In my research for an assignment about Vietnam’s sex ratio at birth (112 males to 100 females in 2008) I discovered some perplexing information about the prevalence of ultrasounds in the country. On average, Vietnamese women have 6.6 scans during pregnancy, with 20% of them having upwards of 10 and some women having more than thirty. The articles I was reading were attributing this over-testing mainly to the wish to know a fetus’s sex. Because the sex ratio at birth has become so male-skewed recently, several papers said that the societal desire for male children, which can increase a woman’s status in her husband’s family, has caused the widespread use of ultrasounds to be used to inform sex-selective abortions. However, you’ll notice that the sex of a fetus can be fairly conclusively determined with several fewer than 6 ultrasounds. Where are the extras coming from?
I learned that for two thirds of Vietnamese women, the reason given for the frequent ultrasounds is purely for reassurance that the baby is “okay”. According to this article about the still prevalent fear of Agent Orange in pregnant women, scans beyond the 1 or 2 necessary for determining sex are primarily to check for birth defects. More than 11 million tonnes of the Agent Orange pesticide was sprayed by American troops to clear foliage during the Vietnam War. Though the risks of being exposed to the chemical today are small, over 150 000 Vietnamese children have suffered birth defects related to it and these images loom large in the national psyche. While having 30 scans over a pregnancy may not be very practically useful, it can provide women with some peace of mind.
However, many women also report that their doctors recommended the numerous scans. After hearing my classmate Danielle’s report on the health care in Vietnam, this begins making sense as well. Though many hospitals and clinics in Vietnam are considered “public”, there has been an extreme commercialization of Vietnamese health care system. This provides an incentive for doctors to use profit seeking tendencies in prescription and diagnosis, including recommending more ultrasound scans than necessary. Do you think recommending these unnecessary tests is a serious problem? What could be done about it?
This extra information showed me that there aren’t just social reasons for the overuse of ultrasounds in Vietnam, but important historical and economic contexts to be considered as well. It serves as a thought-provoking reminder of the complexity of the world around us and will encourage me to be open to learning while away in Vietnam!