Getting pregnant is great, wonderful, a gift and the start of a life-changing path — unless you don’t want to get pregnant. And then it’s something different. So, hey, no judgement, we’re not Catholic. If you want birth control, this is the country to live in! Using it is seen as being a responsible member of society, and if it’s not the cheapest place in the world with the most freely available options, it’s gotta be among the top. Free IUDs, morning-after pills delivered to your door, condoms at the check-out counter of the FamilyMart — so much family planning!
WHAT’S OUT THERE?
“The range of female contraception available in Shanghai is broad,” says Dr. Chen Yuying, a gynecologist at Circle Harmony Health. “There are female condoms, cervical caps, diaphragms, contraceptive sponges, oral contraceptive pills, spermicides, contraceptive patches, injectable birth control, vaginal rings, implant (Nexplanon), emergency contraceptive pills, copper IUDs, intrauterine devices (Mirena, ParaGard, Skyla), sterilization, tubal ligation and more.”
That’s 15 options! Thank you modern science. How do you get them? They are all available over the counter. That includes condoms (of course) but also:
- Cervical caps
- Contraceptive patches
- Oral birth control pills
- Emergency birth control pills (morning-after pills)
The other options are available in hospitals, according to Dr. Chen.
THE BIG FIVE
CONDOMS (安全套, anquan tao)
What do you call people who don’t use condoms? Parents. Zing!
They are easy, they are everywhere, and they also protect against STDs (but get tested anyways, here's how). The most common brands in China are the Japanese Okamoto and British Durex. Prices vary by “feature”. Okamoto, for example, starts around 26rmb for three condoms but goes up to 99rmb for three “001” condoms (0.01mm thin) made of polyurethane, which is thinner than latex. Durex has an Air series for 49rmb. Trojans are on Taobao, where 10 BareSkins will cost you 108rmb or so. And yes, there are Magnums (118rmb for 12).
Alternatively, you can buy condoms on the delivery platforms — Eleme and Meituan both have a lot of choices.
THE IUD (子宫环, zigong huan)
The intra-uterine device — IUD — is the most popular contraception in China, accounting for nearly 40 percent of contraception use according to the United Nations. The non-hormonal copper IUD is free for everyone thanks to government subsidies, though you’ll need to pay for insertion fees. The procedure is about 100rmb at a public hospital’s outpatient family planning department or about 900rmb at Jiahui Health.
Hormonal IUDs are also available. The Mirena hormonal IUD costs about 1,300rmb at Jiahui International Hospital plus insertion fees and lasts up to five years. Here’s a past story about getting one.
Does insurance cover those costs? “Most major insurance companies do not consider family planning medically necessary so birth control is rarely covered,” according to Dr Celia Qi, OB-GYN at Jiahui Health.
THE PILL (避孕药, biyun yao)
In western Europe, over half of women using birth control take the pill, according to that same UN report. In China, it’s completely different, accounting for just three percent of contraception use. According to Dr Qi, “Not every brand of oral contraceptive is available in China, and there is no guarantee that your brand will be available via prescription or over the counter.”
The current major foreign brands of oral contraceptive available are Yasmin and Diane-35. Former brands Marvelon and Mercilon are effectively discontinued in Shanghai according to United Family's pharmacy. Dr Qi again: “These names might not be familiar to you, but you’ll likely be able to find an appropriate replacement for your preferred brand by comparing its active ingredients with those in the pills listed above.”
Or, hey, you could read our 2015 article about that, which goes in depth and still holds up several years later, for the specific hormones and hormone quantities in each brand.
At our neighborhood pharmacy, a 21-pack (no placebos) of Yasmin costs 138rmb. Diane-35, which has the highest amount of estrogen, needs a prescription from a doctor at a private or public hospital, according to Dr. Jenny Zhu, OB-GYN at United Family Healthcare.
(紧急避孕药, jinji biyun yao)
Emergency birth control is just that — emergency. This shouldn’t be a long-term plan. But, hey, sometimes you need it! And in this day and age in Shanghai, it can be delivered to your door, 24 hours a day. Yes, that’s right, the morning-after pill / Plan B is available on Eleme and Meituan.
Search by clicking the 送药上门 (songyao shangmen) button on either app to get to the medicine page and then search for it with the characters above (for jinji biyun yao). Wahaaaa. Like that, options and options that are minutes away. That’s good because, according to Dr. Chen, “it’s especially important as it is advised to take the pill as soon after sex as possible.”
Or you can do it the old-school way: the pharmacy. It’s over the counter. At our neighborhood pharmacy, the one-pill Postinor1 containing levonorgestrel (左炔诺孕酮, zuo que nuo yuntong) was 75rmb; four pills of the generic version containing the same ingredient were 49rmb.
Copper IUDs can also be used for emergency contraception when inserted within five days.
(皮下埋植, pixia mai zhi)
The implant is a hormonal rod the size of a matchstick that is inserted under the skin of the upper arm. This one is not as popular in China as the others, with 0.2 percent of contraception users based on the UN report. In the next few months Jiahui will start providing the arm implant, Implanon, that lasts for three years.
STERILIZATION (绝育, jueyu)
Did you know that female sterilization (输卵管结扎, shuluanguan jieza) is the most common form of birth control in the world, and third most in China after the IUD and condoms.
Tubal ligation, aka getting your fallopian tubes tied, is an irreversible procedure that is more common with married woman than unmarried. It involves a surgery on the fallopian tubes that bands them, burns them, clips them, or cuts and ties them.
Jiahui provides tubal ligation. The procedure is most frequently done immediately after delivery, especially when there is a C-section. The laparoscopic (small incision) procedure will cost 2,500rmb to 3,000rmb, while a laparotomic (big incision) will cost over 5,000rmb.
Vasectomies (输精管切除术 shujingguan qiechu shu) are done by a hospital's urology department. Male sterilization also involves ligation of a tube. The vas deferens is sown up, burned, tied, clamped or plugged.
At United Family, the outpatient surgery is one hour long with total anaesthesia plus a four hour observation after at the hospital, and costs 20,000rmb.
Both tubal ligation and vasectomy are common procedures in most hospitals, including public hospitals. The department of andrology at Shanghai's First People's Hospital comes especially recommended.