Tuesday, May 5, 2015

California hospitals fight “maternity tourism” to promote breastfeeding

A couple of weeks ago I was invited to speak at a staff meeting at AHMC, a medical group that owns and runs six hospitals in Los Angeles area. According to the medical director, they have seen a large increase in their Chinese patient population. The patients come to the United States to deliver their babies and then return to China.

At Monterey Park Community Hospital, one of the hospitals operated by AHMC, 97% of the obstetrics patients are these Chinese women. While the hospital is promoting breastfeeding, it is reported that the Chinese mothers ask for several bottles of infant formula at a time, and appear upset if the staff don’t accommodate them. It frustrates the staff.

Maternity tourism has long been a problem in Los Angeles. After federal agents raided maternity tourism business in Los Angeles last month, some of the business moved down to San Diego. The business challenges the work of breastfeeding promotion.

Currently in China, less than 30% of newborns are breastfed. Breastfeeding is simply not a common practice in the country. It’s hard for the American medical experts to change Chinese women’s life-long beliefs in a two-day hospital stay.

To promote breastfeeding among those mothers who come to the States to give birth is even harder. Maternity tourism is a huge business in Southern California. According to the Chinese government, each year more than 3,000 Chinese women come to the U.S. to give birth, and half of them come to Southern California. To lure potential customers, the maternity travel agencies often tell the mothers, “You can ask for as much baby formula as you want at an American hospital.” Just “Baidu” (the Chinese “Google”) the key words “giving birth in America” and tons of advertisements pop up. Most of them list “free infant formula” as an advantage of giving birth in the States.

A townhouse in San Gabriel that has been converted to "maternity hotel."
My advice for staff is, first, to have Chinese-language breastfeeding education material available. Then distribute it to the Chinese patients when they come to the hospital for the prenatal tour, not when they are in the delivery room.

I also recommend working with the doctors who work and care for these patients. There are Chinese-speaking doctors who enjoy working with maternity travel agencies and particularly receive these Chinese patients. When thousands of miles away from home, it’s much easier for Chinese women to trust these Chinese-speaking doctors than English-speaking hospital staff.

The hospital staff told me that some doctors are part of the maternity tourism industry, and tend to work with the maternity travel agency instead of the hospital. This is discouraging. But still, I insist that we put breastfeeding-promotion brochures and hang posters in the doctors’ offices.

Chinese mothers often become upset when their requests for formula are not accommodated. My suggestion is to give them samples that promote breastfeeding, such as lanolin or hydrogel pads, instead of formula. These women pay a fortune just to give birth in the U.S. It is understandable that they want to get something free.

Finally, I think the hospital staff should set a reasonable expectation for their work of promoting breastfeeding to these Chinese mothers. Again, it is indeed hard for American medical experts to change a long-time cultural belief in a short period of time. Also, Chinese mothers often need more encouragement than American mothers to breastfeed, considering the low breastfeeding rate and baby-unfriendly atmosphere in that country.

The good news is, things are changing. Young and well-educated Chinese mothers are now more aware of the benefits of breastfeeding and are often willing to give it a try. It is our hope that one day they’ll all understand that breast milk is the best gift a mother can offer her baby—even better than American citizenship.

A feature story on maternity tourism I did for KSCI three years ago:


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