When Liu Lu got married last winter, she and her husband spent 4,000 yuan ($506) on wedding photos alone but decided to skip pre-marital medical check-ups, which cost about 100 yuan ($12.70).

"I was confident we were healthy enough to get married," the 29-year-old secretary said. "And the check-ups imply you don't trust your 'other half'."

Since a State Council regulation came into force on October 1, 2003, mandatory pre-marital physical check-ups which started in 1992 became voluntary. And Liu is one of millions who have decided to opt out.

Ministry of Health statistics reveal only 2.67 percent of couples went for the check-ups in 2004, while it was 68 percent in 2002.

But since then, the rate of birth defects has surged in many regions, a matter of great concern for Chi Baorong, professor at Jilin University's medical college and a veteran CPPCC member.

Over the past three years, she has raised proposals to encourage pre-marital medical checks.

"The health check is the first line of defense for a couple's happiness," she said.

Chen Shouyi, leader of the Zhejiang unit of the China Association for Promoting Democracy, wants to go one step further and reinstate compulsory check-ups.

He cited Ningbo in East China's Zhejiang Province as an example. The city's rate of birth defects was 23.1 per thousand last year, an increase of nearly 4 per thousand over the previous three years' average.

Nationwide figures are not available but if the Ningbo figures were extrapolated, it would mean 64,000 more disabled children were born in the country last year.

Ren Yuling, a consultant to the State Council, listed measures taken by some cities to encourage young couples to go for tests before tying the knot; and suggested these practises be promoted widely.

Shanghai, for example, provides free check-ups and even unmarried couples enjoy free consultation.

Zhu Zonghan, former director of the Beijing Public Health Bureau and a senior paediatrician, lauded the measures.

"Many birth defects actually can be avoided if pregnant women use supplements of folic acid during pregnancy," he noted. "If in pre-marital medicals they learn this, it would be very helpful for them to have a healthy baby."

Chi agrees. She thinks it is not important whether the test is compulsory; instead, awareness about the importance of check-ups is key, she said.

(China Daily 03/13/2007 page1)