Pre-marital medical check-up is important.

"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, mandatory² pre-marital physical check-ups which started in 1992 became voluntary. And Liu is one of millions who have decided to opt³ out.

Ministry⁴ 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 defense⁵ 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 compulsory⁶ 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.

Ren Yuling, a consultant⁷ 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 consultation⁸.

Zhu Zonghan, former director of the Beijing Public Health Bureau and a senior paediatrician, lauded⁹ the measures.

"Many birth defects actually can be avoided if women use supplements of folic acid during pregnancy," he noted¹⁰. "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, awareness¹¹ about the importance of check-ups is key, she said.