From quality control to informed choice: Understanding “good births” and prenatal genetic testing in contemporary Urban China

Genetic testing and genetic screening as two selective reproduction technologies (Gammeltoft and Wahlberg, 2014) are frequently used in prenatal health care around the world, and many scholars have examined prenatal genetic testing in different local contexts (e.g., Rapp, 1999; Rothman, 1993; Sleeboom-Faulkner, 2010). In this chapter, we will trace the historical changes in prenatal genetic testing practices in China since the 1990s. We focus particularly on China as an exemplar of the significance that selective reproduction technologies have in social, cultural and regulatory terms, and the role that they play in shaping governance practice, particularly within traditions and communities exposed to non-Western medical cultures. Scholars writing about Chinese genetic testing often take family as an important element of traditional Confucianism culture (Sui and Sleeboom-Faulkner, 2010). While agreeing with this approach, we argue that health professionals often play an important role in families’ decision-making. Hence, our overview includes not only the viewpoint of patients and families affected by prenatal genetic testing (and resulting interventions), but also the voices of bioethicists and frontline health workers from local hospitals. These are important actors who not only contribute to producing discourses regarding population quality and "good births," but also actively practice them in their daily work.