Experiencing Stillbirth in China

Pregnancy loss is deeply personal—and often heartbreaking on its own. Whether it happens early in pregnancy or in the final stages, the experience can be even more overwhelming when it takes place far from home, in a country with unfamiliar medical practices, cultural beliefs, and language barriers. | 妊娠流失是无比私密的经历——本身就足以令人心碎。无论是孕早期还是临产前的意外，当这一切发生在远离故土的异国时，面对陌生的医疗体系、文化观念与语言隔阂时，痛苦往往更加难以承受。

This article offers compassionate information to understanding pregnancy loss and stillbirth in China, specifically for the expat community. From definitions and procedures to cultural attitudes and available support, our aim is to provide clarity, empathy, and direction during a difficult time. | 本文是一份充满关怀的信息，旨在帮助外籍家庭理解中国环境下的妊娠流失与死胎。从定义、流程到文化观念与可行的支持上，我们希望在至暗时刻为你厘清困惑、传递共情，并指明方向。

Definitions and Global Context | 定义与全球背景

An estimated 10–20% of known pregnancies end in miscarriage, with most occurring during the first trimester. Health professionals and laws typically distinguish between miscarriage and stillbirth, though the definitions vary by country. These classifications are often based on gestational age or the baby’s weight. | 据统计，全球约10%-20%的已知妊娠以流产告终，其中大多数发生在怀孕前三个月。医学专家和法律通常将流产（Miscarriage）与死胎（Stillbirth）区分开来，但具体定义因国家而异。其分类标准多基于胎儿的孕周或体重。

Globally, UNICEF defines a stillbirth as the death of a foetus at 22 weeks of gestation or more, though some countries use 24 or even 28 weeks as the threshold. Depending on the chosen criteria, studies estimate around 23 million pregnancy losses annually, including 2–3 million stillbirths. | 全球范围内，联合国儿童基金会（UNICEF）将死胎定义为妊娠满22周及以上的胎儿死亡[Blencowe等，2022]，但部分国家以24周甚至28周为界定标准。根据采用的标准不同，研究估计全球每年约有2300万例妊娠流失，其中包含200-300万例死胎。

Despite growing medical knowledge about causes and prevention, the psychological impact of pregnancy loss has long been underestimated—especially in regions where the loss of an unborn child is viewed primarily as a medical event. | 尽管医学对流产成因与预防的认知不断深化，但妊娠流失对心理的影响却长期被低估——尤其是在那些将未出生儿的失去单纯视为医疗事件的地区。

For grieving families, the definitions used by local institutions may feel cold or even cruel. Yet these definitions can significantly influence access to treatment, recognition of the loss, and whether families can legally bury their child or receive any form of documentation. | 对悲痛中的家庭而言，采用的这些定义可能显得冷漠甚至残酷。然而，这些定义却深刻影响着他们能否获得治疗、孩子的失去能否得到认可，以及是否能为孩子合法安葬或获取任何形式的证明文件。

Understanding China’s Legal and Medical Framework | 中国的法律与医疗体系

In China, a stillbirth is officially recognised only if the foetus dies after 28 weeks of gestation. Losses before this point are categorised as miscarriages. This distinction is critical because babies born still before 28 weeks are not issued a birth or death certificate. Without this documentation, it is almost impossible to arrange for an official funeral or burial. |在中国，只有胎儿在妊娠28周后死亡才会被官方认定为死胎。在此之前发生的妊娠流失均归类为流产。这一区分至关重要——28周前死亡的胎儿无法获得出生或死亡证明。缺乏这些文件，家庭几乎无法为孩子举行正式的葬礼或安葬仪式。

In many hospitals, the body of a baby born before 28 weeks is classified as medical waste. Parents may not be informed of their options, and the baby may be quickly removed—often without any chance to hold, see, or say goodbye. This practice is not rooted in cruelty but reflects a system focused on efficiency and biomedical care rather than emotional support. | 在许多医院中，胎龄不足28周的早产儿遗体会被归类为医疗废弃物。医院可能不会告知父母可选择的处理方式，婴儿可能被迅速地处理——父母甚至没有机会拥抱、见面或告别。这种做法并非源于冷漠，而是反映了医疗体系对效率与生物医学护理的侧重，而非情感支持。

Most medical staff in China have limited or no training in trauma-informed care. With the healthcare system stretched thin by the demands of a large population, emotional and psychological aspects of birth—especially loss—are often overlooked. |中国大部分医护人员缺乏创伤关怀护理的系统培训。面对庞大人口需求下的医疗资源紧张，分娩过程中的情感与心理层面的支持——尤其是妊娠流失带来的创伤——常被忽视。

Cultural Beliefs and Traditions | 文化观念与传统

Cultural attitudes in China can also shape how pregnancy loss is handled. For example, during the confinement period after birth (坐月子), expressing grief through crying is discouraged, as it is believed to interfere with the mother’s recovery or the baby’s spiritual journey. | 中国的文化观念也会影响妊娠流失的处理方式。例如，在产后“坐月子”期间，人们不鼓励通过哭泣表达悲伤，因为传统认为这会妨碍母亲的身体恢复或婴儿的灵魂旅程。

Elders may believe that it brings bad luck for parents (“white hair”) to bury a child (“black hair”), especially one who was “not even born.” Additionally, a strong social value of not burdening others emotionally can lead parents to keep their grief private.These cultural norms are not meant to minimise loss but can feel alienating for foreigners who come from communities where open mourning is encouraged, and rituals around death—at any stage of life—are seen as crucial for healing. | 长辈可能认为，父母（“白发人”）为子女（“黑发人”）举行葬礼会招致厄运，尤其是对“尚未出生”的孩子。此外，社会普遍倡导“不将情绪强加于人”，这也让许多父母选择独自承受悲痛。这些文化传统并非为了淡化失去的伤痛，但对来自鼓励公开哀悼文化的外籍家庭而言，可能感到疏离——尤其当他们习惯通过生命各阶段的死亡仪式来疗愈时。

It is important to note that these challenges are not exclusive to expat families. Chinese women also struggle deeply with pregnancy loss, often navigating it in silence due to social and cultural expectations. The existing legal and medical framework, combined with traditional beliefs passed down from older generations — rooted in Confucian values around family, hierarchy, and emotional restraint — can leave little room for open grief or individual needs. | 值得注意的是，这些挑战并非外籍家庭独有。中国女性同样深受妊娠流失之苦，且往往因社会文化的期许而默默承受。现行的法律与医疗框架，结合代代相传的传统观念（植根于儒家思想中家庭、等级与情感克制的价值观），难以为公开的哀伤或个人需求留出空间。

What’s Possible Within the System | 在现有体系中争取的应对方式

Despite these restrictions, some meaningful actions are still possible for families experiencing loss:

即使存在这些限制，经历丧亲之痛的家庭仍能采取以下有意义的方式：

· Ask for time. Unless there’s an immediate medical emergency, you are allowed time to understand what’s happening, make decisions, and begin to process your emotions. | 争取时间。 若无紧急医疗状况，你有权花时间理清现状、做出决定，并逐步处理情绪。

· Prepare a birth and farewell plan. If you know your baby has died in the womb, you can create a gentle plan for delivery. This might include time with your baby, taking photos or footprints, choosing clothing or a blanket, or playing music. | 制定分娩与告别计划。若已知胎儿在子宫内死亡，可提前规划温和的分娩方式。例如：与宝宝短暂共处、拍摄照片或脚印、选择衣物或毯子包裹、播放音乐等。

· Create a private goodbye. Even if the hospital must take the baby’s body, you can ask to wrap the baby in a blanket or place them in a keepsake box with a letter, drawing, or small item before parting. | 创造一次私密的告别。即使医院需按规定处理婴儿遗体，你仍可以请求用毯子包裹孩子，或将其放入纪念盒，附上一封信、一幅画或小物件，再与孩子道别。

· Hold a memorial ceremony. Some parents choose to organise a small private gathering, lighting a candle, reading a poem, or planting a tree in memory of their baby. | 举办纪念仪式。有些父母会组织一场小型的私密聚会，点燃蜡烛、朗诵诗歌，或种下一棵树，以此纪念他们的孩子。

It may take self-advocacy and outside support to make these things happen, but they can provide profound comfort. | 实现这些或许需要主动争取和外界的支持，但它们能带来深切的慰藉。

Support Options for Expats in China | 外籍家庭可寻求的支持资源

Grieving this kind of loss in a foreign land can be incredibly isolating. Fortunately, there are growing support options for the expat community: |在异国他乡经历这样的丧失，可能倍感孤独。所幸，面向外籍社群的支持资源正逐渐增多：

· Counselling Services. Several bilingual counsellors and psychologists offer support for grief and trauma. Some specialise in perinatal loss. | 心理咨询服务。 部分双语心理咨询师和心理学家提供哀伤与创伤支持，其中一些人专攻围产期丧失辅导。

· Trauma-informed Doulas. A few birth workers in China are trained in supporting families through pregnancy loss and stillbirth. | 创伤关怀导乐师。国内少数导乐师接受过专业培训，可协助家庭应对流产与死胎的创伤。

· WeChat Groups. Online communities such as “Having a Baby in China” and smaller grief-specific groups offer peer support, referrals, and shared stories. |微信社群。 如“在中国生娃”等线上社群提供互助支持、资源推荐及故事分享，也有专门针对哀伤的小型群组。

· Local Initiatives. Some hospitals and birth professionals are working to raise awareness and improve care around stillbirth, though these are still emerging. | 地方倡议。部分医院与生育护理专业人士正致力于提高对死胎的认知并改善相关护理，尽管这些举措仍处于萌芽阶段。

Moving Forward | 向前迈进

Grieving the loss of a baby is a process that unfolds over time. There is no “right” way to feel or heal. For some, it helps to name the baby, write letters, or create art or rituals. For others, speaking with someone who understands—even months or years later—makes a difference. | 失去孩子的哀伤是一个需要时间的过程。感受与疗愈的方式没有“对错”之分。有的人通过为孩子取名、写信、创作艺术或仪式来纾解悲痛；也有的人选择与能够理解这份伤痛的人倾诉——即使时隔数月或数年，倾诉本身也能带来慰藉。

It’s also okay to feel conflicted about how things were handled. Anger, confusion, or disappointment with the medical system, culture, or others’ reactions are natural. Finding validation and support is crucial. |对处理方式感到矛盾也是正常的。对医疗体系、文化观念或他人反应的愤怒、困惑或失望都是人之常情。获得理解与支持至关重要。

Conclusion | 结语

Pregnancy loss and stillbirth in China can be a lonely and bewildering experience for expat families, shaped not just by personal tragedy but also by medical definitions, cultural norms, and legal systems that may not reflect their own values.

Still, even within these constraints, it is possible to create space for grief, to remember, and to honour your baby in meaningful ways. You are not alone—and there is help available.

对在中国的外籍家庭而言，妊娠流失与死胎不仅是个体的悲剧，更可能因医疗定义、文化传统及法律体系与自身价值观的差异，成为一场孤独而困惑的经历。但即使在局限中，你仍能为哀伤留出空间，用有意义的方式纪念和缅怀孩子。请记住：你并不孤单，支持始终存在。