 43 The Business of ‘Best before’ 45 Law Scholars Provide Inspiration for 15 Data Wizard Advances Precision Medicine Special Needs Trust 17 A Saucy Take on History 47 Student Visions for Coral Reefs and 19 Fast Track to Healthy Teeth the Blind 21 Circulation Problem 49 A Global Voice on Sustainability Policy 23 Learning to Play in the Mud Books 25 Summertime, and the Living Is Deadly 27 Tissue of Lives 51 Chinese Art in the Modern Era 29 Turning Tent to Townhouse? Ulaanbaatar’s 53 Journey of Hope Ger Sprawl 31 Wake-up Call for Construction Cover Story MAKING BABIES The rapid changes in technology and society over the past 40 years are affecting how and whether couples can conceive. HKU researchers have been studying the impact of social and political transformations in China and Hong Kong, and of non-natural births. They are also producing research to improve the odds of conception and to identify and treat congenital diseases, so more babies have a chance of a healthy life. The University of Hong Kong Bulletin | May 2019 01 | 02 Cover Story For most women working in the new China, reproduction is a chore and it’s often perceived as a burden – as something to be afraid of. Dr Gonçalo Santos It’s not called labour without reason. The effort Not strictly a medical issue There’s a sense that they want to escape the of pregnancy and giving birth, and then raising natural birth experience,” Dr Santos said, “and children, has been termed ‘reproductive labour’ The state prevailed, marking a dramatic shift there is nothing wrong with that.” by social scientists like Dr Gonçalo Santos of the in how babies were born and who was involved Department of Sociology and Hong Kong Institute in the process. Birth was no longer managed From zero to 100 in a for the Humanities and Social Sciences, who is by local networks of midwives and female generation leading a research group on the technologies of relatives, but shifted to hospitals and biomedical reproductive labour in East Asia with colleagues professionals, including obstetricians who, until Women are also giving birth at a later age, at the University of Chicago and Smith College. the past decade or so, were mostly men. sometimes with the help of assisted reproduction technology – factors that increase risk and thus “The work of reproductive care doesn’t get the “However, birth is not strictly a technical, lead doctors to advise C-sections. attention of something like the One Belt One medical issue. It should be seen from a holistic Road project. But workers are the foundations perspective that allows for the social and cultural Families have reason not to oppose C-sections, of those projects, and as feminists have long dimensions to be taken into consideration, too,” too. Although they must pay for births even in noted, in addition to asking questions about Dr Santos said. public hospitals, the government subsidises at workers, we also have to ask questions about least half the cost. the work that is involved in producing workers,” These dimensions are evident in China’s he said. high caesarean rate of at least 35 per cent Dr Santos believes these subsidies will become of all births, one of the highest in the world. unsustainable in the long run and, for this In China, that work has undergone profound Doctors and hospitals, pregnant women and reason, the government is curbing the growth changes in a very short time period. As their families each have their own reasons for in C-section rates through investment in maternal recently as the 1980s, half of all babies were favouring C-sections. (And note: all three are care and punitive measures against hospitals. still born at home. Today, most are born in involved in providing informed consent for A ‘wellness culture’ that favours natural birth is hospitals – and fully one-third by caesarean birthing procedures in China – it is not just a also on the rise among the urban middle classes, section (C-section). matter between a woman and her doctor.) although not yet to the extent seen in Japan, where it started much earlier. THE LABOUR OF Dr Santos has been a witness to the transformation, Hospitals are more likely to favour C-sections which has been driven by government because they are more profitable and can be “In China and some East Asian societies, there policy, technology, and changing moral and planned – an important consideration given has been a compressed modernity – a story social dynamics. many hospitals are understaffed. Doctors are of emerging economies that went from zero more likely to favour them because their training technology in a biomedical sense to benefitting GIVING BIRTH His work started in the late 1990s, when he is in handling complications and applying the from all these highly-sophisticated technologies undertook fieldwork in rural areas where most techniques they learn, rather than waiting out within practically the space of one generation. China’s transformation into an economic superpower is people still delivered at home. He saw villagers the unpredictability of a natural birth. They have leapfrogged without the middle layer often framed in terms of production output, technological grapple with the one-child policy, which was and didn’t form a culture of natural birth in the advancement and infrastructure. What is often missing is also pushing people towards hospital births Many women regard C-sections as easier than process,” he said. Such a culture is only now another kind of production – that of workers. Dr Gonçalo where it was easier to keep track of numbers. natural delivery. Their mothers and grandmothers starting to take hold under the influence of were better prepared for the physical trials of global discourses of ‘wellness’ and traditional Santos has been tracing the transformation of birth in China “Women were giving birth in secret places and labour because they often engaged in hard Chinese medical wisdom. as it moved from the home to the hospital and became relying on village midwives. Birth became heavily physical work, but people today live more increasingly subject to biomedical interventions. politicised and people tried to negotiate with the sedentary lives, particularly in urban areas. Women should have as much choice and state at various levels over the right way to give “For most women working in the new China, information as possible about giving birth, he birth, where to give birth, whether to follow state reproduction is a chore and it’s often perceived added – something that scholars can contribute prescriptions,” he said. as a burden – as something to be afraid of. to through research. █ The University of Hong Kong Bulletin | May 2019 03 | 04 Cover Story What interested me was how the Family Planning Association of Hong Kong and the Government used Chinese family values to promote birth control. This was totally different from Europe and America where birth control was tied closely with the women’s movement and sexual liberation. Dr Carol Tsang The more things change, the more they remain and the diaphragm. Non-Catholic Christians the same, as Dr Carol Tsang of the Department welcomed her message because they thought of History has discovered. Her area of research birth control could help ordinary people and is women’s health and reproduction in Hong deter abortion, but there was strong opposition Kong and China, and her female students and from Catholics. acquaintances keep reminding her that while they have plenty of opportunities in career and “It was a very colourful debate. Hong Kong education, in the home, not much has changed. people were pretty split in terms of accepting or rejecting artificial birth control, but at the “I have met a lot of women from different same time, many were already practising it by walks of life who feel the social expectations of taking different patented medicines or visiting marriage and motherhood limit their capacity. Chinese abortionists,” Dr Tsang said. The talk They feel pressured to get married by a certain had a lasting effect, though: the FPAHK links its age and to have children, especially a male heir. heritage to Sanger’s visit because she inspired And after having children and marriage, they the establishment of FPAHK’s predecessor, the feel their careers stall. These social expectations Hong Kong Eugenics League. haven’t changed much over the decades,” she said, as her 15 years of research has shown. Abortion was an accepted form of birth control within Chinese society, especially in the chaotic Dr Tsang’s first major project was a history period before the Second World War but, as of the Family Planning Association of Hong today, it exposed rifts in society. The Government An advertorial portraying a happy family in which Kong (FPAHK), an organisation founded in was keen to curtail abortionists, many of whom the wife gave birth to a son after taking a patented medicine published on Wah Kiu Yat Po in March 1926. 1950 to promote birth control to ordinary came from Mainland China and were regarded Chinese families in the context of traditional as charlatans by officials, and it wanted to values.

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