Shanghai municipal government will offer free premarital medical check-ups, throughout its jurisdiction, to couples, amidst concerns that the absence of such checks could lead to a rise in birth defects, announced Jiao Yang, a Shanghai government spokeswoman, yesterday.

By the end of the month, each couple that registers to wed will be advised to have a premarital health consultation. Depending on the result of the consultation, the doctor may suggest the couple undergo a medical check-up.

"It is all free if the check-up is within the regular categories like reproductive organ examination, blood tests or testing for sexually transmitted diseases such as syphilis," said an official, surnamed Ge, from the Shanghai Municipal Health Bureau.

"Couples only pay for the part of the test that involves testing for HIV and other items that are beyond routine tests."

Jiao pointed out that both the consultation and the check-up are optional.

"No one will be forced to take these tests," said Jiao.

After the check-up, the doctor will give the couple a report to say whether or not they are suitable, or temporarily unsuitable for marriage. Couples with some curable reproduction-related diseases will be advised to postpone their marriage.

But people can still get married even if a problem is found.

However, it is written clearly in Chinese law that a marriage with either partner having a serious disease that is considered as unsuitable will be annulled.

People suffering from mental illness or a contagious disease during an outbreak, fall into the six categories of being unsuitable or temporarily unsuitable for marriage.

China abolished the compulsory premarital check-up rule in October 2003.

Before that, a health report from a hospital was a prerequisite for a couple when registering to marry.

If the report suggested the couple delay or give up the marriage, the government would not issue them a certificate.

The cancellation of the rule, which is considered as an indication of social progress and an increased respect for privacy, led to a sharp drop in the percentage of couples taking premarital check-ups.

In Shanghai, numbers dropped from over 98 percent of couples to around 3 percent.

In some other cities, the figure has dropped to almost zero.

In Shanghai, in 2003, 648 people were found to have syphilis following premarital health check-ups. In 2004, the disease was detected in only 13 people.

Ge of the health bureau said Shanghai has recorded more birth defects this year, but refused to release the figure.

"But many hereditary diseases appear only when children grow older," added Ge.

Most couples who married without taking a check-up after the cancellation of the rule have not yet had a child.

Observing the sharp decrease in check-ups, Hangzhou and Ningbo in Zhejiang Province offered free check-ups, while Heilongjiang Province has resumed the compulsory system.

Shanghai started offering free premarital consultation and check-ups in six of its 19 districts and counties on a trial basis. City and district governments share the cost of the check-ups, about 120 yuan (US$15) for each couple.

"People's privacy can still be guaranteed as the consultation is given in an isolated room," said Jiao.

In Zhabei District, for example, the recent percentage of couples taking the check-up has grown to 55 percent.

(China Daily August 18, 2005)