Measures for the Implementation of the Maternal and Child Health Care Law (2022 Revision)

Implementation Measures of the Maternal and Child Health Care Act

(Promulgated by State Council Decree No. 308 on June 20, 2001, and amended in accordance with the Decision of the State Council on Amending and Repealing Certain Administrative Regulations of March 29, 2022)

Chapter I General Provisions

Article 1: These Measures are formulated in accordance with the "Law of the People's Republic of China on Maternal and Infant Health Care" (hereinafter referred to as the Maternal and Infant Health Care Law).

Article 2: Establishments and their personnel engaged in maternal and infant health care service activities within the territory of the People's Republic of China shall abide by the Maternal and Infant Health Care Law and these Measures.

Establishments engaged in family planning technical services carrying out family planning technical service activities shall be carried out in accordance with the provisions of the "Regulations on the Administration of Family Planning Technical Services".

Article 3: Technical services for maternal and child health care mainly include the following matters:

(1) Science publicity, education and consultation on maternal and child health care;

(2) Premarital medical examinations;

(3) Prenatal diagnosis and diagnosis of genetic diseases;

(4) Midwifery techniques;

(5) Performing medically necessary birth control surgeries;

(6) Newborn disease screening;

(7) Other reproductive health care services related to fertility, birth control, and infertility.

Article 4: Citizens enjoy the right to make informed choices about maternal and infant health care. The State guarantees the right of citizens to appropriate maternal and child health services.

Article 5: Maternal and child health care efforts are centered on health care and aimed at safeguarding reproductive health, and implement the principle of combining health care and clinical care, and focusing on groups, grass-roots units, and prevention.

Article 6: People's governments at all levels shall include maternal and child health care efforts in the national economic and social development plans for that level, provide the necessary economic, technical and material conditions for the development of maternal and child health care, and give special support to maternal and child health care in ethnic minority areas and poverty-stricken areas.

Local people's governments at or above the county level may, on the basis of the actual conditions and needs of their respective regions, establish special funds for the development of maternal and child health care.

Article 7 The administrative department of health under the State Council shall be in charge of the work of maternal and child health care throughout the country and shall perform the following duties:

(1) Formulate the Maternal and Infant Health Care Law and the supporting rules and technical specifications of these Measures;

(2) In accordance with the principle of hierarchical and classified guidance, formulate national development plans and implementation steps for maternal and child health care work;

(c) Organize the promotion of appropriate technologies for maternal and child health care and other reproductive health;

(4) Supervise maternal and child health care efforts.

Article 8: Departments such as for finance, public security, civil affairs, education, labor security, and family planning of people's governments at the county level or above shall, within the scope of their respective duties, cooperate with the health administrative departments at the same level to do a good job of maternal and child health care work.

Chapter II: Premarital Health Care

Article 9: The premarital health guidance referred to in article 7 of the Maternal and Child Health Care Law includes the following matters:

(a) Health care and education related to sexual health;

(2) Contraceptive knowledge and family planning guidance for newlyweds;

(3) Pre-pregnancy health care knowledge such as pre-conception preparation, environment and impact of diseases on offspring;

(4) Basic knowledge of genetic diseases;

(5) Basic knowledge of diseases affecting marriage and childbearing;

(6) Other reproductive health knowledge.

When physicians conduct premarital health consultations, they should provide scientific information to the clients of their services, guide the possible consequences, and make appropriate recommendations.

Article 10 In areas where premarital medical examinations are carried out, both men and women who are preparing to marry shall go to medical or health care institutions to conduct premarital medical examinations before registering their marriages.

Article 11: Medical and health care establishments engaged in premarital medical examinations shall be examined by the administrative department of health of the people's government at the county level where they are located;

Article 12: Medical and health care establishments applying to engage in premarital medical examinations shall meet the following conditions:

(1) Separately set up special premarital medical examination rooms for men and women, equipped with equipment for routine examinations and specialized examinations;

(2) Set up premarital reproductive health publicity and education rooms;

(3) Have qualified practicing physicians to conduct premarital medical examinations for men and women.

Article 13: Premarital medical examinations include asking for medical history, physical examinations, and related examinations.

Premarital medical examinations shall comply with the norms for premarital health care work and be conducted in accordance with premarital medical examination items. The norms for premarital health care work and the items for premarital medical examination shall be prescribed by the administrative department of health under the State Council.

Article 14: After a premarital medical examination, medical or health care establishments shall issue a premarital medical examination certificate to the parties receiving the premarital medical examination.

The premarital medical examination certificate shall indicate whether the following disorders have been found:

(1) designated infectious diseases during the period of infection;

(2) Relevant mental illness during the onset period;

(3) Serious genetic diseases that are not suitable for procreation;

(4) Other diseases that are medically considered inappropriate for marriage.

Where diseases in items (1), (2) and (3) of the preceding paragraph are discovered, the physician shall explain the situation to the parties and put forward suggestions for prevention, treatment, and the adoption of corresponding medical measures. On the basis of the doctor's medical opinion, the parties may suspend their marriage, or they may voluntarily use long-acting contraception or sterilization surgery; medical and health care institutions shall provide medical consultation and medical services for their treatment.

Article 15: Where, after premarital medical examination, medical or health care establishments are unable to confirm the diagnosis, they shall be transferred to the medical or health care institutions designated by the health administrative departments of the people's governments at or above the districted municipal level for confirmation.

Article 16: In areas where premarital medical examinations are carried out, marriage registration organs shall, when handling marriage registration, examine the premarital medical examination certificate or the medical appraisal certificate provided for in article 11 of the Maternal and Infant Health Care Law.

Chapter III: Health Care During Pregnancy and Childbirth

Article 17: Medical and health care establishments shall provide women of childbearing age with consultation and medical care services related to contraception, birth control, childbirth, infertility, and reproductive health.

Where physicians discover or suspect that couples of childbearing age have serious genetic diseases, they shall submit medical opinions; where it is difficult to diagnose a diagnosis limited to the existing level of medical technology, they shall explain the situation to the parties. Couples of childbearing age can choose corresponding medical measures such as contraception, birth control, and infertility.

Article 18: Medical and health care establishments shall provide pregnant women with the following health care services:

(i) Establish health manuals (cards) for pregnant women and conduct regular prenatal check-ups;

(2) Providing medical guidance and counseling for pregnant women in the areas of hygiene, nutrition, and psychology;

(3) Carry out key monitoring, follow-up, and medical care services for high-risk pregnant women;

(4) Providing technical services for pregnant women to give birth safely;

(5) Conduct regular postpartum visits to guide women in scientific feeding of babies;

(6) Providing contraceptive counseling guidance and technical services;

(7) Conduct reproductive health education and scientific parenting knowledge education for pregnant women and their families;

(8) Other health care services during pregnancy and childbirth.

Article 19: Where medical or health care establishments discover that pregnant women suffer from the following serious diseases or are exposed to physical, chemical, biological, or other toxic or harmful factors, which may endanger the safety of the pregnant woman's life or may seriously affect the pregnant woman's health and the normal development of the fetus, they shall conduct medical guidance and the following necessary medical examinations for the pregnant woman:

(1) Serious pregnancy complications or complications;

(2) Serious mental illnesses;

(3) Other diseases that seriously affect fertility as prescribed by the administrative department of health under the State Council.

Article 20: Where pregnant women have any of the following circumstances, physicians shall make a prenatal diagnosis:

(1) Too much or too little amniotic fluid;

(2) Abnormal fetal development or suspicious fetal malformations;

(3) Exposure to substances that may cause fetal birth defects in the first trimester;

(4) Those who have a family history of genetic diseases or who have previously given birth to a baby with a serious congenital defect;

(5) The age of the first mother is more than 35 years old.

Article 21 The catalogue of serious hereditary diseases of the fetus, the serious defects of the fetus, and the list of serious diseases of pregnant women that may endanger their life and health safety as provided for in article 18 of the Maternal and Child Health Care Law shall be prescribed by the administrative department of health under the State Council.

Article 22: Where a child with a serious genetic disorder or serious defect has been born, before becoming pregnant again, both husband and wife shall follow the relevant provisions of the State to go to a medical or health care institution for medical examination. Medical and health care establishments shall introduce knowledge about genetic diseases to the parties, and give consultation and guidance. Where a person is diagnosed with a serious genetic disease that is medically considered inappropriate for procreation, the physician shall explain the situation to the person concerned and submit a medical opinion.

Article 23: It is strictly forbidden to use technical means to conduct sex identification of fetuses.

Where it is suspected that the fetus may be a concomitant genetic disease and it is necessary to conduct gender identification, the medical and health care institutions designated by the health administrative departments of the people's governments of provinces, autonomous regions, and municipalities directly under the Central Government shall conduct the appraisal in accordance with the provisions of the health administrative department under the State Council.

Article 24: The State advocates hospital delivery. Medical and health care establishments shall, in accordance with the technical operation specifications formulated by the administrative department of health under the State Council, carry out sterilization and resuscitation of newborns, prevent obstetric complications such as birth injuries and postpartum hemorrhage, and reduce maternal and perinatal morbidity and mortality.

Where there are no conditions for hospital delivery, the birth shall be delivered by a family delivery personnel who have been trained and have the corresponding ability to deliver babies.

High-risk pregnant women should give birth in hospital at medical or health care facilities.

Chapter IV: Infant Health Care

Article 25: Medical and health care establishments shall follow the relevant provisions of the State to carry out screening, diagnosis, treatment, and monitoring of congenital and hereditary metabolic diseases of newborns.

Article 26: Medical and health care establishments shall follow provisions to conduct visits to newborns, establish child health care manuals (cards), conduct regular health examinations, provide scientific knowledge such as disease prevention, reasonable diet, and promotion of intellectual development, and do a good job of medical care services such as infants with multiple diseases and prevention and treatment of common diseases.

Article 27: Medical and health care establishments shall follow the prescribed procedures and items to carry out vaccination of infants.

The guardian of the infant shall ensure that the infant receives vaccination in a timely manner.

Article 28: The State promotes breastfeeding. Medical and health care institutions shall provide technical guidance for the implementation of breastfeeding and provide necessary breastfeeding conditions for women who give birth in hospitals.

Medical and health care establishments must not publicize or recommend breast-milk substitutes to pregnant women and infant families.

Article 29: Packaging labels for breast-milk substitute products shall indicate the superiority of breastfeeding in a conspicuous position.

Producers and sellers of breast-milk substitutes may not donate samples of products to medical or health-care institutions or conditionally provide equipment, funds and materials for the purpose of marketing.

Article 30 Women enjoy maternity leave as prescribed by the State. For women with infants under the age of 1, their employer shall arrange a certain amount of breastfeeding time for them during working hours.

Chapter V: Technical Appraisal

Article 31: The Maternal and Infant Health Care Medical Technical Appraisal Committee is divided into three levels: provincial, municipal, and county.

Members of the Maternal and Child Health Care Medical Technical Appraisal Committee shall meet the following requirements for holding office:

(1) Members of the county-level maternal and child health care medical technical appraisal committee shall have professional and technical positions of attending physician or above;

(2) Members of the districted municipal and provincial maternal and child health care medical technical appraisal committees shall have professional and technical positions of deputy chief physician or above.

Article 32: Where parties have objections to the results of premarital medical examinations, genetic disease diagnoses, or prenatal diagnoses, and it is necessary to further confirm the diagnosis, they may submit a written appraisal application to the Maternal and Child Health Care Medical Technical Appraisal Committee at the county level or districted municipal level where they are located within 15 days of receiving the results of the examination or diagnosis.

The Maternal and Child Health Care Medical Technical Appraisal Committee shall make a medical technical appraisal opinion within 30 days of receiving the appraisal application, and promptly notify the parties.

Where the parties have objections to the appraisal opinion, they may apply for re-appraisal to the Maternal and Infant Health Care Medical Technical Appraisal Committee at the level above within 15 days of receiving the notice of the appraisal opinion.

Article 33 When conducting medical appraisals, the Maternal and Infant Health Care Medical Technical Appraisal Committee shall have 5 or more members of the relevant professional medical technical appraisal committees participate.

Members of the appraisal committee shall sign the appraisal conclusions; dissenting opinions shall be truthfully recorded. The appraisal committee shall issue an appraisal opinion to the parties on the basis of the appraisal conclusions.

The Administrative Measures for the Technical Appraisal of Maternal and Child Health Care Medicine shall be formulated by the administrative department of health under the State Council.

Chapter VI: Supervision and Management

Article 34 The health administrative departments of local people's governments at or above the county level shall be responsible for the supervision and management of maternal and child health care within their respective administrative regions, and shall perform the following supervision and management duties:

(1) In accordance with the Maternal and Infant Health Care Law and these Measures, as well as the conditions and technical standards stipulated by the administrative department of health under the State Council, license institutions and personnel engaged in maternal and child health care work, and issue corresponding license certificates;

(2) Conduct supervision and inspection of the implementation of the Maternal and Child Health Care Law and these Measures;

(3) Give administrative punishments in accordance with law for violations of the Maternal and Infant Health Care Law and these Measures;

(4) Responsible for other matters concerning the supervision and management of maternal and child health care work.

Article 35 Medical and health care institutions and personnel engaged in the diagnosis and prenatal diagnosis of genetic diseases shall be licensed by the health administrative departments of the people's governments of provinces, autonomous regions and municipalities directly under the Central Government; however, medical and health care institutions engaged in prenatal diagnosis and prenatal screening shall be licensed by the health administrative departments of the people's governments at the county level.

Medical and health care institutions and personnel engaged in premarital medical examinations shall obtain the permission of the health administrative department of the people's government at the county level.

Medical and health care institutions and personnel engaged in midwifery technical services, sterilization surgery and pregnancy termination surgery, as well as personnel engaged in home delivery, must obtain the permission of the health administrative department of the people's government at the county level and obtain the corresponding certificate of conformity.

Article 36 When performing their duties, health supervision personnel shall present their certificates.

Health supervision personnel may learn about the situation from medical and health care institutions, obtain necessary information, supervise and inspect maternal and child health care work, and medical and health care institutions must not refuse or conceal them.

Health supervisors are obliged to maintain the confidentiality of technical information provided by medical and health care institutions.

Article 37: Medical and health care establishments shall, on the basis of the business they are engaged in, allocate corresponding personnel and medical equipment, strengthen on-the-job professional training and professional ethics education for personnel engaged in maternal and child health care work, and periodically inspect and evaluate them.

Physicians and midwives (including family birth attendants) shall strictly abide by the relevant technical operation specifications, conscientiously fill in various records, and improve the quality of midwifery technology and services.

The management of midwifery personnel shall be carried out in accordance with the provisions of the administrative department of health under the State Council.

Practicing physicians engaged in maternal and child health care work shall obtain corresponding qualifications in accordance with the provisions of the Maternal and Child Health Care Law.

Article 38 Medical and health care establishments shall, in accordance with the provisions of the administrative department of health under the State Council, provide operational guidance for the work of kindergartens and health care.

Article 39: The State establishes monitoring and reporting systems for maternal deaths, infant deaths, and neonatal birth defects.

Chapter VII Penalties

Article 40 Where medical or health care institutions or personnel engage in premarital medical examinations, genetic disease diagnosis, prenatal diagnosis, pregnancy termination surgery and medical technology appraisals without authorization without obtaining a technical license for maternal and child health care, or issue relevant medical certificates, the administrative department of health shall give a warning and order the illegal conduct to cease and confiscate the illegal gains; where the illegal gains are more than 5,000 yuan, a fine of not less than 3 times but not more than 5 times the illegal gains; if there are no illegal gains or the illegal gains are less than 5,000 yuan, And impose a fine of 5,000 yuan to 20,000 yuan.

Article 41: Where personnel engaged in maternal and child health care technical services issue false medical certification documents, administrative sanctions are to be given in accordance with law; in any of the following circumstances, the department that originally issued the certificate is to revoke the corresponding maternal and child health care technical qualifications or physician practice certificates:

(1) Delaying diagnosis and treatment, causing serious consequences;

(2) Causing serious consequences to the parties' physical and mental health;

(3) Causing other serious consequences.

Article 42 Where the sex determination of the fetus is carried out in violation of the provisions of these Measures, the administrative department of health shall give a warning and order the illegal conduct to cease; the directly responsible supervisors and other directly responsible personnel of medical and health care institutions shall be given administrative sanctions in accordance with law. Where fetal sex identification is conducted more than twice or for the purpose of making a profit, the organ that originally issued the certificate is to revoke the corresponding maternal and child health care technology practice qualifications or physician practice certificates.

Chapter VIII Supplementary Provisions

Article 43 The format of the premarital medical examination certificate shall be prescribed by the administrative department of health under the State Council.

Article 44: "Medical and health care institutions" as used in the Maternal and Child Health Care Law and these Measures refers to all types of medical institutions at all levels that have obtained medical institution practice licenses from health administrative departments in accordance with the Regulations on the Administration of Medical Institutions.

Article 45: These Measures take effect on the date of promulgation.

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