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China’s Banking Transformation
China’s Banking Transformation
TH E U N TO L D STO RY
James Stent
1
1
Oxford University Press is a department of the University of Oxford. It furthers
the University’s objective of excellence in research, scholarship, and education
by publishing worldwide. Oxford is a registered trade mark of Oxford University
Press in the UK and certain other countries.
9 8 7 6 5 4 3 2 1
Printed by Sheridan Books, Inc., United States of America
Contents
Preface vii
Abbreviations xv
2. Culture Matters 25
5. Bankers 100
6. Systems 123
vii
viii Preface
is an Asian transplant of late nineteenth-century brick and stone Dutch architecture in vogue
among Japanese at that time.1
China’s ongoing reforms had recently mandated modern corporate governance
practice in listed companies such as Minsheng Bank. Under the new requirements,
Minsheng’s board should include four independent directors. Jing Shuping had selected
three Chinese professionals to be independent directors, but he also wanted to identify
a foreigner with both banking experience and Chinese language ability to serve as the
fourth independent director. Consultation with, the International Finance Corporation,
a World Bank affiliate, which was advising Minsheng at that time, led to the suggestion
that I might be a candidate.
An inner door of the ornate century-old reception room opened, through which
walked Chairman Jing, dapper in well-tailored suit and tie, but walking slowly at the
age of 83. Slight of frame and frail in appearance, he nonetheless exuded warmth,
energy, charm, and a piercing intelligence. Born into a Shanghai capitalist family,
he had assisted his father prior to 1949 in running the family’s manufacturing busi-
ness, and was one of the capitalists who had chosen to stay in China after the civil
war ended. The Cultural Revolution years were not kind to him, but he had endured
and gone on to become one of the most respected and senior non-communist party
figures in China during the ’80s and ’90s, serving as vice chairman of the People’s
Consultative Congress and as chairman of the All-China Federation of Industry and
Commerce. Through these positions, he developed a broad network of contacts in
the emerging Chinese entrepreneurial world. Jing and several other leading entrepre-
neurs in the All-China Federation proposed to the then-Deputy Prime Minister Zhu
Rongji that a new commercial bank be established, to be owned entirely by private
businessmen. Zhu backed the idea, and the Minsheng Bank was established in 1996,
with Jing as chairman of the board, and shareholders who ranked among the wealthi-
est of China’s new capitalists.
Our conversation ranged for half an hour across a variety of subjects, touching on cul-
ture, travel, and of course banking. Chairman Jing indicated that I would be nominated
as an independent director at the forthcoming annual general meeting of the bank’s
shareholders, and thus began the Chinese portion of my banking career.
The circuitous path that had led me to that interview with Chairman Jing had begun
in 1973, when I joined Citibank of New York as a junior officer in its Asian Division.
After brief training in head office, I spent four years in Citibank’s Philippine and Hong
Kong branches. In Hong Kong I transferred to Crocker National Bank of San Francisco,
which assigned me first to Hong Kong, and then to Thailand, where I lived and worked
from 1979 through 2002, and again from 2007 to the present time.
Those eight years during the 1970s working in American banks comprised the first
stage of my banking career. It was in those two banks that I absorbed the conservative
1
Li Luke and Hu Jiezhong, eds., Beijing Gujianzhu Ditu (Beijing: Tsinghua University Press, 2009), 204–205.
Preface ix
tenets of an earlier era of banking practice. Those were the last years of the highly regu-
lated era of banking that had been the norm in America since the New Deal reforms of
the 1930s. Banking was a stodgy career choice. Yet the American banking system was then
relatively stable and the postwar economy was going through a golden era of prosperity.
In those days at Citibank new recruits underwent intensive training in the basics of
the profession. We rotated through every department in our training. From the tellers we
learned out how to pay out and receive cash and how to balance ledgers at the end of the
day, from the foreign department clerks we learned the intricacies of negotiating letters of
credit, and so forth. The emphasis was on controlling risk, and on doing things properly.
The bank’s thick accounting and procedure manual was our bible. I was imbued with the
craft of banking, with the precepts of risk control, and with a strong sense of protecting
the interests of the depositors and of the bank. Most of what I know and believe to be
important about banking, I learned in those early years of my career.
That was the style of banking that had stood America in good stead during the first
three prosperous postwar decades. But change was afoot, the Reagan revolution started in
1981, and the rational markets theories of economics gained broad support, providing the
intellectual rationale for sweeping deregulation over the next twenty years. The culture
and style of Citibank of today is far different from the Citibank for which I had worked.
At just that time, when the banking world was changing, I left Crocker and American
banking to join a small, privately owned Thai bank, the Bank of Asia. I was to spend eigh-
teen years with Bank of Asia, during most of which time I was its only foreign employee.
The youthful CEO, Yos Euarchukiati, scion of the Sino-Thai family that was the domi-
nant shareholder of the bank, realized that the days of old-fashioned overseas Chinese
style banking would soon be over in Thailand. The bank would need to professionalize
to meet the challenges of the rapidly developing economy of Thailand. First under Yos,
and then under his successor Chulakorn Singhakowin, I worked as part of a team of Thai
professionals to change Bank of Asia from a traditional into a modern bank.
My stints with the two American banks had provided me with the fundamentals of
the craft of banking as it had been practiced in America prior to the deregulation era.
The succeeding years with the Thai bank gave me an opportunity to work inside an Asian
financial institution in a developing country, tasked to introduce international best prac-
tice and bring about organizational change in a local bank. One of the lessons I learned
at Bank of Asia was that change must be sequenced, that “big bangs” within an Asian
organization were a likely road to failure. Another lesson was the importance of change
management—ensuring that all stakeholders in the organization are fully supportive of
the change agenda, and that their interests have been given due respect. If all stakeholders
were not “with the program,” those left out could all too easily subvert the change agenda.
I learned to be patient with a pace of change that might seem unnecessarily slow, but
which in the end would prove a reliable path to reaching our objectives. Those lessons in
organizational change at the micro level would provide me with insights into understand-
ing how the reform program worked in China at a national level.
x Preface
The years of modernizing and professionalizing the bank paid off. The Bank of Asia
survived the systemic meltdown of the Thai economy during the Asian financial crisis of
1997—the bank’s sound management attracting a large capital infusion from ABN AMRO
Bank of the Netherlands. From the crisis itself, and from the painful but quick recovery
over the next five years, I learned not only about sustainable banking, but also about mac-
roeconomic policy pitfalls in developing countries—real estate and stock exchange bub-
bles, ill-advised monetary and foreign exchange policies, and the hubris that accompanies
rapid economic growth, leaving a country vulnerable to unanticipated shocks.
In 2002 I retired from Bank of Asia, moved to Beijing, and worked on several projects
there, including service on the board of Minsheng Bank. I developed the highest respect
for Chairman Jing Shuping. Despite his advanced years, and despite having been cut
off from the West for thirty years, Jing was keenly aware of international economic and
financial currents, was extraordinarily progressive, and immediately grasped new con-
cepts presented to him. The strong growth of the bank in those early years owed much to
his leadership and vision.
Shortly after completion of my three-year term as an independent director of Minsheng
Bank, I accepted an offer to be an independent director of China Everbright Bank. Both
Minsheng and Everbright are listed on the Shanghai Securities Exchange, but Minsheng
shares are almost entirely in the hands of private shareholders, whereas, following a recap-
italization mandated by the State Council in 2007, the state, through several vehicles, is
the majority shareholder of Everbright Bank.
I served two terms (the maximum allowed by governance regulations) of three years
each as an independent director of Everbright Bank, starting in 2006 and finishing in
2012. During most of that period, I chaired the Board’s Audit Committee, and was also
a member of the Risk, Strategy, Nominations, and Compensation Committees. The full
board met at least five or six times each year. Committee meetings were held immediately
prior to the full board meetings, altogether lasting two or three days. After the completion
of my two terms as an independent director, I was elected one of two outside members of
the bank’s board of supervisors, where I served until the completion of my term in 2016.
Widespread skepticism about Chinese bank quality prevails among both analysts and
the general public. I acknowledge that my view that there has been a “night-and-day”
transformation of Chinese banks since the 1990s is contrary to the impression conveyed
by most foreign media accounts—which generally describe Chinese banks as fragile and
inefficient, perhaps headed for crisis. This view has now become widely accepted outside
of China. I find these views ill-informed, misleading, and perhaps imbued with a bias,
sometimes conscious but generally unconscious, against a system that is avowedly “social-
ist” at a time when adherents of neoliberalism and market capitalism are intolerant of
alternative models.
I felt the need for a corrective to the prevailing gloomy and censorious view, so in
2012 I began the research and writing of this book on the banking transformation to
which I had been privileged to be a front-line witness. In the wake of the financial
Preface xi
collapse of 2008, the published academic analyses and popular accounts of the failures
of banks in America and the United Kingdom have been of high quality and insightful.
Collected together, they would fill several bookshelves. Curiously, although journal-
ists and investment analysts have written frequently on day-to-day developments and
problems in Chinese banking, only a handful of books, think tank specialist surveys,
consultant and rating agency publications, chapters in larger overall studies on China’s
economy, and academic articles have dealt with the development and prospects of
Chinese banks, and most of these are not easily accessible to the non-specialist. I hope
this book fills that gap.
Unlike more academic treatments, or journalistic accounts, I have not written from the
vantage point of an outside observer or researcher. This book is an account of banking
told by a professional banker, with the benefit of access within banks and of input from
many Chinese and foreign banking practitioners. This book is not, however, intended
to be an authoritative or scholarly history of the development of Chinese banking over
recent decades. Such a book is much needed, and hopefully will be written.
China is the second largest economy in the world. A banking crisis in China would
have enormous impact on China’s economy, and that would rapidly turn into a global
economic and financial crisis. Moreover, as China moves beyond Deng Xiaoping’s for-
eign policy of “hiding its light” and asserts itself internationally, how China manages the
stability of its banking system, how its banks expand overseas, how its financial system
becomes more open and integrated with global systems, and what China thinks about
global financial architecture take on global importance. It is therefore imperative that
anyone concerned with China’s political economy should have a deeper understanding of
China’s banking system than perusal of the media provides.
Development of the Chinese banking sector, lying at the heart of the nation’s economy,
can serve as a case study for understanding what happens in other sectors of China’s econ-
omy, even in non-economic areas. It is my hope not only that readers will take away from
this book a clearer picture of Chinese banks, but also that an understanding of the bank-
ing sector will provide a prism through which to understand how China as a whole works.
The introductory chapter, “China’s Hybrid Banks” sets forth the overall argument
of the book that China’s banks are hybrid creatures, operating in most ways like mod-
ern Western banks, but designed to serve the real economy under the guidance of the
Communist Party in a market socialist political economy. The hybrid character of
Chinese banks combines extensive borrowing of Western banking practice and concepts
of corporate governance with traditional Chinese beliefs in how society and the political
economy should be ordered. The result is a banking system that has effectively contrib-
uted to national economic growth, but which has attracted a plethora of foreign criticism
because it does not adhere to conventional Anglo-American concepts of how modern
banking systems should run.
China’s banking transformation story would not be comprehensible to non-Chinese
readers without explanation of how China’s culture and historical development have
xii Preface
influenced contemporary Chinese banking, and how Chinese banks fit into the broader
political economy. Too often misunderstanding of Chinese banking practice and poli-
cies stems from viewing the Chinese system through the lens of a non-Chinese, and par-
ticularly Anglo-American, ideological framework that does not take sufficient account of
the very different culture and political economy in which Chinese banking is embedded.
Chapters 2, “Culture Matters,” and 3, “Leninism and Pragmatism: China’s Communist
Party,” provide essential background on Chinese culture and political economy to make
the main narrative of the banking transformation comprehensible in the broader context
of how China works today. They explain how the persistence in contemporary China
of Confucian views of how society should be ordered provide the rationale for strong
party-state control of the banks. They also explain the “why” and “how” of the Party’s role
in Chinese banks, particularly through its powerful Organization Department, which
controls senior appointments in the banks.
Chapter 4, “Transformation: From Bursars to Bankers,” provides a chronological nar-
rative of the development of Chinese banking over the years since Opening and Reform
commenced in 1976. It relates the principal phases of development, the search for a model
of banking that would suit China’s needs, and the financial turmoil of the 1990s, which
led to recognition of the priority that should be given to development of a healthy bank-
ing system and thus to Zhu Rongji’s dramatic reform program to transform banking into
a modern system.
Having related how the transformation took place, Chapters 5 and 6 describe Chinese
banking as it is today. Chapter 5, “Bankers,” discusses how Chinese banks are managed
and governed, the quality of human resources, and the role of the Communist Party
in banks. Chapter 6, “Systems,” is a more technical chapter discussing the credit qual-
ity and risk management, internal controls and auditing, IT capabilities, strategies and
nature of competition of Chinese banks. These two chapters are heavily based on my own
understanding of how Chinese banks work arising out of my service on the boards of
two banks, corroborated by a large number of Chinese and foreigners with sound knowl-
edge of Chinese banking from various different perspectives. What I have written in these
chapters has been confirmed by other foreigners and Chinese with firsthand knowledge
of Chinese banks.
Chapter 7, “Power of the State,” describes how the state exercises control over the bank-
ing system indirectly through its coordination of the resources of the “national balance
sheet” and directly through ownership of banks and through the financial regulatory
authorities.
The achievements of the government in expanding financial access broadly through
society and the economy are contrasted with the underdevelopment of “direct finance”—
the bond and equity markets—in Chapter 8, “Financial Structure, Deep but Narrow.”
Chapter 9, “Coming In and Going Out,” describes the restricted but nonetheless impor-
tant role that foreign banks play in the Chinese system, and the challenges that Chinese
banks are facing as they expand overseas.
Preface xiii
Is China’s present banking system, as described in this book, entirely a creature of the
present communist regime, or has it arisen out of Chinese ways of organizing the political
economy that predate communist control of the country? Is the way in which banks oper-
ate within the broader political economy unique to China, or does the Chinese experi-
ence bear similarities with the experience of other countries? These questions are explored
in Chapter 10, “China’s Banks, Sui Generis?,” through a retrospective of Chinese banking
from late imperial times up to the end of the Republican era in 1949, and through looking
at two of the other Asian developmental states, Japan and South Korea.
The arguments of those who believe China’s banking system remains fragile and head-
ing for crisis are examined in Chapter 11, “Collapsing or Adapting?,” followed by a sketch
of the principal challenges facing Chinese banks—particularly asset quality issues and
the threat from nonbank digitally based competition. The likely course of future banking
reform is the subject of Chapter 12, “Reform Directions.”
The concluding chapter discusses the challenges China’s banks face as the economy
transitions into a lower-growth, less investment-and export-dependent economy—the
New Normal. The success of the banking transformation in terms of providing the coun-
try with a banking system that provides broad financial access, allocates capital efficiently,
and is a sustainable and stable system is evaluated.
China’s Banking Transformation takes a generally positive view of what has happened
in Chinese banking. Some have protested to me that I am ignoring the costs that China
has paid in terms of environmental degradation, cultural heritage loss, increased inequal-
ity, etc. There is broad agreement among Chinese and foreigners that these are immense
problems, but this book is not about those issues. If I were to write a book on those
subjects, it would not be a positive story. This book, however, is about banking, which is
a positive story.
Others have warned me that the speed of change occurring in China will make any-
thing I write about banking out of date soon after the book is published. There is some
truth in that, and no doubt some things in this book will soon be dated. This book,
however, is not primarily concerned with the issues faced by banks in 2016 as the book
goes to press, but rather seeks to explain the longer-term role that Chinese banks play
in the political economy, to explain how Chinese banks work in ways both similar to
and different from Western counterparts, and to demonstrate how the nature of Chinese
banking arises out of China’s culture and is conditioned by its history. I do not expect
that any of these will soon change in China.
This book is based on my accumulated experience and observations over the thirteen
years that I have served on the boards of two Chinese banks. To my colleagues on the
boards and in the management of the two banks, I owe an immeasurable debt. Through
the years they have shared with me their hopes and ideas, frustrations and worries, suc-
cesses and failures, permitting me to become a “member of the team.” As the only for-
eigner in both banks, I have felt honored and privileged. My position on the boards of
these banks has provided me with access that has been available to only a handful of other
xiv Preface
foreigners. I hope that the years of experience I have accumulated over a lifetime of bank-
ing and which I have shared with my Chinese colleagues has contributed in some way to
the development of these banks.
Despite my privileged access, my personal experience of Chinese banking was lim-
ited to what I learned from my work on the boards of two banks and, despite my
best efforts, was invariably colored by my American cognitive framework. I expanded
my understanding and checked the validity of my book’s themes through conducting
interviews with approximately 150 people, mostly Chinese, but also foreigners, and in
a few cases interviewed the same person more than once. People interviewed included
banking practitioners, government officials, journalists, academics, economists in
multilateral organizations, and businessmen. Interviews were conducted in Chinese
and English languages, depending on the preference of my interlocutor. The people
interviewed were all knowledgeable and extremely generous in sharing their views and
experience with me. They asked only that I be objective in what I write in this book,
pointing out both the strengths and weaknesses of the Chinese system. Those who
spent time with me in interviews were too numerous to acknowledge individually
here, but I want to express my deep appreciation to all of them for the time they took
out of busy schedules to share their knowledge and insights with me. Without their
assistance this book could not have been written.
I would like to acknowledge my debt to two people in particular. First is Hugh Peyman,
who accompanied me on most of my interviews. Hugh has shared with me his great
understanding of China’s contemporary economy. His critical challenges to my assump-
tions and beliefs sharpened my own thinking. Michael Yang provided invaluable research
support, and Michael went beyond research to also caution me when I was misunder-
standing some aspect of Chinese culture or society.
I have also benefited greatly from first learning about Chinese history, language, and
culture in America and Hong Kong fifty years ago, studying under great teachers who con-
veyed not only their knowledge of China but also their passion for the country, its people,
its language and its culture—Frederick Mote, Ch’en Ta-Tuan, Joseph Levenson, Frederick
Wakeman, James Cahill, Edward Shafer, Liu Ming, and Liu Yamei, among others.
In writing in this book of my experience working within Chinese banks, I have been
mindful not to disclose confidential bank and government material to which I had access.
I would like to thank Michael Aldrich, Robert Binyon, Darrell Duffie, Michael Ipson,
Frank Rokers, Andy Rothman, Danny Unger, and Wei Anning for taking the time to
read a draft of my manuscript in its entirety and provide me with most helpful sugges-
tions, criticisms, and corrections. Several others also read and commented on sections of
the text in which they had expertise: Joern Helms, Dennis McNamara, Keith Pogson, Ed
Wu, Xiao Bing, Xu Jun, and Arthur Zou. Their feedback has greatly improved the final
product. I am also grateful to David Shambaugh for the encouragement and guidance he
gave me. Ultimately, though, I am solely responsible for everything in this book.
Abbreviations
xv
xvi Abbreviations
P2P People to people
PBOC People’s Bank of China
PSB Postal Savings Bank
SME Small and Medium Enterprises
TARP Troubled Asset Recover Program
WMP Wealth Management Products
WTO World Trade Organization
China’s Banking Transformation
Some people think of the financial markets as a kind of glorified casino, with no relevance to
the real economy—where the jobs, factories and shops are. But that’s wrong. Finance is more
like the circulatory system of the economic body. And if the blood stops flowing … well, you
don’t want to think about it.
Alan Blinder, 20131
We should make good use of the roles of both the market, the “invisible” hand, and the
government, the “visible” hand.
Xi Jinping, 20143
1
Alan S. Blinder, After the Music Stopped: The Financial Crisis, the Response, and the Work Ahead (New York: The
Penguin Press, 2013), 5–6.
2
Xie Pingru, ed. Xiaoping Said: Build Socialism with Chinese Characteristics (Guangzhou: Guangzhou Higher
Education Press, 2014), 62.
3
Xi Jinping, The Governance of China (Beijing: Foreign Languages Press, 2014), 128.
4
Charles W. Calomiris and Stephen H. Haber, Fragile by Design: The Political Origins of Banking Crises and
Scarce Credit (Princeton, NJ: Princeton University Press, 2014), 9, 23–24.
1
2 China’s Banking Transformation
Everyone knows that the economic rise of China over the past four decades is unprec-
edented in world history. Yet in the 1990s, just as this economic rise was accelerating
and China was poised to become an economic player on the world stage, China’s banks
were mired in bad debt, technically bankrupt, and backward in management and opera-
tions. They were not actually commercial banks in the real sense of the word, since they
operated as vestiges of the old planned economy model that China was rapidly leav-
ing behind. As China dismantled its centrally planned economy and replaced it with a
hybrid capitalist economy increasingly driven by market forces, it studied the workings of
Western capitalist economies. It recognized that a system to effectively provide financial
intermediation to channel the flow of funds from savings into investment was essential
to the workings of a modern market economy. China could not achieve its economic
growth objectives if its banking system remained dysfunctional.
Replacing banks of the old planned economy with banks that function well in a more
market-based economy—in other words, creation of a modern banking system—became
a priority national strategic objective. Achievement of that objective in little more than
a decade is one of China’s major achievements. Today, the largest Chinese banks are real
commercial banks, playing an important role in the nation’s economic development.
China’s modernized commercial banks are hybrid creatures—in part resembling Western
counterparts, in part shaped by China’s political economy framework and by its own
cultural heritage. They conform to global best practice in structure, management, and
operations. As in Western banking systems, Chinese banks measure efficiency primarily
by their creation of shareholder value, as reflected in return on equity (ROE). The pub-
lished average ROE of the listed Chinese banks over the past few years has been consis-
tently above 15%. In this focus on bottom line profitability, and in the payment of a share
of profits to shareholders in the form of dividends, Chinese banks are no different from
banks in the market capitalist U.S. and U.K. economies.
This market capitalist banking model is, however, only half the story of Chinese
banks. The market capitalist model has been modified to accord with Chinese cultural
norms, and it has been adapted to fit China’s political economy, which is directed by the
Communist Party. The rationale for banking in China and the role that banks play in
China’s political economy differs from what animates banking in the Anglo-American
economy and to a lesser degree from most European banking systems. The rationale for
Chinese banks is utilitarian—to be effective instruments for the state in fostering eco-
nomic development, to serve the real economy. Chinese banks have a dual role to play,
giving rise to what I term the hybrid nature of Chinese banks.
This hybrid nature follows the thinking of Deng Xiaoping and Xi Jinping in the
quotes at the head of this chapter, in which they spoke of combining the market and the
China’s Hybrid Banks 3
government in the economy, resulting in market socialism (as opposed to market capi-
talism). Political scientist Sujian Guo explains that if pure laissez faire market capitalist
economies lie at one end of the spectrum and pure planned economies at the other end,
then in between lie “mixed economies,” of which “market socialism” is an apt description
of the Chinese mixed economy toward which Deng Xiaoping pointed the way when
he launched Reform and Opening in 1978. Guo defines “market socialism as a type of
economic system that combines the socialist principle of public ownership with the prin-
ciple of the market economy, with predominant public ownership in those areas deemed
critical to the implementation of socialist principles and social policy.”5 Commercial
banking, of course, is one of those “critical” areas.
This hybrid role both arises out of the historical legacy of the communist planned econ-
omy and is embedded in traditional Chinese thinking about the proper role of the state
in the economy. Chinese banks have enthusiastically adopted and incorporated into their
operations international standards of shareholder ownership and governance; systems of
risk management, accounting, and internal control; listing on securities exchanges; and
focus on value added to shareholders—all designed to promote the efficient manage-
ment of the banks and to protect the banks from a repeat of the failures of the 1990s.
Chinese bank regulatory authorities have put in place a strict supervision system mod-
eled on global best practice. This capitalist packaging should not, however, obscure the
reality that Chinese banks are managed not only to create shareholder value but also to
play a vital role in promoting Chinese economic development. They must make money
for shareholders and contribute to national economic development goals, as defined by
the Communist Party. This is the essence of banking in China’s market socialism and
is the fundamental difference between banks of market socialism and Anglo-American
market capitalism.
In Chapter 10 I compare the Chinese banking system and the banking systems of
nations that practice a form of capitalism, such as Germany, Sweden, Japan, and the
Netherlands, whose capitalism is termed “cooperative capitalism” in the social science
literature. In those nations, single-minded focus on shareholder value is lessened, as
shareholders must cooperate with other stakeholders, including labor, the general public,
and the state, thereby situating those systems somewhere between market capitalism and
socialist capitalism.
Market socialist hybrid banking as it exists today is the result of the past two decades
of financial reform that have brought about a “night and day” transformation in the qual-
ity of China’s banks. Although there are valid criticisms that China’s banks still do not
efficiently allocate capital, nonetheless it is unlikely that China’s spectacular economic
growth over the period of financial transformation could have occurred if Chinese banks
5
Sujian Guo, Chinese Politics and Governance: Power, Ideology, and Organization (London: Routledge, 2013),
252–253.
4 China’s Banking Transformation
had not played a generally positive role. From shareholders’ perspective, while Western
banks have been battered by a combination of bad debt and scandals since 2007, Chinese
banks have thrived, growing rapidly in size, profitability, and adequacy of capital and pro-
visions. They have also been responsive to national economic policy directions, thereby
playing the role that the government expects of them in supporting the real economy and
national infrastructure development.
The timing of China’s bank transformation was fortuitous. Bankers know that “It is
easy to lend money in the good times; good bankers are the ones who get repaid in the
bad times.” China’s economy was booming. Furthermore, to ensure that banks restored
profitability and stability after the debacle of the 1990s, China effectively protected and
subsidized banks through interest rate repression (government policy keeping interest
rates at below market rates, penalizing savers and consumers, and subsidizing borrowers
and investors), through implicit guarantees of state-owned enterprise (SOE) debt, and
through intervention to prevent troubled industries from defaulting on their bank debt.
China’s banks transformed in a short period of years that coincided with the highest
sustained economic growth rates of any major economy in world history, and bank assets
grew at very high rates by lending into what was a low-risk economic environment. The
timing could not have been better, for both the financial sector and the real economy.
The real economy could not have taken off so rapidly without a functioning banking
system, and the banking system could not have performed so robustly in the absence of
a booming economy.
China is now commencing a wrenching transition to what is called the New Normal,
which involves structural rebalancing and a deceleration of growth. New growth targets
of around 6.5% are still high compared with performance of the rest of the world, but
the deceleration from successive years of growth at the rate of 10% and higher, and the
accompanying structural rebalancing of the economy, are shocks to the economy, which
inevitably will entail considerable adjustment on the part of businesses and perhaps a
certain amount of Schumpeterian destruction. Some industries, no longer competitive,
will decline, to be replaced by newly emerging industries. Some firms will no longer be
profitable and will either go under or reinvent themselves in new, more competitive
guise. Moreover, the government, the banks, and business enterprises of China have over
the past two decades of hyper growth learned to manage under boom conditions. They
lack the experience of managing in an environment of decelerating economic growth.
Nonetheless, notwithstanding the complex challenges, if the competence of China’s
management of the economy over the past few years is any guide, it is likely that the
government will be able to guide the economic transition in ways that mitigate problems
while opening new avenues for renewed vigorous economic growth.
How banks fare in this less benign economic environment will tell the tale of how
robust the bank management systems put in place over the past two decades really are
and how well the banks have calibrated the risk/reward trade-off on their loan portfolios.
Only in the bad times is the quality of banks truly put to the test. Furthermore, many
China’s Hybrid Banks 5
of the supports and protections previously provided by the government to the banks as
they developed their management capabilities are now being bit by bit withdrawn. The
hybrid nature of China’s banks, with strong state ownership and guidance, will to a cer-
tain extent shield banks from the full brunt of the transition. Over the next few years, not
only will the quality of banks be tested by adverse economic winds, but also the reforms
of the financial system will be ongoing. As China’s venerable economic thinker Li Yining
recently wrote, referring to the economy as a whole, and reflecting the pragmatic flexibil-
ity of China’s mainstream economists:
As China’s economy grows and changes, new challenges will appear, and in response
new development objectives will rise to the top of the agenda: greater efficiency of
capital allocation, reduction of income and wealth inequality, cleaning up the natural
environment, urbanization, and a host of other reform items. In each of these areas,
banks will be expected to play a role. China’s modernization and the strengthening of
its banking system is a major achievement, but the development of bank capabilities
and evolution of the financial system, of which banks are a part, is an ongoing story.
Li Yining said that in the economy “structural adjustment will continue,” so in the
banking system evolution will be ongoing to meet new situations and new challenges.
A few key aspects of the likely path of evolution can be discerned now with reasonable
certainty: ongoing interest rate deregulation; “debanking”—reducing dependence of
the economy on indirect finance through banks, increasing the funding role of direct
finance through equity and bond markets; cautiously affording a greater role to the
private sector in bank ownership; the rise of non-bank “fintechs” such as Alibaba to
contest the banks for financial transaction settlement; and greater international expo-
sure of banks.
Other aspects of the system’s evolutionary path are less certain. For example, pos-
sible privatization or reduction of government shareholding in existing major state
commercial banks; fostering the development of universal banking (banks offering
financial services such as insurance and brokerage products); giving banks greater
scope for developing derivatives business; providing a larger role for foreign banks;
6
Li Yining, Chinese Economy in Dual Transition (Hong Kong: Zhonghua Book Company, 2014), 8.
6 China’s Banking Transformation
and the ultimate disposition of the non-bank financial institutions comprising today’s
“shadow banking system.” However the system evolves, one can be certain that, barring
major change in the political institutions of China, the government will retain more
control over the financial system than in the United States and most European nations.
China’s banking is unlikely over the next few years to evolve from the hybrid model
of market socialism into a market capitalist form of banking. Xi Jinping has made it
clear that even though the “invisible” hand of market forces have now been officially
declared by the government to be “decisive,” the “visible” hand of government guidance
will not be withdrawn.
As long as the national reform process maintains the dynamism of the past two
decades, there are grounds for optimism about the ability of the banking system to
make the necessary adjustments needed to cope with new stages of economic growth
and development. Given the importance that the Chinese government accords to the
financial sector, there is every reason to believe that the evolution, of which economist
Li Yining writes, will be ongoing. Nonetheless, the difficulties the banking system will
face in adapting to a rapidly changing economic environment, both domestically and
internationally, and the challenges posed to banks by accelerating digital technology
advances are formidable.
The extent of the banking transformation can only be fully appreciated if one recalls what
Chinese banking was like from the 1950s through the 1980s. Under Mao Zedong’s leader-
ship (1949–1976), China had no need for banks. Almost all economic activity was owned,
directed, and funded by the state. Within two years of the establishment of the People’s
Republic of China (PRC) in 1949, all the existing banks remaining from the Republican
era had been wound up, leaving only one financial institution in China—the People’s
Bank of China (PBOC), which served for the next three decades as the bursar for gov-
ernment allocation of funds throughout the country. The PBOC was an accounting and
cashier unit that provided the funding needed to carry out the central economic plan.
Bank of China continued to exist in the form of overseas branches to handle China’s for-
eign trade and foreign exchange requirements in jurisdictions that recognized the PRC
government, such as the United Kingdom, Hong Kong, and Singapore, but had no inde-
pendent domestic existence.
In 1978 Deng Xiaoping launched “Reform and Opening”—reform of a Soviet-style
planned economy that had failed China as a development model and opening to the
West in search of capital, technology, ideas, and institutions needed to break out of pov-
erty. Deng was a supreme pragmatist, not wedded to any particular ideology, committed
only to using whatever policies and programs would provide China with the economic
stability and energy to regain national “wealth and power.”
China’s Hybrid Banks 7
At the start of Reform and Opening, China did not know how to build a financial
system or how to run banks, so it proceeded cautiously, listening to the advice of main-
stream Western economic advisors such as the World Bank, the International Monetary
Fund (IMF), foreign consulting firms such as Boston Consulting and A. T. Kearney, for-
eign commercial banks setting up training programs in China, and international audit
firms such as KPMG and Price Waterhouse, to name just a few. Chinese went on study
missions to learn how banking systems in other countries worked. Thousands of young
Chinese brought back with them new ideas acquired studying in universities in America,
Europe, Japan, and elsewhere. As with other aspects of its national development over
the past three decades, so also in the financial arena, much of China’s success can be
attributed to the diligence, enthusiasm, and openness with which Chinese have studied
global best practice and then applied what they had learned to building a new and stable
Chinese banking system.
Step by step, the Mao-era monobanking system was broken up. Out of the PBOC
and the Ministry of Finance were created four nationwide state banks: the Bank of
China (BOC—as mentioned above, it had continued to exist overseas), the China
Construction Bank (CCB), the Agricultural Bank of China (ABC), and the Industrial
and Commercial Bank of China (ICBC). In the 1980s several joint stock banks were set
up, mostly owned by one state entity or another, and a host of credit cooperatives and
credit trusts were licensed. The big banks, however, still more closely resembled cashiers
funding the remains of the planned economy than modern commercial banks. They dis-
bursed money not based on credit analysis or efficient capital allocation, but, based on
government plan, they loaned to state-owned companies, most of which were inefficient
and money-losing. To compound the problem, no proper system of banking regulation
yet existed.
In the mid-1990s, China’s private sector was taking off, but China did not yet have a
modern commercial banking system to support entrepreneurs. State banks loaned only
to state companies. Moreover, banks did not understand how to manage the risks of lend-
ing. The state companies in turn did not understand how to manage their debts. Bad
debts piled up on the books of the banks, estimated to reach as much as 40–50% of bank
assets.
At that time, the extraordinary economic growth of China’s real economy was still
in its early stages. The accomplishments of the twenty years after 1978 were impressive,
but China’s gross domestic product (GDP) in 2000 was still only $1.2 trillion, while the
United States in the same year was a $10 trillion economy.7 China was growing rapidly
but was overall still a poor country.
A combination of the high level of bad debts on bank books, the collapse of some
Chinese financial institutions, and the spectacle of the Asian financial crisis devastating
7
World Data Bank, http://databank.worldbank.org/data/views/reports/tableview.aspx, accessed May 10, 2015.
8 China’s Banking Transformation
the banking systems and economies of Thailand, Korea, and Indonesia in 1997–1998 con-
vinced China’s leaders that its banking system had become a bottleneck that would hold
back growth of the real economy. Thorough reform of the banking system was required.
China’s banks would have to become modern commercial banks.
The question was: What kind of modern commercial banks? Even among
Organisation for Economic Co-operation and Development (OECD countries), which
provided the models of successful financial development that China studied, there were
several models, reflecting the varieties of capitalism that existed in these economies.
The U.S. model was the most powerful and influential at that time, but was structurally
not typical of other OECD countries’ banking systems, due to the high priority given
to shareholder interests in the United States, the light hand of government regulation,
the high degree of independence from government, and the instability of the system
over time. The U.K. system was similar to the U.S. system but was oligopolistic and had
a different regulatory approach. The Japanese “coordinated capitalist system” and the
German “collaborative capitalist system,” which can together be described as “coopera-
tive capitalism,” offered models that saw shareholders as one among multiple stakehold-
ers, emphasizing instead value for multiple stakeholders and according a strong guiding
role to the state.
Creation of a modern banking sector had begun in 1992, when then Deputy Prime
Minister Zhu Rongji took on the additional post of Governor of the PBOC, China’s
central bank. Zhu began to lay the groundwork for banking transformation. The trans-
formation, however, only really picked up speed in 1998, after the twin shocks of the
Asian financial crisis and the collapse of two large Chinese credit trusts and hundreds of
local credit cooperatives provided the impetus for concerted and thorough overhaul of
the sector and made the task urgent. Although Zhu retired from government service in
2003, when the transformation was still in early stages, he is rightly given credit for work-
ing out the strategy that was followed over the next several years.
China studied the different banking models of advanced economies, developed
plans for creation of a modern Chinese banking system incorporating foreign ele-
ments suited to China’s needs, and then proceeded to overhaul its banks, transform-
ing bankrupt bank-cashiers into modern commercial banks. The focus was primarily
on the four giant state banks: ICBC, CCB, BOC, and ABC. If they could be put on
the right track, then the smaller banks would fall into place. Zhu’s transformation
strategy had three elements: first, break the planned economy cultures of the banks
by converting them into corporate entities, to be managed in accordance with sound
corporate governance and banking practice; second, clean up their balance sheets by
stripping bad loans off bank books and housing them in asset management compa-
nies, paying for the exercise with government-backed bonds; and third, recapitalize
the banks and list them on international stock exchanges, forcing them to submit to
market discipline.
China’s Hybrid Banks 9
Listing on international securities exchanges was a brilliant move not only because
it brought in fresh capital, but because it also effectively “outsourced” part of the job of
forcing the bureaucratic state banks to improve efficiency, balance sheet quality, profit-
ability, and corporate governance. To obtain approval for listing, the banks had to sat-
isfy the listing requirements of the Hong Kong securities exchange, which were more
stringent than those of the domestic exchanges. Additionally, foreign shareholders were
demanding new stakeholders, registering their approval or disapproval every trading day
by their purchases and sales of bank shares. Share prices became a preoccupation of bank
boards and managers—a new way of keeping score.
By 2010, in the short space of just over a decade, the transformation, at least for the
top tier banks, was basically complete. Assigning a date to the completion of the trans-
formation into a modern commercial banking system is a subjective exercise. The year
2010, when the last of the four giant state banks, ABC, was listed on the Hong Kong
Securities Exchange, is probably as good a cut-off point to use as any. China’s lead banks
had become profitable, well capitalized, well provisioned, competently managed, and
technologically advanced. The main elements of modern commercial banking had been
put in place in not only the four giant state banks (by then the number had changed to
five, including the Bank of Communications), but also in the twelve joint stock banks.
Some of the more than 100 city banks were beginning to perform credibly as well.
The building blocks of modern banking were in place, including corporate governance,
proper bank accounting, profit oriented management, risk control, internal audit, infor-
mation technology (IT), and acceptable retail branch service standards. Moreover, in
2003, the bank regulatory function had been spun off from the PBOC and lodged in
the newly established China Bank Regulatory Commission (CBRC), headed in its first
decade by the able and visionary Liu Mingkang. By 2010, the CBRC’s capabilities were
maturing; it had established its reputation as a competent, hands-on regulator, acknowl-
edged by foreigners familiar with its work to be on a par in professional capability with
central banks of most major countries. It differed, however, from other top-level central
banks in two ways. First, it was not independent. Second, it exerted vast influence on
the strategy, tactics, and daily operations of Chinese banks to an extent that would be
regarded as intrusive in other banking jurisdictions.8
Since 2010, change has been more evolutionary than transformational. China’s banks
were no longer government cashiers; they had become real commercial banks undertak-
ing financial intermediation. But, as Li Yining stated, there is no end to the adjustment
process. The banking system needs to provide broader access, capital markets need to
develop further to provide financial deepening, and the financial markets need to become
8
Private communication from Frank Rokers, formerly seconded by ING to be Chief Risk Officer at Bank of
Beijing.
10 China’s Banking Transformation
more market driven and less administratively controlled—topics explored in later chap-
ters of this book.
China’s banks today are diverse in size and type. For the purposes of this book, I have
grouped the banks into three tiers. First are the seventeen tier 1 banks, which are distin-
guished by their size and also by the fact that they operate nationwide networks. The
CBRC officially and appropriately classifies the seventeen tier 1 banks as the “major
commercial banks,” subdividing them into the five “large commercial banks” and the
twelve joint stock banks. The tier 1 banks held 59% of total banking system assets at
the end of 2014. Aside from size, the distinguishing feature of the five large commercial
banks is that the state directly owns a majority shareholding in each of them: ICBC,
CCB, BOC, ABC, and Bank of Communications. These are extremely big institutions.
The largest in terms of assets is ICBC, which at the end of 2014 had total assets of $3.31
trillion, making it the largest bank by assets in the world. ICBC had 17,122 branches
nationwide in China and 338 offices overseas in 41 countries on six continents. It had
over 5 million corporate customers and 465 million individual customers.9
Smaller than the five giants, but still tier 1 major commercial banks, are the twelve
joint stock banks, nine of which are majority owned through various mechanisms by the
government, and three of which are owned by private shareholders. Of these seventeen
tier 1 banks, the big five large commercial banks and eight of the twelve joint stock banks
are listed on the Shanghai, Shenzhen, or Hong Kong stock exchanges. Some are listed on
more than one exchange.
Tier 2 banks are the 145 city banks, which are mostly owned by provincial and local
governments and generally are restricted to operating in their base areas. Only three of
these are listed on domestic securities exchanges, and one on the Hong Kong exchange.
Although city banks only comprised 10% of total banking system assets at the end of
2014, some of the city banks rival the tier 1 banks in quality. Others are in need of con-
siderable improvement in governance, management, and operations. They tend to be
more susceptible to influence from local governments than are the national banks, as
local governments are often significant shareholders or can influence the banks through
local power networks.
Tier 3 banks are localized and special purpose institutions that number in the thou-
sands and break down into several different license categories, including rural credit
cooperatives, town and village banks, small loan companies, the state-owned Postal
Savings Bank, and several others. Many in number, their quality varies greatly, but alto-
gether they only account for 19% of total banking system assets. Their significance lies in
9
ICBC 2014 Annual Report, Chinese version, 23–24, 149, and 152.
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delivery, takes her child, and going down to the nearest stream,
washes herself and it, and returns to the usual labor of her station.”
“The wonderful facility with which the Indian women bring forth
their children,” say Lewis and Clark in their well known journal,
“seems rather some benevolent gift of nature, in exempting them
from pains which their savage state would render doubly grievous,
than any result of habit. One of the women who had been leading two
of our pack horses, halted at a rivulet about a mile behind, and sent
on the two horses by a female friend. On enquiring of one of the
Indian men the cause of her detention, he answered, with great
appearance of unconcern, that she had just stopped to lie in, and
would soon overtake us. In fact, we were astonished to see her in
about an hour’s time come on with her new-born infant, and pass us
on her way to the camp, apparently in perfect health.”
Washington Irving, in his work entitled Astoria, relates a similar
incident in the following language: “The squaw of Pierre Dorion
(who, with her husband, was attached to a party travelling over the
Rocky Mountains in winter-time, the ground being covered with
several feet of snow) was suddenly taken in labor, and enriched her
husband with another child. As the fortitude and good conduct of the
woman had gained for her the good will of the party, her situation
caused concern and perplexity. Pierre, however, treated the matter as
an occurrence that could soon be arranged, and need cause no delay.
He remained by his wife in the camp, with his other children and his
horse, and promised soon to rejoin the main body on their march. In
the course of the following morning the Dorion family made its
appearance. Pierre came trudging in advance, followed by his valued,
though skeleton steed, on which was mounted his squaw with the
new-born infant in her arms, and her boy of two years old wrapped
in a blanket, and slung on her side. The mother looked as
unconcerned as if nothing had happened to her; so easy is nature in
her operations in the wilderness, when free from the enfeebling
refinements of luxury and the tampering appliances of art.”
When it has been ascertained that the labor is natural, or that
there are no impediments or obstacles, there will be very little more
to do than superintend the process. It will be necessary to give
instructions to the attendants to make suitable preparation, or have
everything required in readiness.
The woman may be delivered upon a bed or a cot, as is most
convenient; if a bed be used, all but the mattress should be turned
back toward the head, and it should be so prepared that the moisture
from the uterus and other discharges may not add to the discomfort
of the woman. A dressed skin, oilcloth, or folded blanket may be
placed on that part of the mattress on which the body of the woman
is to rest; a coarse blanket folded within a sheet, ought to be laid
immediately beneath the patient, to absorb the moisture, which must
be removed after delivery; the rest of the bed-clothes are to be put on
in the ordinary way. The woman, when she is no longer able to
remain up may lie down, with her head elevated in any position
which is most desirable; and in nearly every case that I have ever
attended the back has been preferred, although most all writers
recommend that the woman be placed upon her side: the latter
practice is unnatural and wrong, for obvious reasons; it retards the
labor pains, and prevents the midwife from superintending the
progress of the labor; the pillow that is directed to be placed between
the knees, to keep them widely separated, soon gets displaced by the
motion or change of the female; and the legs, instead of being kept
apart, again come in contact, and thus the passage of the child is
obstructed: but when the female is placed upon her back this
difficulty is obviated, a free passage is permitted, the pains are more
effectual, the spine is better supported, and better access can be had
to the parts during labor and after the delivery of the child; in short,
there is a decided advantage in this position in every respect.
The dress of women in labor should be light and simple, both to
keep themselves from being overheated, and to prevent anything
from being in the way of what assistance is necessary. In addition to
the means recommended, I direct a sheet to be placed around the
waist of the woman, to prevent the blood, excrements or waters from
coming in contact with the linen or clothes, and, as much as possible,
the bed; her linen may be tucked or pushed up so far that there will
be no necessity of a removal after delivery.
Every thing being thus adjusted, very little more will be necessary
but to wait patiently the efforts and operations of nature. There
should be but few attendants in the room, and these are not to
whisper to each other, or to express any fears or doubts.
A humane midwife will use every ingenious effort in her power to
quiet the useless fears, and support and comfort the patient. A crowd
of frightened, hysterical women, assailing the ears of the woman with
tales of woe and sad disasters that have happened should be
admonished. Half a dozen midwives, each making pretensions to
great skill, ambition, and competition for obstetric fame, assembled
around a feeble woman when labor is of a lingering character, is
always an unfortunate circumstance, and it would be much better if
nearly every one were afar off.
When the pains become very severe, quickly succeeding each
other, the midwife, or the person who officiates, may sit by the side
of the woman, and, upon every severe pain, may keep her hand upon
the parts, even though no manner of assistance can be afforded, and
occasionally, when the head of the child presses hard, it may be
gently touched or pressed with the longest finger, in order to
ascertain the parts that prevent the progress of labor, as well as to be
able to give from time to time suitable encouragement: not only so;
in the last stage of labor the hand may be kept near the parts, to
know the moment when the head of the child presents, as some little
assistance at this time is called for; but not by supporting the
perinæum, as some advise, but,
First. To remove any obstruction which often arises from the
clothes.
Second. To support the child in its passage, and in the interval of
pains; and to keep the head from pitching downward, and thus
obstructing the labor.
Third. To detach the umbilical cord or navel-string from the neck
when it encircles it, as is often the case, and which endangers the life
of the child.
Fourth. To deliver the woman in case of hemorrhage or great
flooding; but at the same time there must be no further interference
of art; little or nothing can be done toward facilitating the delivery of
the child, except when a large bag or collection of water presents and
opposes, when it may be ruptured with the longest finger, which
often affords much aid, although such is the ignorance and credulity
of some women, that they suppose almost everything to be
accomplished by art. Physicians or midwives who watch only the
process of labor, and do little or nothing, are pronounced inhuman
and cruel, and perhaps ignorant, because they are honest in not
interfering with the simple and beautiful process of labor, or in other
words, for relying upon the great resources of nature: but such is the
fashion and credulity of mankind, or rather womankind, that
physicians are obliged to take the advantage of such ignorance and
credulity, and regulate their proceedings accordingly. We have often
been obliged to stand for hours over a woman, under pretence of
aiding delivery, when, in reality, we did nothing at all. The labor
would have progressed just as well had we been out of the room; but
this deception we have been obliged to practise, in order to satisfy
ignorant, gossiping, or crying attendants. When the woman is
disposed to make much noise, she should be directed to hold her
breath during the pains, and aid or assist them by pressing
downward as much as possible. The feet may press against the bed-
post, and the woman take hold of a handkerchief and pull when a
pain occurs; or she may grasp the hand of an assistant for that
purpose. Sometimes, from various causes, labor is very much
retarded, from rigidity of the parts, the situation of the child,
debility, &c.; when this occurs, and labor is tedious and protracted,
our reliance must still be upon the powers of nature. We may,
however, aid her efforts, by warm fomentations of bitter herbs, often
applied to the lower part of the belly, which will prove relaxing, and
will facilitate the labor; warm diluent drinks may also be given, such
as tansy, pennyroyal, &c.
If the labor still continues stationary, we have nothing to fear,
provided there is a right presentation; but should the pains become
feeble or lessened from flooding, debility, or any cause, or should
they prove unavailable, after a reasonable length of time, a drachm of
spurred rye or ergot may be put into a tea-cup, and a gill of boiling
water poured upon it, and, when cool, a tablespoonful given every
fifteen minutes. This will increase the pains, and speedily accomplish
a delivery; but it should be very seldom, or never, used, except when
there is a right presentation, and under the most urgent
circumstances.
It is prudent, by judicious precaution and care, to remove
obstructions, prevent accidents by holding or supporting the child in
a proper position, and giving such aid as reason and judgment will
dictate. Receiving the child, preventing its fall, securing the navel
cord, assisting in the removal and disposal of the after-birth, are
objects which are to be accomplished, and all in the most calm and
simple manner; no hurry or excitement is necessary, but, on the
contrary, they embarrass. Yet how common is it that females in
general, married and unmarried, are so uninformed and ignorant,
that, instead of attending to those duties, if necessary, or in cases of
emergency, they are thrown into the greatest consternation, and
perhaps run out of the room and let the child suffocate by the bed-
clothes, or by the navel cord twisted about the neck, and die merely
for the want of a little common sense and knowledge, which might be
acquired in an hour. Is it not highly disgraceful, if not criminal, that
farmers can, and do, attend to those duties toward their stock, and
yet remain entirely ignorant of them toward their nearest relations?
Young women and men are taught music, dancing, drawing, needle-
work, and many ornamental branches considered so essential to a
polite education; yet they are suffered to remain entirely ignorant on
a subject of so much vital importance. Is there any hope or prospect
of enlightening this generation, or must it be delayed till the next,
and have them look back with amazement at our ignorance? We
hope there is something yet redeeming in a large proportion of the
community; that the people will yet awake to their own interests.
When the head is delivered, all that is necessary to do is, to
support it, and wait for the pains to expel the child; except it seems
livid and in danger of injury, or when the cord is twisted around the
neck, when assistance must be rendered, to accomplish the delivery.
The face of the child must now be turned upward, and the cord freed
from the neck or body; the person who assists will pass a narrow
piece of tape around the cord or navel-string, about an inch from the
body, and tie as tight as it can be drawn, otherwise hemorrhage or
bleeding will take place; and another must be tied at a little distance
from it, above, and be separated between them with a pair of
scissors. The child is then to be given to the nurse, to be washed,
dried, and dressed. The woman must now be covered, and directed
to lie quiet.
The After-birth.—The after-birth or placenta must be detached or
removed, if nature does not accomplish it in a short time. Generally,
after about twenty or thirty minutes, a pain is felt, which may be
sufficient to expel it; if it should not, and should there be no pain,
gentle manual attempts may be made to remove it.
The head and breast may be elevated, and the cord taken hold of
by the left hand: the two first fingers may be carefully introduced
into the vagina, and the anterior or forepart of the placenta or after-
birth held in this situation for some minutes, in order to excite a
contraction of the uterus. The woman may now be directed to hold
her breath and press down, which forces it forward; and at the same
time a little extension may be made upon the cord with the left hand,
while extension is made upon the after-birth with the right; this will
almost invariably extract it in a few minutes. If from any cause it
should not, no farther attempts must be made for the present, but
left for a few hours, when, if the natural contractions of the uterus do
not remove it, it must be done in the manner recommended, with
this difference, that a little more force be used. In the interval,
however, everything wet must be taken away.
Subsequent Treatment.—After the labour has been thus
completed, if the woman is not too weak, assistants may raise her up,
and seat her upon the side of the bed or cot, while another removes
all the wet clothing from the patient and her bed, and with a little
warm spirits washes off the blood, water, &c., that remain on her
person. This is particularly necessary, as the omission of it may give
rise to puerperal fever. We know not that others have practised this
method; but we have found it conducive to the comfort as well as the
health of the patient. Some practitioners will not suffer the woman to
be removed from the situation in which she has been delivered under
twelve or twenty-four hours, for fear of hemorrhage or flooding; but
this is a great and dangerous error. It is impossible to tell what
mischief may arise in consequence of suffering her to remain
drenched in water and blood for this length of time.
After these precautions have been observed, and the bed properly
prepared, on which has been placed folded blankets, skin, or oilcloth,
covered with a warm sheet, she may be laid down, and a diaper or
suitable piece of muslin laid to the parts to absorb the lochial
discharges. A bandage may be also placed around the abdomen or
belly, and made moderately tight, but not so as to render her
uncomfortable. A large tub, previously well dried, may be placed by
the side of the bed, and the woman directed to place her feet in it,
and, when she is lifted up, everything that is around her wet to be
passed into it. It prevents the necessity of afterward washing the
floor and carpet, which might prove injurious by causing a check to
perspiration.
Preternatural labor, or cross-births, are those in which some
other part than the head presents. We cannot in general assign any
reason for such occurrences, nor can the woman, by any sensation of
her own, be assured that the presentation is unusual. Apprehensions
of this kind should not be indulged in. If the feet or breech present,
the delivery is to be accomplished by properly accommodating the
position of the child to the capacity of the pelvis, but no force should
be employed; and though there is always some risk to the life of the
infant, yet there is none to the mother. If the arm, shoulder, or sides
of the child present, the delivery is not impossible, but difficult, until
the infant be turned and the feet, brought down into the passage.
This is an operation which may be done with comparative ease and
safety, if the wrong position of the infant be discovered before the
waters are discharged; but other wise both mother and child are in
considerable danger, though there is often a spontaneous evolution,
and delivery is effected. The womb closely contracting round the
body of the infant when the water is drained away, and being soft
and spongy in its texture, it is liable to be torn if much force be
employed, and then either the child may escape into the cavity of the
belly, or, if it be extracted by the feet, blood may be effused from the
womb into that cavity, and such injury be done as to prove fatal.
Women too frequently add to the danger of the operation of turning,
by their restlessness and impatience; they should remember how
much is at stake, and exert all their fortitude, so as not to embarrass
the practitioner.
The labor having been thus accomplished, it will be necessary to
guard against any subsequent symptoms which may occur or take
place.
In tedious and very difficult labors, and where common physicians
use the lancet, the hot bath will be found of extraordinary benefit in
facilitating labor, by its relaxing the system without debility;
altogether better than bleeding. First apply spirits, water, and salt to
the head; then let the woman continue in the bath about fifteen
minutes.
Still-born Infants.—This occurs from difficult labors, or the cord
encircling the neck; or a membrane may cover the head or body.
When anything of the kind occurs, the membrane should be
immediately removed. If no signs of life appear, the infant may be
put into the warm bath, and the mouth and body wiped dry. A little
cold water may be dashed into the face, the lungs inflated by some
person, and a slight motion made upon the chest in imitation of
breathing. The navel-string may be permitted to bleed a little.
TREATMENT AFTER DELIVERY.
A child must not be put to the breast, if the mother’s health is very
poor, or if she has any venereal, scrofulous, consumptive taint, or
herpetic disease, St. Anthony’s fire, &c. We have conversed with
females who are subject to the last complaint, and who have
communicated it to their children, which destroyed them all. The
poison is transmitted from the mother to the child. In any of these
cases, the infant must be reared on the nursing bottle. It is best to
use cream instead of milk; the child thrives well upon it, less quantity
answers, and it does not curdle, like milk, upon the stomach.
Atrophy from Suckling.—Some women of a delicate constitution
cannot suckle long without an evident appearance of declining
health; and, if persisted in, it might terminate in a general wasting of
the body and loss of strength, or some morbid affection of the lungs.
When, therefore, a woman finds her health declining, and that she
gets weaker every day with loss of appetite and languor, she ought
immediately to leave off suckling; she should use a generous diet,
with a moderate quantity of wine bitters daily, and, if convenient,
change the air, particularly if an inhabitant of a large and populous
city or town. If the change is not found sufficiently efficacious of
itself, when conjoined with a restorative diet, a course of tonics
should be given. Gentle exercise on horseback or in a carriage will
greatly assist the effect of these remedies.
INFLAMMATION OF THE BREASTS.