Healthy debate over premarital checks

Most people in Beijing have a free physical checkup every year, which they believe plays the same role as the premarital checkup, said Ji, to explain the low rate of premarital checks in the city. She added that heavy workloads mean many people are unwilling to spend their free time on the checks.

The rise in the number of birth defects has resulted in calls for the reinstatement of mandatory premarital checks. Some municipal health authorities have decided to promote a one-stop premarital medical checkup to encourage more people to voluntarily undergo the examinations.

Earlier this year, it was reported that Guangzhou, the capital of Guangdong province, had resumed mandatory testing. Although the reports turned out to be untrue, they helped trigger a heated debate. Seventy-two percent of those who responded to an opinion poll conducted by Sina Weibo, China's most prominent microblogging site, were in favor of a return to mandatory testing.

To encourage more young couples to take the test, the Beijing health bureau has provided free checkups for residents since 2009. With Beijing hukou - the permanent residence permit - couples can get the checkup in any of the 19 clinics or hospitals in the city that provide it.

A number of other cities and provincial areas also provide free premarital examinations. Wuhan, in Hubei province, has done so since 2008 and Dalian in Liaoning province started in 2007.

The rate of premarital checkups has risen as a result of the policy, but many people still mistakenly believe that a prepregnancy test plays the same role as the premarital checkup.

"My husband and I undertook the prepregnancy physical checkup and it has even more items than the premarital checkup," said Xu Fang, who refused to have a premarital checkup because of her conviction that marriage is about love not health.

Xu said the free health check provided by the State-run institution where she works guarantees her basic health. "Checkups relating to fertility can be left for the prepregnancy test," said Xu, who underwent the test three months before she became pregnant. She gave birth to a boy in November 2011.

"The list of questions and tests was longer than for the premarital checkup and even included a check on the quality of my husband's sperm. I think it is more meaningful," she said.

"It (the premarital check) cannot be replaced by checkups during pregnancy. If the baby is shown to have a severe health problem, the parents will have to decide whether to have an abortion, which can bring great harm to the mother and also the family," said Li Huajun, director of the obstetrics and gynecology department at the China-Japan Friendship Hospital in Beijing.

He added that the rate of birth defects in China is 10 times higher than in the US and some European countries.