HowToLiveWorse

CHAPTER 27 · 17 SOURCE ENTRIES

Pregnancy and Childbirth

怀孕和生产：从发现怀孕到出院办证

[← 回总目录](../README.md) 这一节前半段算的是孕妇和胎儿的死亡风险。后半段算的是钱和跑腿时间。两种账不放在一起换算。内容只讲「什么时候做什么」。孕期营养、胎教这类没有硬证据、或者作用很小的事，这里不写。生育津贴、产假和养孩子的钱账见第 18 节，孩子出生之后怎么带见第 20 节，急症见第 13 节。 世界卫生组织给的数字：2023 年，全球约有 26 万名女性死于怀孕和生产。其中约 75% 死于这五类原因：产后大出血、感染、妊娠期高血压疾病（怀孕后血压升高的一类病，包括子痫前期和子痫）、分娩时的并发症、不安全的人工流产。世界卫生组织同时说，「大多数孕产妇死亡是可以预防的，因为

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27-001
Evidence AlifespanSource-sensitive

Starting daily folic acid supplementation at 0.4 mg before pregnancy and continuing through the first trimester

准备怀孕就开始每天补 0.4 毫克叶酸，一直吃到孕早期满 3 个月

Taking one folic acid pill daily before and during early pregnancy can cut the risk of neural tube defects in babies by roughly 70%. These defects include conditions like anencephaly and spina bifida. For women who’ve already had a child with such a defect, this regimen reduces the likelihood of a repeat occurrence to about one third of the original risk.

Open the low-ROI detour

Move “Starting daily folic acid supplementation at 0.4 mg before pregnancy and continuing through the first trimester” to Future Me's calendar

Future Me has a clearer calendar, more patience, and apparently the same responsibilities.

Today I keep a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off
27-002
Evidence AlifespanSource-sensitive

Register for the Maternal and Child Health Handbook at a community health center before 13 weeks of pregnancy to claim free prenatal checkups

孕 13 周前去社区卫生服务中心建《母子健康手册》，把免费产检额度用掉

You are entitled to at least five free prenatal checkups during pregnancy, plus home visits after delivery and a 42-day postpartum checkup, all paid for by the state. To access these services, you must register for the Maternal and Child Health Handbook at a community health center before 13 weeks of gestation. Failing to do so means you lose out on all these free services.

Open the low-ROI detour

Move “Register for the Maternal and Child Health Handbook at a community health center before 13 weeks of pregnancy to claim free prenatal checkups” to Future Me's calendar

If I do not open the notes, no new task has technically appeared.

Today I keep a few minutes and avoid interrupting my default routine.

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27-003
Evidence AlifespanSource-sensitive

Getting tested for HIV, syphilis, and hepatitis B during the first prenatal visit — free prevention options available

第一次产检就把艾滋病、梅毒、乙肝三项查掉，查出来也有免费的阻断

During your very first prenatal checkup, you can get tested for HIV, syphilis, and hepatitis B at no personal expense. Even if results show a positive diagnosis, there are still effective ways to prevent transmission to your baby. The government offers free medication and treatment plans to block the spread of these infections from mother to child — this is known as maternal and infant transmission prevention.

Open the low-ROI detour

Move “Getting tested for HIV, syphilis, and hepatitis B during the first prenatal visit — free prevention options available” to Future Me's calendar

One more exception feels free because the bill arrives outside the current scene.

Today I keep a few minutes and avoid interrupting my default routine.

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27-004
Evidence AlifespanSource-sensitive

No smoking or drinking at all throughout pregnancy — and no one else in the house should smoke either

整个孕期一支烟一口酒都不要，家里人也别在屋里抽

Smoking during pregnancy raises the chances of premature birth, a baby being born underweight, and cleft lip or palate. It also doubles the risk of abnormal bleeding during pregnancy and childbirth, and increases the risk of sudden infant death syndrome. Secondhand smoke from anyone smoking indoors counts just the same. It is never too late to quit, no matter when you start.

Open the low-ROI detour

Move “No smoking or drinking at all throughout pregnancy — and no one else in the house should smoke either” to Future Me's calendar

I can spend longer deciding whether to start than the small action would take.

Today I keep a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off
27-005
Evidence AlifespanSource-sensitive

For women at high risk of preeclampsia, start taking one low-dose aspirin tablet daily after week 12 of pregnancy

有子痫前期高危因素的，孕 12 周后开始每天一片小剂量阿司匹林

Preeclampsia is a type of high blood pressure that occurs during pregnancy. Women falling into any of these six categories are at high risk: those who had preeclampsia in a previous pregnancy, women carrying multiples, women with chronic hypertension, women with diabetes prior to pregnancy, women with kidney disease, and women with autoimmune diseases. For these women, taking one low-dose aspirin tablet daily starting at week 12 can reduce the risk of preeclampsia by roughly 15%, the risk of premature birth by about 20%, and the risk of perinatal death by nearly 20%. Women not in these categories should not take it on their own.

Open the low-ROI detour

Move “For women at high risk of preeclampsia, start taking one low-dose aspirin tablet daily after week 12 of pregnancy” to Future Me's calendar

The routine already works until the day the source says it may not.

Today I keep a little money, a few minutes, a bit of persistence and avoid interrupting my default routine.

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27-006
Evidence AlifespanSource-sensitive

Get screened for gestational diabetes at 24 weeks of gestation or later — don’t mind drinking the sugary solution

孕 24 周及以后做一次妊娠期糖尿病筛查，别嫌喝糖水麻烦

Gestational diabetes is high blood sugar that appears only during pregnancy. At 24 weeks or later, spending half a morning drinking a sugary solution and having several blood tests can detect it. Skipping this test raises the risks of having a macrosomic baby, difficult labor, cesarean delivery, preeclampsia, and neonatal hypoglycemia.

Open the low-ROI detour

Move “Get screened for gestational diabetes at 24 weeks of gestation or later — don’t mind drinking the sugary solution” to Future Me's calendar

There is no immediate alarm, so the sensible choice can wait for a less busy week.

Today I keep a little money, a few minutes and avoid interrupting my default routine.

Read the source and trade-off
27-007
Evidence AlifespanSource-sensitive

Memorize this “go to the hospital immediately” checklist — it applies throughout pregnancy and the first year after childbirth

背下这张「立刻去医院」的清单，孕期和产后一年内都算数

If any of the following symptoms appear, head to the hospital on the same day — do not wait until the next morning. Persistent or worsening headaches, changes in vision, fever reaching 38°C. Severe swelling of the hands or face, trouble breathing, chest pain or a rapid heartbeat. Unrelenting severe abdominal pain, no fetal movement or a noticeable drop in fetal movement. Vaginal bleeding or fluid leakage. Swelling, pain and redness in one arm or leg. Thoughts of harming yourself or your baby. The full list is included in the Benefits section below. These guidelines apply equally in the first year after childbirth.

Open the low-ROI detour

Move “Memorize this “go to the hospital immediately” checklist — it applies throughout pregnancy and the first year after childbirth” to Future Me's calendar

Future Me has a clearer calendar, more patience, and apparently the same responsibilities.

Today I keep a few minutes and avoid interrupting my default routine.

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27-008
Evidence BlifespanSource-sensitive

If your water breaks, lie down flat, elevate your hips, and call 120 — don’t walk around or take a shower

破水了就地平躺、垫高臀部、打 120，不要走动也不要洗澡

If your water breaks, there’s no time to calmly gather your things and head out. The right thing to do is lie down right where you are, raise your hips, and call 120 immediately. Walking around while standing up causes amniotic fluid to leak even faster, and the umbilical cord can be pulled out along with it. This is a life-threatening emergency for the baby.

Open the low-ROI detour

Move “If your water breaks, lie down flat, elevate your hips, and call 120 — don’t walk around or take a shower” to Future Me's calendar

If I do not open the notes, no new task has technically appeared.

Today I keep a few minutes and avoid interrupting my default routine.

Read the source and trade-off
27-009
Evidence Atime-energySource-sensitive

Ask for labor analgesia — it does not raise the risk of C-section

想要无痛分娩就直接说，它不增加剖宫产的风险

Labor analgesia involves injecting anesthetic into the lower back to dull the pain of childbirth. It works far better than other pain‑relief options and does not make a C-section more likely. The claim that “it causes lifelong back pain” is also unfounded. Nowadays it is offered as a separate charge, so hospitals are more willing to provide it.

Open the low-ROI detour

Move “Ask for labor analgesia — it does not raise the risk of C-section” to Future Me's calendar

One more exception feels free because the bill arrives outside the current scene.

Today I keep a little money, a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off
27-010
Evidence AlifespanSource-sensitive

Don’t request a C-section without medical indication, and avoid scheduling one just to pick a “lucky” date

没有医学指征就别主动要求剖宫产，也别为了挑日子开刀

According to the World Health Organization, once the C-section rate in a region exceeds 10%, further reductions in maternal and neonatal mortality become unlikely. When a C-section is medically necessary, it must be performed. However, opting for one solely to choose a favorable date or to avoid labor pain means undergoing a major abdominal operation for no real reason.

Open the low-ROI detour

Move “Don’t request a C-section without medical indication, and avoid scheduling one just to pick a “lucky” date” to Future Me's calendar

I can spend longer deciding whether to start than the small action would take.

Today I keep a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off
27-011
Evidence AmoneySource-sensitive

Check your yibao enrollment status before getting pregnant — even unemployed spouses can claim maternity medical expenses

怀孕前就确认生育保险的参保状态，未就业的配偶也能报生育医疗费用

If your employer pays into yibao, both maternity medical costs and maternity leave benefits come out of that fund. Even if your spouse isn’t employed, they can also claim maternity medical expenses. You must confirm beforehand whether you’ve met the minimum enrollment period and whether you need to register in advance for childbirth outside your local area — these details cannot be fixed later.

Open the low-ROI detour

Move “Check your yibao enrollment status before getting pregnant — even unemployed spouses can claim maternity medical expenses” to Future Me's calendar

The routine already works until the day the source says it may not.

Today I keep a few minutes and avoid interrupting my default routine.

Read the source and trade-off
27-012
Evidence Atime-energySource-sensitive

Get the “Medical Certificate of Birth” sorted out before discharge; decide on the baby’s name early and avoid typos.

出院前把《出生医学证明》办掉，名字提前想好、别写错字

This certificate is a prerequisite for registering the child’s hukou, enrolling in yibao (basic medical insurance), and sending the child to school. Only the medical institution where the delivery took place can issue it for the first time. If you try to obtain it after discharge, you’ll have to follow a completely different process and submit extra documentation. Also, make sure the characters you pick for the baby’s name can be entered into the household registration system without any issues.

Open the low-ROI detour

Move “Get the “Medical Certificate of Birth” sorted out before discharge; decide on the baby’s name early and avoid typos.” to Future Me's calendar

There is no immediate alarm, so the sensible choice can wait for a less busy week.

Today I keep a few minutes and avoid interrupting my default routine.

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27-013
Evidence AlifespanSource-sensitive

Don’t skip newborn heel‑prick and hearing tests

新生儿足跟血筛查和听力筛查都别拒绝

A single heel‑prick blood test and one hearing test can detect hypothyroidism, phenylketonuria, and hearing loss even when the baby appears perfectly healthy. By the time symptoms become obvious, any intellectual damage is already irreversible.

Open the low-ROI detour

Move “Don’t skip newborn heel‑prick and hearing tests” to Future Me's calendar

Future Me has a clearer calendar, more patience, and apparently the same responsibilities.

Today I keep a little money, a few minutes and avoid interrupting my default routine.

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27-014
Evidence AmoneySource-sensitive

Enroll your newborn in yibao right after getting the birth certificate — don’t wait until household registration is complete

拿到出生医学证明就给孩子办居民医保，别等落完户

As soon as you receive the birth certificate, you can enroll your baby in yibao online — no need to wait for household registration. Once enrolled, most hospitalization costs can be reimbursed right at discharge. Newborn hospital bills can be quite high, so having yibao makes a big difference.

Open the low-ROI detour

Move “Enroll your newborn in yibao right after getting the birth certificate — don’t wait until household registration is complete” to Future Me's calendar

If I do not open the notes, no new task has technically appeared.

Today I keep a little money, a few minutes and avoid interrupting my default routine.

Read the source and trade-off
27-015
Evidence AfreedomSource-sensitive

Registering a newborn’s birth at a police station within one month

孩子出生后一个月以内去派出所申报出生登记

The law sets a strict one‑month deadline — it’s not a suggestion that you can ignore when convenient. Completing the hukou registration is a prerequisite for vaccinations, preschool enrollment, school admission, and obtaining an ID card. The longer you wait, the more additional documents you’ll need to provide.

Open the low-ROI detour

Move “Registering a newborn’s birth at a police station within one month” to Future Me's calendar

One more exception feels free because the bill arrives outside the current scene.

Today I keep a few minutes and avoid interrupting my default routine.

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27-016
Evidence AlifespanSource-sensitive

Don’t skip that 42-day postpartum checkup — it also screens for postpartum depression

产后 42 天那次复查别跳过，它同时是产后抑郁的筛查

This checkup costs nothing and includes a complete blood count, vaginal discharge test, plus a screening for postpartum depression. Serious problems can arise at any time during the first year after birth, so don’t assume you’re out of danger just because the postpartum period is over.

Open the low-ROI detour

Move “Don’t skip that 42-day postpartum checkup — it also screens for postpartum depression” to Future Me's calendar

I can spend longer deciding whether to start than the small action would take.

Today I keep a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off
27-017
Evidence BlifespanSource-sensitive

During pregnancy, you do not need to rehome a cat; delegate litter cleaning and prevent infection through food and soil hygiene

怀孕了不用把猫送走，猫砂换别人每天铲，肉要做熟、碰土戴手套

The cited studies did not find that owning a cat itself raises toxoplasmosis risk. Undercooked meat and contaminated soil were more relevant exposures; pregnancy can make first infection serious.

Open the low-ROI detour

Move “During pregnancy, you do not need to rehome a cat; delegate litter cleaning and prevent infection through food and soil hygiene” to Future Me's calendar

The routine already works until the day the source says it may not.

Today I keep a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off

Source snapshot: a994b6a0c90598b0fe15cb837343f438dbf7b95d. Every original stays available in Chinese alongside the English edition.